Yes. Not only would I recommend you do IDS, but also your resin coating layer and you “fail safe zone” with Ribbond fiber. It will take you some time for you to mill your Cerec, during that time your hybrid layer/IDS is “aging”, and that is what improves the bond strength in that layer. This information is represented in the Sema Belli paper. Thanks for watching!
Is it necessary to remove biofilm inside the cavity before we restore the tooth with composite resin or the IDS ? If needed, how can we achieve? Do you recommend we use disclosing agent to make sure the cavity is biofilm-free?
In regards to the 2 Step self etch technique, do you apply the primer on both dentin and enamel and the bonding on both too ? Or do you apply the primer selectively on the dentin then the bonding on both dentin and enamel?
Thank you for this content. The restored tooth fracture resistance study really blew my mind. I see the data and I still can't believe my eyes. Question: how does new resin adhere to previously placed resin if the oxygen inhibition layer has been fully polymerized, polished off etc? What kind of bond is formed there? Also, would like to see more content on provisional onlays. They have to be bonded in order to stay on, but there's a fine line between too much and too little bonding.
This article will answer your questions regarding to bonding to the IDS. Some free radicals are present as well as the micro-mechanical retentive surface we create with micro-etcher. reader.elsevier.com/reader/sd/pii/S0022391305005573?token=2F46EB37F6614FFE145C5F264881F30B1155194AE21343AC2D60F3AF31E960786409A9D8A25A4C9EAE860BB65B6829C6&originRegion=us-east-1&originCreation=20220411200251
Thank you so much for that lecture !! Amazing as always , and incredible work. I just have one question, towards the end of the presentation, when you cemented the indirect restoration on the molar , there was a slight "greyish" line between the ceramic and the tooth it self on the buccal side, I am asking because that has happened to me before, but the greyish line was more prominent, and I'm not sure why that happened? Can you please explain why that happened and how we can avoid it or make it to a minimal? Thank you so much in advance!
Thank you for watching and for your question, what you are seeing in the tradition line between the ceramic and the actual tooth structure. The more different the are (color and opacity) the more noticeable. I select A3 shade for all my posterior ceramic restorations. Hope this helps. Dr. R
is direct composite overlay/onlay a good option for patients who cannot afford indirect or semi direct restorations? what is the expected life span of it i'm asking because most of my patients cannot afford it. Thank you doctor, always to the point with these lectures
Hi Angelica, I think they are a great alternative. If you fabricate them in your office and post cure them, you should get at least 5-7 years of service (this is my personal experience). The idea is always to “save” teeth regardless of the restoring material used. Control every step as best as possible and you should be good. Thanks for following and watching our videos!
Hello Dr R Thank you for sharing. I have a couple of questions if you can help me with 1-Why do you first build the tooth up with composite and then prepare it for onlay rather than just preparing a inlay-onlay from the initial cavity with divergent walls without composite involvement? 2- How do you prepare marginal ridges for onlay when they are not cavitated; should there be boxes? Many thanks
1. I do it for 2 reasons. The first, uniform preparation. The second, sealing the dentin (IDS). 2. No need to remove marginal ridge and prepare a box unless the lesion extends IP. These preparations preserve as much healthy tooth structure as posible. Thanks for watching Dr. R
always appreciate ur lecture, really get benefit from ur webinar. Wanted to ask about the provisional part, is that temporary cement able to use with the provisional resin? will the removal of the temporary cement with bur / ultrasonic scaler causing the removal of part of the IDS layer?
Thank you for your question. You only need a small etched and bonded enamel surface and to apply vaseline on the entire prep (IDS dentin also) to avoid them bonding together. It is very easy to clean with micro-etcher and you won’t damage IDS surface.
@@romerodentalseminars thank you for ur reply, just to clarify so that a dual-cure resin cement can be used to cement a provisional restoration after spot etch and bond followed by Vaseline application on the entire prep?
Nice lecture as usual According to my reading any tension cusps (buccal upper)with less than 2_3mm to be onlay as they will be prone to fracture The study showed that they are more stronger than the intact teeth?? May you clarify for me if iam wrong
This is a clinical decision we have to make and it depends on many other factors like occlusion, position of the tooth, etc. The study that I show only refers to Tue extra “strength” obtained after bonding of a ceramic restoration regardless of the preparation type. One thing is true, try to preserve as much tooth structure as possible is always the best.
very informative. Thank you. do i have to do IDS, when I make indirect restorations chairside at the same day wit Cerec?
Yes. Not only would I recommend you do IDS, but also your resin coating layer and you “fail safe zone” with Ribbond fiber. It will take you some time for you to mill your Cerec, during that time your hybrid layer/IDS is “aging”, and that is what improves the bond strength in that layer. This information is represented in the Sema Belli paper. Thanks for watching!
Is it necessary to remove biofilm inside the cavity before we restore the tooth with composite resin or the IDS ? If needed, how can we achieve? Do you recommend we use disclosing agent to make sure the cavity is biofilm-free?
I use AquaCare with low pressure (2 bar) aluminum oxide (25 micron). Thanks for the question
@@romerodentalseminars thanks doc
Thank you for the lecture! I Learned a lot!
@@aaronreimer1869 thank you for watching!
@@romerodentalseminars 🙌🏼💯
@@romerodentalseminarsno problem! I appreciate it!
Muchas gracias Profe....desde Cuba....It s a pleasure learn from you
In regards to the 2 Step self etch technique, do you apply the primer on both dentin and enamel and the bonding on both too ? Or do you apply the primer selectively on the dentin then the bonding on both dentin and enamel?
I thought the IDS was about applying an adhesive and a low viscosity composite, was I wrong then?
Selectively, but I always use a diamond bur to “clean” the enamel from any adhesive. Remember, we only need to seal the dentin prior to impression.
@@drkevinnsawela7583 it depends on the type of adhesive you are using. Filled or unfilled? If unfilled then you can use a filled flowable composite
Amazing doctor
Amazing explanation 💜
Lots of respect
Thank you for this content. The restored tooth fracture resistance study really blew my mind. I see the data and I still can't believe my eyes. Question: how does new resin adhere to previously placed resin if the oxygen inhibition layer has been fully polymerized, polished off etc? What kind of bond is formed there? Also, would like to see more content on provisional onlays. They have to be bonded in order to stay on, but there's a fine line between too much and too little bonding.
This article will answer your questions regarding to bonding to the IDS. Some free radicals are present as well as the micro-mechanical retentive surface we create with micro-etcher.
reader.elsevier.com/reader/sd/pii/S0022391305005573?token=2F46EB37F6614FFE145C5F264881F30B1155194AE21343AC2D60F3AF31E960786409A9D8A25A4C9EAE860BB65B6829C6&originRegion=us-east-1&originCreation=20220411200251
what do u mean by 2 bottel of selective bonding? plz write down the detail etching time for dentin and enamel and bonding. thank u
Thank you so much for that lecture !! Amazing as always , and incredible work.
I just have one question, towards the end of the presentation, when you cemented the indirect restoration on the molar , there was a slight "greyish" line between the ceramic and the tooth it self on the buccal side, I am asking because that has happened to me before, but the greyish line was more prominent, and I'm not sure why that happened? Can you please explain why that happened and how we can avoid it or make it to a minimal?
Thank you so much in advance!
Thank you for watching and for your question, what you are seeing in the tradition line between the ceramic and the actual tooth structure. The more different the are (color and opacity) the more noticeable. I select A3 shade for all my posterior ceramic restorations. Hope this helps.
Dr. R
You are amazing.
Thank you for this informative videos.
is direct composite overlay/onlay a good option for patients who cannot afford indirect or semi direct restorations? what is the expected life span of it
i'm asking because most of my patients cannot afford it.
Thank you doctor, always to the point with these lectures
Hi Angelica, I think they are a great alternative. If you fabricate them in your office and post cure them, you should get at least 5-7 years of service (this is my personal experience). The idea is always to “save” teeth regardless of the restoring material used. Control every step as best as possible and you should be good. Thanks for following and watching our videos!
Hello Dr R
Thank you for sharing. I have a couple of questions if you can help me with
1-Why do you first build the tooth up with composite and then prepare it for onlay rather than just preparing a inlay-onlay from the initial cavity with divergent walls without composite involvement?
2- How do you prepare marginal ridges for onlay when they are not cavitated; should there be boxes?
Many thanks
1. I do it for 2 reasons. The first, uniform preparation. The second, sealing the dentin (IDS).
2. No need to remove marginal ridge and prepare a box unless the lesion extends IP. These preparations preserve as much healthy tooth structure as posible.
Thanks for watching
Dr. R
Soooo accurate it is 11 am on a Saturday morning 😂😂
And yes I want to be a better dentist
ok how much thanks is enough for my appreciation????? thank u sir
always appreciate ur lecture, really get benefit from ur webinar.
Wanted to ask about the provisional part, is that temporary cement able to use with the provisional resin? will the removal of the temporary cement with bur / ultrasonic scaler causing the removal of part of the IDS layer?
Thank you for your question. You only need a small etched and bonded enamel surface and to apply vaseline on the entire prep (IDS dentin also) to avoid them bonding together. It is very easy to clean with micro-etcher and you won’t damage IDS surface.
@@romerodentalseminars thank you for ur reply, just to clarify so that a dual-cure resin cement can be used to cement a provisional restoration after spot etch and bond followed by Vaseline application on the entire prep?
Nice lecture as usual
According to my reading any tension cusps (buccal upper)with less than 2_3mm to be onlay as they will be prone to fracture
The study showed that they are more stronger than the intact teeth?? May you clarify for me if iam wrong
This is a clinical decision we have to make and it depends on many other factors like occlusion, position of the tooth, etc. The study that I show only refers to Tue extra “strength” obtained after bonding of a ceramic restoration regardless of the preparation type. One thing is true, try to preserve as much tooth structure as possible is always the best.
🎉 fine
👌