Amazing work as always Dr. Stevenson. I must say all of your videos are extremely informative and helpful, sadly even more so than my dental school 😅 I'm having lot's of trouble working with indirect vision and positioning myself and the patient correctly, if you could make an in depth video regarding this i shall be forever in your debt. thanks a bunch.
Thank you, Dr. Stevenson for creating these videos! They have helped me in my restorative classes I was wondering if you can also show a Class II restorative that extends to the facial, as well? Thank you!
Amazing and professional work and approach. My issue is to protect the next tooth to the prep and we are not allowed in exams to use safeguard wedges. Any other ideas?? thanks heaps
Thank you for this video Dr. Stevenson. I will be taking my exam next month at USC and I definitely feel that I need a refresher on this. Do have a link where we can purchase these teeth along with the wedge and bur so that we can practice? I talked with ADEX and they simply will be giving the typodont out during the exam but do not have anything on their website for purchase to practice. Any help would be greatly appreciated. Thank you so much again for the videos. I hope to see more.
@@StevensonDentalSolutions thank you Dr Stevenson. I have already taken the exam but I just wanted to let everyone know that the diamond 330 burs helped me so much cutting through the hard, brittle plastic tooth. Really comes in handy when dropping a box.
Thank you for your videos Dr Stevenson. They are very helpful. Could you kindly upload a video on class V cavity preparation on buccal and palatal surface of an upper molar (for composite) please.
Cheers for another insightful video! Sturdevant operative dentistry textbook describes another outline preparation for smaller proximal carious lesions that looks more like a tear drop shape (completed with a round bur). Could you please perhaps consider doing a future video to cover this approach?
I came across your videos only yesterday stumbling upon the 3/4 gold crown preparation video by chance. I subbed immediately. Excellent videos Dr Stevenson. Just one request, if possible. I have difficulties in knowing the nuances of rubber dam placement; is this something you could consider demonstrating, namely arch isolation, isolating deep margins etc.? No worries if not. I look forward to your coming videos
Thank you for all these helpful videos! After removing caries with a round bur, do we go back and try to smooth the internal walls? and if yes, with what instrument?
When you're removing caries on axial wall, did you extend the entire axial wall to prevent any undermined enamel? Or is it wise to only chase the caries and leave as much axial wall as possible?
Leave as much as you can, and then ask again for removal of the undermined enamel that is created. It's best to try to use a small enough round bur to avoid unroofing the lingual wall, but sometimes it is necessary.
Thank you for the wonderful video. I saw this video and another #30 class II video by you, both of the preps finally generated undercut after removing all caries. Is it OK to leave undercut behind? Do we have to modify the cavity outline after caries removal?
Research, and the abundant enamel present, and the occlusion - not a good idea to have occlusion on a lingual bevel. All national exams (ADEX, WREB, CDCA, etc.) don't expect to see bevels.
Bevels are necessary for retention, enamel support and to provide esthetic blending. I along with the Operative Dentistry leaders in the US - from Cliff Sturdevant to James Summitt all agree that placing bevels on small class IIII preparations is contraindicated. It serves no advantage and potentially places the thin composite in occlusion, and more likely to chip/fracture. It is also harder to restore. Placing bevels in class II in the proximal makes good sense, however, getting adaptation to the margin with the matrix is challenging, unless you advocate flowable composite for this purpose. Not a single study published in the last 10 years shows that bevels provide any increased longevity in conservative preparations. Follow the evidence, then make your decision. It takes a lot of work to stay on top of science and most don't have the time. Even professors! The two largest testing agencies in the US, the CDCA, and the WREB do not require nor expect bevels - they made this determination by the overwhelming advice of academic experts.
Hi Dr., I was wondering at what dimensions facially and axially would you be comfortable going on the ADEX before asking for a modification? Both for class III and class II. I can't seem to find a universal answer since the manual just says 0.5-1mm beyond what is necessary
Great question. We answer this precisely in our ADEX review course (hint hint), but I'll give you some tips: 1. Always prep to ideal first. 2. Then modify to the maximum extensions allowed to keep your score "ACC" if required due to caries. 3. If further extensions are required to remove caries, submit your request to the clinical floor examiner (CFE) in writing, requesting 0.5 mm incremental extension requests. The class II and III will be 0.5 mm into dentin on the axial walls to be considered ideal. The one unique extension is the facial on the class III. When you view the anterior tooth from the proximal, the tooth measures about 4.5 mm faciolingually. Caries will be located at the midpoint from this view, hence the facial extension would be at least 2.25-2.5 mm (more than the full length of the 330D bur). You will likely break facial contact at this stage and be solidly located within the lesion. This would be the ideal prep, now you'll simply extend as per the ADEX guidelines to the maximum allowed (if necessary) to keep your grade "ACC". If more decay is encountered, then bring in the CFE and submit your written request. Sincerely, Dr. Stevenson
great video...is it possible to make a class 3 cavity prep and still retaining the marginal ridge (i mean the cavity window made in a way that you don't cross the marginal ridge area)?
Hi Dr.Stevenson! Are we supposed to fill the water bottle which is connected to the turbine unit? Does the handpiece need to spray water while doing cavity/crown preparations?Or just air is enough?
Do not fill the water bottle - schools don't use water for the exams. Cut dry, but use light pressure and variable speed. Change carbides after 1-2 preps, change diamonds after 4-5 preps.
Hello Dr! When you deepened the facial wall to create the facial clearance did you only deepen the part of the facial wall closest to the cavosurface margin? Or did you deepen the entire facial wall until you achieved the required clearance?
Good question. This is referred to as "facial extension" not "facial wall deepening", but to answer your question, no, I simply kept the wall relatively flat.
@@jarredhanley6002 I would much the but to 2.5 mm facially before asking for a modification request - this has been a good starting point for our candidates.
@@StevensonDentalSolutions Thanks Dr. Stevenson! I actually had this come up on my exam. My initial facial extension was only about 1.5mm extended (I hadn’t broken the facial contact yet) and there were caries still remaining on the facial wall. I extended facially until the facial contact was open about 0.5mm (preserved incisal contact and gingival wall). I was able to remove the caries without asking for an unnecessary modification. I ended up only having to request axial modifications from there. Did not understand this concept until I saw your video. Thanks again.
Your videos are amazing Doc! Would you consider uploading endo videos? I’m preparing for licensure and I have only seen one helpful video on TH-cam for endo and it’s a big part of licensure exams!
what do you think about the strength of emax crowns on second molar teeth with evidence of physiological wear already present? i find that the emaxs are not strong enough compared to zirconia.
@@StevensonDentalSolutions thanks for the reply. You do great work in showing the mechanical side how about treatment planning? Do you think it is OK to adjust an opposing second molar which has over erupted and worn down the molar that requires restoring?
Resistance form is not the question - the tooth and restoration are not it risk for fracture. Retention is created with the nearly parallel walls of the incision and gingival, but mostly by the enamel bonding which will be robust and resist the displacement of the restoration. This prep is the US standard of care in 2020.
It may be done, however two issues/challenges arise: access to completely remove caries (this was the death of the "tunnel prep" years ago) and the potential for unsupported enamel if the occlusal forces are high. Nonetheless I dig your style! Use the microscope and rubber dam and save enamel with an angled prep. Very bad ass.
!["สนธิ" ห่วงมีขบวนการปกป้อง "ทนายตั้ม" : [THE MESSAGE]](http://i.ytimg.com/vi/2GQNp3EoMc0/mqdefault.jpg)
You helped so many people like me of becoming a dentist. So the smallest thing to say to you is may God bless your life with his blessings
So nice of you to say. Wishing you the best, Dr. S
Thank you for taking the time to make these high quality videos, please keep it up doc!
Thank you!
Really amazing informative video
Best educational videos i have seen
Very nice of you! Best wishes, Dr. Stevenson
Amazing work as always Dr. Stevenson. I must say all of your videos are extremely informative and helpful, sadly even more so than my dental school 😅 I'm having lot's of trouble working with indirect vision and positioning myself and the patient correctly, if you could make an in depth video regarding this i shall be forever in your debt. thanks a bunch.
th-cam.com/video/GxWqppkToAg/w-d-xo.html
Thank you doctor for your excellent work and explaining everything in simple way you are legend i respect you very much keep making videos
So kind. Thank you Doctor. I will!
🙏 big thanks to you
My pleasure!
Thanks doctor for such an excellent video.. I will be waiting for the demonstration of restoration of the same. Thanks
It's up already...th-cam.com/video/wz6h1_s-Pi0/w-d-xo.html
Thank you, Dr. Stevenson for creating these videos! They have helped me in my restorative classes
I was wondering if you can also show a Class II restorative that extends to the facial, as well? Thank you!
I will put that idea into the queue! Thank you, Dr. S
Great video as always! Would you be willing to do an updated video regarding an MOL prep? Thank you.
For sure
Amazing and professional work and approach. My issue is to protect the next tooth to the prep and we are not allowed in exams to use safeguard wedges. Any other ideas?? thanks heaps
Tough to do. use the tooth as a guard by leaving a very thin shell, then undermine and chip carefully to obtain extensions.
Dr. Stevenson. Thank you for all the information. May I know the ideal depth (linguo-facial) of composite class III prep?
The facial extension is usually about 2.0 mm on most anterior maxillary teeth from the lingual access.
Thank you for this video Dr. Stevenson. I will be taking my exam next month at USC and I definitely feel that I need a refresher on this. Do have a link where we can purchase these teeth along with the wedge and bur so that we can practice? I talked with ADEX and they simply will be giving the typodont out during the exam but do not have anything on their website for purchase to practice. Any help would be greatly appreciated. Thank you so much again for the videos. I hope to see more.
stevensondentalsolutions.com/product-category/cdca-adex-exam-supplies/
@@StevensonDentalSolutions thank you Dr Stevenson. I have already taken the exam but I just wanted to let everyone know that the diamond 330 burs helped me so much cutting through the hard, brittle plastic tooth. Really comes in handy when dropping a box.
Thank you for your videos Dr Stevenson. They are very helpful. Could you kindly upload a video on class V cavity preparation on buccal and palatal surface of an upper molar (for composite) please.
Good idea! I’ll put this on my list.
Cheers for another insightful video! Sturdevant operative dentistry textbook describes another outline preparation for smaller proximal carious lesions that looks more like a tear drop shape (completed with a round bur). Could you please perhaps consider doing a future video to cover this approach?
Thank you Doctor. Yes, I will.
I came across your videos only yesterday stumbling upon the 3/4 gold crown preparation video by chance. I subbed immediately. Excellent videos Dr Stevenson. Just one request, if possible.
I have difficulties in knowing the nuances of rubber dam placement; is this something you could consider demonstrating, namely arch isolation, isolating deep margins etc.? No worries if not. I look forward to your coming videos
I do have rubber dam videos, but I’ll plan on a special cases video for rubber dam soon! Thank you.
@@StevensonDentalSolutions Thank you very much Sir, you're a star. Keep up the excellent work
Thank you for your videos Dr. Stevenson. Can you please make one for block temporary for #3-x-#5?
That sounds like fun! Will put this in the queue
Thank you for all these helpful videos! After removing caries with a round bur, do we go back and try to smooth the internal walls? and if yes, with what instrument?
Once the caries is removed (in dentin) do not touch the walls again.
i learned a lot from you and still learning from every single video you post . thank you
Great!
When you're removing caries on axial wall, did you extend the entire axial wall to prevent any undermined enamel? Or is it wise to only chase the caries and leave as much axial wall as possible?
Leave as much as you can, and then ask again for removal of the undermined enamel that is created. It's best to try to use a small enough round bur to avoid unroofing the lingual wall, but sometimes it is necessary.
Thank you for the wonderful video. I saw this video and another #30 class II video by you, both of the preps finally generated undercut after removing all caries. Is it OK to leave undercut behind? Do we have to modify the cavity outline after caries removal?
If the undercut is in dentin, yes - leave it. Thank you
@@StevensonDentalSolutions Thankyou! Dr. Stevenson.
@@tianlimon6590 You are welcome!
Thank you so much sir!
Why are the bevels not required anymore? Is it because of the material of the tooth, or current research?
Research, and the abundant enamel present, and the occlusion - not a good idea to have occlusion on a lingual bevel. All national exams (ADEX, WREB, CDCA, etc.) don't expect to see bevels.
@@StevensonDentalSolutions Good to know, thanks doc!
My professor argues that we should always use a bevel when prepping enamel for composite. Thoughts?
Bevels are necessary for retention, enamel support and to provide esthetic blending. I along with the Operative Dentistry leaders in the US - from Cliff Sturdevant to James Summitt all agree that placing bevels on small class IIII preparations is contraindicated. It serves no advantage and potentially places the thin composite in occlusion, and more likely to chip/fracture. It is also harder to restore. Placing bevels in class II in the proximal makes good sense, however, getting adaptation to the margin with the matrix is challenging, unless you advocate flowable composite for this purpose. Not a single study published in the last 10 years shows that bevels provide any increased longevity in conservative preparations. Follow the evidence, then make your decision. It takes a lot of work to stay on top of science and most don't have the time. Even professors! The two largest testing agencies in the US, the CDCA, and the WREB do not require nor expect bevels - they made this determination by the overwhelming advice of academic experts.
Hi Dr., I was wondering at what dimensions facially and axially would you be comfortable going on the ADEX before asking for a modification? Both for class III and class II. I can't seem to find a universal answer since the manual just says 0.5-1mm beyond what is necessary
Great question. We answer this precisely in our ADEX review course (hint hint), but I'll give you some tips: 1. Always prep to ideal first. 2. Then modify to the maximum extensions allowed to keep your score "ACC" if required due to caries. 3. If further extensions are required to remove caries, submit your request to the clinical floor examiner (CFE) in writing, requesting 0.5 mm incremental extension requests.
The class II and III will be 0.5 mm into dentin on the axial walls to be considered ideal. The one unique extension is the facial on the class III. When you view the anterior tooth from the proximal, the tooth measures about 4.5 mm faciolingually. Caries will be located at the midpoint from this view, hence the facial extension would be at least 2.25-2.5 mm (more than the full length of the 330D bur). You will likely break facial contact at this stage and be solidly located within the lesion. This would be the ideal prep, now you'll simply extend as per the ADEX guidelines to the maximum allowed (if necessary) to keep your grade "ACC". If more decay is encountered, then bring in the CFE and submit your written request.
Sincerely, Dr. Stevenson
Dr do u have complete denture vedios I’m D3 and having hard time understanding the steps
Not yet! Try checking out videos by Dr. Mark Durham. He’s a great teacher!
great video...is it possible to make a class 3 cavity prep and still retaining the marginal ridge (i mean the cavity window made in a way that you don't cross the marginal ridge area)?
It is very difficult to do this without undermining the marginal ridge enamel but it is possible for small cavitated lesions.
@@StevensonDentalSolutions what kind of bur and angulation of handpiece would be ideal doc?
Hi Dr.Stevenson!
Are we supposed to fill the water bottle which is connected to the turbine unit?
Does the handpiece need to spray water while doing cavity/crown preparations?Or just air is enough?
Do not fill the water bottle - schools don't use water for the exams. Cut dry, but use light pressure and variable speed. Change carbides after 1-2 preps, change diamonds after 4-5 preps.
@@StevensonDentalSolutions thanks alot!
It would be great if you could remove the prep tooth and show how it looks from the side
True! I do this in my hands-on courses all the time. Wish I had done that here as well...
Hello Dr! When you deepened the facial wall to create the facial clearance did you only deepen the part of the facial wall closest to the cavosurface margin? Or did you deepen the entire facial wall until you achieved the required clearance?
Good question. This is referred to as "facial extension" not "facial wall deepening", but to answer your question, no, I simply kept the wall relatively flat.
@@StevensonDentalSolutions Would this be part of the initial outline form or would you ask for a modification request to achieve this?
@@jarredhanley6002 I would much the but to 2.5 mm facially before asking for a modification request - this has been a good starting point for our candidates.
@@StevensonDentalSolutions That makes sense, otherwise you would create a very uneven facial wall. Thank you Doctor!
@@StevensonDentalSolutions Thanks Dr. Stevenson! I actually had this come up on my exam. My initial facial extension was only about 1.5mm extended (I hadn’t broken the facial contact yet) and there were caries still remaining on the facial wall. I extended facially until the facial contact was open about 0.5mm (preserved incisal contact and gingival wall). I was able to remove the caries without asking for an unnecessary modification. I ended up only having to request axial modifications from there. Did not understand this concept until I saw your video. Thanks again.
Your videos are amazing Doc! Would you consider uploading endo videos? I’m preparing for licensure and I have only seen one helpful video on TH-cam for endo and it’s a big part of licensure exams!
That's the plan!
what do you think about the strength of emax crowns on second molar teeth with evidence of physiological wear already present? i find that the emaxs are not strong enough compared to zirconia.
You are correct!
@@StevensonDentalSolutions thanks for the reply. You do great work in showing the mechanical side how about treatment planning? Do you think it is OK to adjust an opposing second molar which has over erupted and worn down the molar that requires restoring?
can you please, make video on laminate veneer?
Please check my video library on my channel- I have a whole series.
Great!!! thank you
Thank you Doctor.
Hello, Dr!
where is the resistance form and retention form located?
Thank you before..
Resistance form is not the question - the tooth and restoration are not it risk for fracture. Retention is created with the nearly parallel walls of the incision and gingival, but mostly by the enamel bonding which will be robust and resist the displacement of the restoration. This prep is the US standard of care in 2020.
I see you are using an enamel hatchet a lot, but what do you think about using ultrasonics to remove the unsupported enamel?
Works well - but Piezo might be even better.
Hello Dr,
What pressure should I set my air compressor at?It is California air tools 8 gallon.
80 PSI at the compressor adjustment and 3 bars at the turbine unit.
@@StevensonDentalSolutions thankyou so much!
Can I repost your video to my APP, I will indicate the author
Yes, proceed.
Very nice thanks:)
Great - glad it was helpful.
What brand chisel do you recommend for this?
Any 10-6-14 hatchet. We sell Brasseler brand on our site because they are stiff and precise.
is there a video for the class 2?
Sure, just subscribe and click on the icon for my video library
God bless
Happy to help!
Dr. Stevenson in our exam we are not allowed to cross marginal ridge is there any way to remove caries without crossing marginal ridge on mesial side
Hi Dr. Luthra, you mean distal marginal ridge here?
amlan pankaj no mesial marginal ridge when removing caries on mesial side of 11
I don't think it's possible to access caries in ml surface in class 3 without cutting through mesial marginal ridge.
amlan pankaj that’s why we use 1/2 1/4 round burs
It may be done, however two issues/challenges arise: access to completely remove caries (this was the death of the "tunnel prep" years ago) and the potential for unsupported enamel if the occlusal forces are high. Nonetheless I dig your style! Use the microscope and rubber dam and save enamel with an angled prep. Very bad ass.
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