Question about etching/bonding system from a student.Would love some advice.

Discussion in 'Dental Restoration' started by examid, Oct 14, 2018.

  1. examid

    examid

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    Hello,i had a patient a few days ago and made a class 3 preparation on her D3-3, next to it there was a cavitated lesion on 3-4 so i decided to access it mesialy(basically from the other preparation) and save the marginal ridge to make the treatment of this tooth minimally invasive. Everything went fine and a filling was placed,but when it was time to fill the 3-3 i only had 30 minutes left and my teacher told me that i can try to make that one too,i used total etch technique as per instruction,placed a bonding agent,light cured but later on because the space between the teeth was narrow and the gingival wall of 3-3 prep was quite low i had problems placing matrix and was in a rush so i decided to calmly put IRM and finish next time.
    Now the question is when i remove the IRM should i etch and apply bonding agent again? Maybe wasnt the smartest thing to do it in the first place but it happened. So can all of this affect the quality of restoration and should i repeat the steps when i will finally fill the cavity.
    Thanks in advance for the answers.
     
    examid, Oct 14, 2018
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  2. examid

    Busybee

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    I'm not a dentist but common sense would tell me that yes you would need to etch and apply bonding agent again if you have not completed the restoration. Otherwise how will it work? But I would love to see an opinion from one of our dentists. My own opinion would be that you should not start treatment on a human subject if you are time constrained to finish. They have to live with it in the meantime.
     
    Busybee, Oct 15, 2018
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  3. examid

    MattKW Verified Dentist

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    Freshen up the margins lightly, then re-etch and rebond. It's OK when things like this happen; the important thing is that you made sure the patient wasn't harmed or in pain until the next appointment. Your timing will get better as you gain more experience, but sometimes things go awry and you have to wind up in the best way possible. I generally try and start on the tooth likely to give me the most trouble (filling, extraction,...) in case I run over. The most memorable case was when I numbed up a patient for an immediate denture, then checked the denture to find the lab hadn't done it as per instructions! Luckily I hadn't started the extractions. S*** happens.
     
    MattKW, Oct 15, 2018
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  4. examid

    examid

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    ok,thanks a lot,will do as you said!yeah there was no problem with the patient,i just thought maybe that could make the bond weaker but after thinking it over,should be fine.Next time ill think twice before starting the filling process though if im running out of time.But yeah,thanks for the reply anyway.
     
    examid, Oct 15, 2018
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  5. examid

    honestdoc Verified Dentist

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    With IRM, you have the Eugenol component which decreases dentinal bonding. Because of this, it is important that you touch up the margins like Dr. MattKW mentioned and remove all the IRM. If you have trouble placing the matrix, try pre-wedging the interproximal and allow it to expand. I used to separate & protect the adjacent teeth with a matrix band during preparation but my mean instructor took it away from me.

    I don't like to do class 3's on molars and premolars due to difficult access. What school do you attend? Hopefully they don't teach you "extension for prevention," and isthmus preparation. I would do a conservative class 2 box prep (if caries are minimal).
     
    honestdoc, Oct 15, 2018
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