My name is Sami. I'm a restorative dentist
located in Southern California
and the owner of a dental-educational channel
called Smile Influencers.
One tooth has a broken front tooth,
another tooth has a cavity underneath an old crown,
and the third tooth has a broken filling,
and they all need to be fixed.
This case shows a broken tooth on a mannequin.
Here, I'm using a thin diamond burr
that I use to create a 45-degree bevel
onto the tooth's surface.
The white stuff you see here is Teflon tape
that I apply to the adjacent teeth
in order to protect the adjacent teeth
from the chemicals that I'm about to use.
The blue stuff that I'm using is phosphoric acid etchant,
which essentially prepares the tooth for bonding.
I make sure to wash off the etchant thoroughly
in order to decrease the likelihood
of postoperative sensitivity.
The clear stuff that I'm applying is a bonding agent
that I apply to the prepared tooth surface
and a little bit beyond.
I am curing the tooth with an LED curing light,
which essentially polymerizes
any light-cured resin-based composites.
The blue putty that you see here
is a hydrophilic VPS impression material.
It is a guide that helps us in many cases.
Here, you can see us using composite resin
packed in incremental layers
to replace that missing tooth structure
and hopefully create a filling that is very strong.
And a lot of these have different colors
that allow us to pick a shade
that closely matches our patient's teeth.
We also have different composite resins
that have different translucency properties,
different opaque properties,
and this allows us to create a filling
that looks as natural as possible.
In this particular case, since it's on a typodont,
we're just using one shade to give you an example
of how to build up that missing tooth structure.
After, I use a series of disks that go from coarse to fine
to polish the filling, to make sure there's no ledges,
and make sure that it's as smooth as possible.
Now, when patients break their teeth,
it can be due to a variety of causes.
Trauma. Let's say you get into a fight
and someone punches you.
Falling down onto a hard surface like concrete.
Anytime you put a strong force onto your front teeth,
you can put it in jeopardy.
This tooth has a crown with an access hole
in the middle of it.
And there is a large cavity that's developing
underneath that hole.
Crowns are very strong,
and they're typically bonded onto the tooth.
And one of the safest ways to remove a crown
is by using a little bit of leverage
to take the crown off.
I use a variety of large diamond burrs
in order to clean the majority of the tooth cavity.
And at the very end, I use a round carbide burr
that runs at a slower speed
in order to get the very last bits of the cavity.
Bonding agent is then used.
We use a microbrush to apply
the bonding agent onto the tooth.
Core Paste is a composite resin system
that has a high compressive strength,
and it replaces a lot of the lost tooth structure.
And we use an LED curing light to cure
the outermost layer of the Core Paste,
although it will also naturally harden over time.
Here we are fabricating an acrylic temporary crown.
We use temporary cement called TempBond
to place our temporary crown onto the tooth.
This essentially maintains the space
until our lab technician finishes
fabricating a new dental crown.
Typically, cavities form from poor oral hygiene,
maybe not brushing or flossing the right way
or having a diet that's high in sugar.
This tooth has a broken filling
with a large cavity developing
between the filling and their natural tooth.
In order to clean the decay out,
I first have to remove the existing filling.
And in this particular case, I'm using a diamond burr
to remove all of the old composite resin.
After that's removed, I use a round carbide burr.
That's used on a slower speed to make sure
that I remove any infected dentin
or areas where there is a cavity present
until we have nice healthy tooth structure.
In this particular case,
I'm using a bonding agent called Clearfil SE Bond.
The primer and bond essentially
prepare the tooth surface for the application
of our composite resin filling material
in order for the filling material
to successfully adhere.
This is called flowable resin.
It's less viscous compared to other resins,
but it does a great job at sealing margins
and preventing postoperative sensitivity.
Packable composite resins are highly viscous resins
that contain a high volume of filler particles,
which gives them a stiff consistency.
At the very end, we are adjusting the shape of the filling
in order to make the occlusion of the patient
feel as natural as possible.
We're hoping that when our patient moves
left and right, front and back
that there is no interference
between the patient's motions
and the new filling that's in place.
I always tell my patients that there are things
that you can do to protect your teeth,
like brushing and flossing in the morning and at night.
Avoid dangerous habits
like opening packages with your teeth,
because although our teeth are very strong,
they can break, and we want to be very careful
and conscientious about what we put in our mouth.