{"id":534,"date":"2012-04-22T22:47:41","date_gmt":"2012-04-23T03:47:41","guid":{"rendered":"http:\/\/allisonwatts.com\/blog\/?p=534"},"modified":"2020-12-23T13:58:18","modified_gmt":"2020-12-23T19:58:18","slug":"materials-prep-design","status":"publish","type":"post","link":"https:\/\/allisonwatts.com\/materials-prep-design\/","title":{"rendered":"Materials And Prep Design"},"content":{"rendered":"
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Materials And Prep Design<\/span><\/span><\/span><\/strong><\/div>\n
by Allison Watts, DDS<\/span>
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We have already chosen the type of restoration and prep design we are planning on<\/strong> doing on each tooth based on the esthetic (including patient expectations), occlusal, structural and biological findings—we will be using veneers, crowns, or partial coverage restorations such as inlays or onlays or any combination of the above. <\/span><\/span><\/div>\n
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We have a good idea of the materials we will be using as well based on all the parameters.  If the tooth is dark or significantly off-color from the desired shade, a deeper prep or a more opaque material will be needed. If the tooth is short, we need to increase resistance and retention form in our prep design and our cementation. There are all kinds of little guidelines that alter the way we prep (that I learned mostly from Frank Spear). I can’t name them all here….<\/span><\/span><\/div>\n

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I believe in being as conservative as possible while making sure that we can meet the treatment goals.<\/strong> I will do veneers and partial coverage restorations whenever possible as long as all the goals are met in order to create esthetic, occlusal, structural and biological success.  The lab can be very helpful in making sure that the materials we have chosen will be able to give us everything we are looking for. <\/span><\/span><\/div>\n
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If you want to check the labs ideal depth of prep for particular case, you can take digital photos<\/strong> of the prep color or post or whatever you’re seeing and communicate that to the lab, then alter your prep to fit their recommendations. This almost guarantees exceptional results. I have a friend who regularly (I’ve done it a few times if I have a question or concern) takes an impression of her preps at this appointment and sends it to the lab for direction and case planning. This takes extra time, but she feels it is why her results are so good. <\/span><\/span><\/div>\n
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Once you know the type of restoration, material, and prep design you are using and you have a wax up based on that, select the shade you will make the temps (you may want to take photos if you are matching something) and begin preparing the teeth. If a tooth is too far facial and you will be bringing it into alignment, reduce the tooth to even with the adjacent tooth or until the facial is where you would want it to end up and then prep with the correct reduction from there.   If the tooth is lingual to where it will end up, the reduction can generally be more conservative. <\/span><\/span><\/div>\n
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Don’t just blindly go in and start prepping. You may want to do these slight adjustments then place temp material in the matrix and put it over the teeth like you are making temporaries.<\/strong> Measure to make sure it’s correct and then, prep through the plastic into the teeth only as much as you need to to get the teeth to the final result.<\/span><\/span><\/div>\n
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*In general, unless you are doing gold, the prep guidelines<\/b> are as follows:<\/span><\/span><\/div>\n
2mm incisal \/occlusal reduction<\/span><\/span><\/div>\n
1-1.5 mm shoulder or chamfer for crowns<\/span><\/span><\/div>\n
1-1.5 mm on the facial and lingual<\/span><\/span><\/div>\n
rounded line angles<\/span><\/span><\/div>\n
*for inlays\/onlays: 1.5-2 mm isthmus and 1-1.5 mm gingival floor with butt joint<\/span><\/span><\/div>\n
*for veneers: .3-.8 mm on the facial, 1 mm in the facial incisal 1\/3 (after incisal<\/span><\/span><\/div>\n
reduction), chamfer margin<\/span><\/span><\/div>\n

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Magnification (either loupes or microscope) makes all the difference in the world for prepping<\/strong>. I like using depth-cutting burs and checking with reduction guides for accuracy and consistency.   Once you have them prepped the way you like, I recommend polishing the preps with a white stone and a brownie. Then take shade photos of the prepped tooth, impressions, BR, facebow and make the provisionals in whichever way you prefer.<\/span><\/span><\/div>\n
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Prep design is boring, but so important.   One of the best experiences I had was doing the Spear Anterior Live Patient course. My hygienist of 14 years was my patient and we were doing veneers on tetracycline-stained teeth. I wasn’t sure my lab at the time could make opaque enough veneers without them looking fake — he only did PFG and Authentic restorations (which were pretty translucent). I chose to work with a new lab and we planned the case together. I also emailed him digital photos of the preps during the appointment to show him how dark the tetracycline stain was compared to the shade she wanted. He coached me to prep deeper and wrap through the interproximals (basically a slice prep), which I had never done before. The outcome was excellent and my hygienist was thrilled.<\/span><\/span><\/div>\n
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Another important thing to coach the lab on is that if the preps aren’t correct, you don’t want them make the restorations. Instead have them send the case back with instructions on how to make it right. Patients will appreciate your attention to detail if you explain it in a positive way with benefits to them.<\/span><\/span><\/div>\n

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Hope this helps! Let me know if you have any specific comments or questions or if there’s something you want to hear about.  <\/span><\/span>Comments are appreciated. You can find me on facebook <\/a>or via email<\/a>.<\/strong><\/font><\/span><\/span><\/div>\n

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           <\/div>\n
Prep masterfully,<\/strong><\/span><\/span><\/div>\n
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Materials And Prep Design by Allison Watts, DDS   We have already chosen the type of restoration and prep design we are planning on doing on each tooth based on the esthetic (including patient expectations), occlusal, structural and biological findings—we will be using veneers, crowns, or partial coverage restorations such as inlays or onlays or […]<\/p>\n","protected":false},"author":1,"featured_media":535,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_cloudinary_featured_overwrite":false,"footnotes":""},"categories":[310,22,25,4,24,27],"tags":[12,19,58,140,179,208,207,115,113,63,206,56,210,82,209],"class_list":["post-534","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","category-clinical-excellence","category-communication","category-empowerment","category-leadership","category-patients","tag-allison-watts-dds","tag-builiding-a-profitable-dental-practice","tag-clinical-excellence-2","tag-dental-coaching","tag-dental-consulting","tag-dental-labs","tag-dental-materials-and-prep-design","tag-dental-mentoring","tag-dental-practice-success","tag-full-mouth-reconstruction","tag-full-mouth-reconstruction-series","tag-full-mouth-rehabilitation","tag-partial-coverage-dental-restorations","tag-transformational-practices-com","tag-working-with-dental-venners"],"yoast_head":"\nMaterials And Prep Design - 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