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12 Minutes to Pain Relief and Cosmetic Nirvana

Dr. Brian Gray – Washington, DC

The challenge:  My referring endodontist’s office manager, Jen, is in for a hygiene visit and has a sensitive tooth.  I just sent two emergency patients to their office, causing a bit of chaos – so she needs to get back there ASAP.  Of course, her treatment is free because we love her and her office and the fact that they see our patients on short notice.  Jen has meticulous hygiene and regular recare but a nagging abfraction lesion on the facial of #11, which has cold and tactile sensitivity.  Worse yet, she told me about it last time and we kind of blew it off (You know, the “shoemaker’s kids” syndrome).

So, how can I numb her up, place a composite that looks highly esthetic, and get her back to work in the most efficient and effective way I know how? Easy. I’m even going to take photos during the entire restoration and still get it done in less than 15 minutes using Tokuyama Dental’s new OMNICHROMA composite. The first truly UNIVERSAL ONE-SHADE COMPOSITE.

  1. 20 seconds: Pre op photo. I anesthetized Jen in the hygiene chair with Mepiviciane 4%, no epi.  Note the Carbocaine injection site delivered during prophy.
    Brian Gray fig2
  2. 20 seconds: Place moderate bevel with fine diamond.
  3. 20 seconds: MicroAirAbrasion (Danville, PrepStart), with Zekrya Gingival Protector (DMG America (Zenith)), for superior bond strength and no gingival trauma.Brian Gray fig4
  4. 60 seconds: Full etch and rinse.Brian Gray fig5Brian Gray fig6Brian Gray fig7
  5. 90 seconds: Gluma desensitizer (Kulzer), Tokuyama Universal Bond (Tokuyama Dental), air dry. Bond requires no agitation or curing light!

     

  6. 60 seconds: OMNICHROMA placement. Note the white-opaque color - no worries, it will cure to match the adjacent tooth structure.Brian Gray fig8
  7. 30 seconds: Light cure.Brian Gray fig9
  8. 60 seconds: 13 fluted carbide (Brassler), smooth and contour.
    Brian Gray fig10Brian Gray fig11
  9. One minute: Polish with Enhance (Dentsply Sirona) and PoGo (Dentsply Sirona) system.Brian Gray fig12Brian Gray fig13
  10. One minute: Admire the restoration. Take some more photos.

     

    Brian Gray fig14 Brian Gray fig15

     

  11. Two more minutes admiring that new composite, WOW! No time spent on shade selection, easy placement, great polishing, durable stuff, reliable company. Alright, you go Tokuyama, we are loving your OMNICHROMA!
  12. OK everyone, back to work. We’ve got patients to treat. And we better order more OMNICHROMA because we are using it all the time!

Brian Gray, DDS maintains a fee for service cosmetic restorative practice in Washington, DC.

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