haha - saving bundhs since 2018! Yes, do wash off the glycerine. This is why glycerine is preferred to petroleum jelly/vaseline as Glycerine is water soluble
one point of confusion for me is the bond between your luting cement and the refreshed IDS surface. as far as I understood, you are bonding old composite resin to your luting cement. Do you treat this IDS surface with HF acid? or is applying the the tooth primer sufficient after air abrasion to achieve good bond strength?
good point - i believe there is a difference between a composite placed and 'covered over' for a few weeks, so a composite that is many months old. Composite placed a few weeks ago behaves more like 'new composite' than it does 'old composite' from when I have asked this question to those such as Mahul Patel or David Gerdolle. Also, HF acid etch is not recommended for composite, it is for glass ceramics, from my understanding. Therefore a modern tooth primer is sufficient to reactivate the composite in addition to air abrasion. Some other techniques employed include use of CoJet sand for air abrasion, and then ceramic primer.
I understand the theory behind IDS and the proposed benefits of reduced post operative sensitivity, elimination of undercuts and reduced dentine contamination at cementation rather well however, the increased bond strength that is claimed verses delayed dentine sealing is a bit of an issue for me. Are there actually any high quality randomised control trials that compare long term retention between indirect restorations cemented using IDS and those using traditional delayed dentine sealing? All I have come across thus far are in vitro studies which while useful are not quite the smoking gun one would be looking for when thinking whether such a procedure would be worthwhile doing as often as possible.
Great insight and I totally agree. I talked to Pasquale Venuti about this in a previous episode - there are ZERO randomised controlled trials. A lot of this stuff focuses on PROCCESSES and not on OUTCOMES that matter the most: longevity. The in vitro data is promising enough that I have chosen to implement this to my protocols. I don't think its doing harm and there are the adjunctive benefits you mentioned. Would love a clinical trial!
Can you post a link where to get this small ultrasonic bath on amazon Do I have to use fancy dental alcohol in the bath? Will good Russian vodka do? and how do I heat treat the onlay?
currently unavailable but anything like this (the one I have) amzn.to/3VqAGGQ - you can use the distilled water they use for the autoclave - got gallons of the stuff!
Great job on creating such informative and engaging content! Looking forward to more of your awesome episodes!
Thx for little dental pearls...like the floss/tape coloured with articulating paper.... appreciate it
I know game changer is used too much but....GAME CHANGER!
You saved my bundh. I used to do composite buildup thinking it was ids. Should we rinse using 3/1 after the glycerin lightcure?
haha - saving bundhs since 2018! Yes, do wash off the glycerine. This is why glycerine is preferred to petroleum jelly/vaseline as Glycerine is water soluble
one point of confusion for me is the bond between your luting cement and the refreshed IDS surface. as far as I understood, you are bonding old composite resin to your luting cement. Do you treat this IDS surface with HF acid? or is applying the the tooth primer sufficient after air abrasion to achieve good bond strength?
good point - i believe there is a difference between a composite placed and 'covered over' for a few weeks, so a composite that is many months old. Composite placed a few weeks ago behaves more like 'new composite' than it does 'old composite' from when I have asked this question to those such as Mahul Patel or David Gerdolle. Also, HF acid etch is not recommended for composite, it is for glass ceramics, from my understanding. Therefore a modern tooth primer is sufficient to reactivate the composite in addition to air abrasion. Some other techniques employed include use of CoJet sand for air abrasion, and then ceramic primer.
I understand the theory behind IDS and the proposed benefits of reduced post operative sensitivity, elimination of undercuts and reduced dentine contamination at cementation rather well however, the increased bond strength that is claimed verses delayed dentine sealing is a bit of an issue for me. Are there actually any high quality randomised control trials that compare long term retention between indirect restorations cemented using IDS and those using traditional delayed dentine sealing? All I have come across thus far are in vitro studies which while useful are not quite the smoking gun one would be looking for when thinking whether such a procedure would be worthwhile doing as often as possible.
Great insight and I totally agree. I talked to Pasquale Venuti about this in a previous episode - there are ZERO randomised controlled trials.
A lot of this stuff focuses on PROCCESSES and not on OUTCOMES that matter the most: longevity.
The in vitro data is promising enough that I have chosen to implement this to my protocols. I don't think its doing harm and there are the adjunctive benefits you mentioned. Would love a clinical trial!
Can you post a link where to get this small ultrasonic bath on amazon
Do I have to use fancy dental alcohol in the bath? Will good Russian vodka do?
and how do I heat treat the onlay?
currently unavailable but anything like this (the one I have) amzn.to/3VqAGGQ - you can use the distilled water they use for the autoclave - got gallons of the stuff!