It’s no secret that Dr. Michael DiTolla and I are close friends. We've known each other since I started with Dental Economics in 2015. One of the reasons that I admire Dr. DiTolla so much is that I saw him speak right after I graduated from dental school at the Texas Dental Association annual session—the Texas Meeting—and he highlighted the reverse preparation technique. My dental school taught depth cuts but not at the same level and precision as Dr. DiTolla. For those of you who aren’t familiar with the reverse preparation technique, imagine prepping a nice deep chamfer margin first and then reducing all of the axial excess above that. Traditionally, we are taught the opposite: Reduce the axial walls until you can place a chamfer margin.
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At first blush, I thought the technique was a “cute” idea and mentally filed it away in my brain’s trash can. After struggling with a tough prep one day, the technique bounced back into my mind. I dug up the old bur kit from the course and gave it a shot on my next prep. I have not stopped using the reverse preparation technique since.
The easiest way to try the technique is to get Dr. Mike’s Reverse Prep Bur Kit by DentalCADCAM. Inside this little bur block of awesomeness and professional fulfillment, you will find all of the burs you need. The key burs are the depth-cut burs. The barrel diamonds and the football diamond that are also included are burs that are probably already on your existing block. The three depth-cutters will allow you to prep any tooth in the mouth using this technique.
The round diamond burs are the workhorse of the set. They are what allow you to put a nice chamfer depth-cut at the margins on the buccal and lingual sides of either posterior or anterior teeth. The round shape leaves you with a perfect chamfer every time. There are four different sized round burs. Your choice is based on the material you chose for the crown. The 801.021 is a great choice for glass ceramics. The 801.018 would be a great choice for minimal preparation zirconia, and the smaller two (801.016 and 801.014) would work well for a minimal preparation gold crown.
I would recommend checking out some of the reverse preparation technique videos on YouTube that Dr. DiTolla made during his time at Glidewell Laboratories. The videos demonstrate the technique very well and will give you a good grasp on how to execute the preparation technique. Yes, Mike and I are friends, but I wouldn’t be recommending this kit if I didn’t believe in the technique. I use this technique every day, and it makes my life easier and more predictable.
Editor's note: This article appeared in the May 2022 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
