Pearl 1 Click here to enlarge imagePearl 1 — Smartprep Instruments from SS White. I can remember the first cavity prep that I did in dental school many years ago. It was an occlusal on a lower left molar (pretty good tooth selection!). It took me all afternoon to do it. When I reached the decayed dentin, I took out a shiny new No. 6 round bur and proceeded to remove the decay. At this point, it occurred to me to wonder, "How do I know when I'm finished?" I've been trying to answer this question ever since. We use round burs, we use spoon excavators, we use dyes, we use magnification, we read and listen to many theories, but still we all wonder — how do I know when I've reached sound dentin?
I think that SS White has an answer for this question in the form of a revolutionary new concept — a cutting instrument that only cuts decayed dentin. For the last eight months, I have been using the Smartprep Instruments in all sorts of clinical situations. This instrument "knows" when it reaches sound dentin. There is no guessing, no dyes, no explorers, and no spoons — the Smartprep simply quits cutting when it reaches sound dentin. Sounds unbelievable, doesn't it? But it works. Two university studies are in progress. However, this bur definitely requires a learning curve. It will probably take five to 10 of these instruments for you to get the "feel" of it. Try using them on extracted teeth. The Smartprep will remove decay in any situation, but initially I would advise starting with Class I and V preparations.
Since this is a revolutionary approach to removing decay and conserving healthy tooth structure, there are some guidelines that you must follow to get the best results. Gain access to the decay using specially chosen carbide burs in the Caries access kit. Both sound enamel and dentin will dull the cutting blades of the Smartprep, so you must be certain that you have complete access to the decay. Now, switch to the Smartprep in your existing slow-speed handpiece (running very slowly at 500 to 800 rpm) to begin removing the decayed dentin. This is probably the hardest thing to do since most of us like to rev up the handpiece and run at full speed. Use the instrument to "peel" away layers of decay from the outside in. When the instrument contacts healthy dentin, it will rapidly dull and stop cutting. In most cases, I was able to complete treatment without using a local anesthetic. Think what this could mean in your busy practice.
Order Smartprep from your dealer or visit SS White's Web site at www.sswhiteburs.com for more information.
Pearl 2 — Stardental Titan® E-lectric motor system from the DentalEZ group. I have been using StarDental handpieces for most of my career. They have always offered innovative designs with great service and have been cost effective for my practice. So I was excited when this company introduced an electric handpiece. As most of you probably know, I am sold on electric handpieces and wouldn't think of cutting a tooth with anything else. An electric handpiece allows me to complete tooth preparations in less time and with less trauma to the tooth and the patient. Since torque is a constant with electric handpieces, I am constantly cutting on teeth with little vibration and almost no noise. Patient response has been extremely positive to the electric handpiece. The other day, I was able to complete a 13-veneer prep case in two hours from start to finish!