Techniques to deal with interproximal lesions
From: "mark hampson" mark@...
Date: Wed Jun 23, 2004 3:50 pm
Subject: Re: Technical advice welcomed
Hi Paul
Welcome to healozone - firstly don't get frustrated, the technique
comes in the end & I'm a hell of a lot better than i was 18 months
ago.
I employ various simple techniques to deal with interproximal lesions
1)- Tunnel prep revived - for a fresh interproximal lesion I
sometimes punch an occusal access cavity with an air abrador (we use
prep starts) - then treat as an occusal. Any air getting in via the
interproximal can usually be blocked out by a cement ( I tend to use
poly carboxilate(poly-f) - old fashioned but it works) as it usually
hasn't set by the time I've finished & is easily removed.
2)Matrix band - sometimes you can get a perfect seal gingivally (not
always) - it you can't I often float a fuji7 along the gingival
margin this achieves the objective usually & I restore initially with
this anyway usually.
3)Fingers - finger & thumb pressed either side of the interproximal
may sound basic but it often does produce a seal & allows the lesion
to be treated. I sometimes also simply place a blob of thick poly f
there as well, then remove it afterwards.
4)Rubber cups piggyback - this I've found useful for long
teeth/lesions - place a large cup over the area( not on the handpiece)
then place one of the smaller ones (on the handpiece) on top & into
the first cup - this seems to work & I've had good follow-up results
(perhaps Kavo might consider manufacturing a cup double the length of
the current ones - please).
One piece of advice I would give is that when I first used healozone
I was despirate to see the results & got the patients back after 8
weeks - I was a little under-impressed! At 6/12 review things were
much better, & 12/12 even better still. - i.e. as caries is a
relatively slow process over months/years I think it's reversal is
also over a similar timescale. Also consider that in my experiance
the lesions seem to heal from the base (the deepest part) up & the
surface is the last to reharden.
I also explain in detail the mechanism of caries & the role of
sugars/ lactobacilli to each patient - if they understand this then
they begin to comprehend the technology.
Have faith in the technology - it works, I'm still waiting for the
catch.
Have fun
Mark
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