hello and welcome to a brand-new chairside live my name is Megan strong and I'm will Schmidt RDA and
we've cooked up a brand new format of chairside life it's we've gotten more clinical content and
it's gonna be delivered in a fun and easily digestible way so let's start digesting what
today we've got your first segment of across the chair what do we got today we're going to focus on
opening what I like to call bold embrasures during interim dentistry using bio temps
Provisionals great and so speaking of Provisionals you're going to be talking about the importance
of planning ahead during the provisional stage and creating the best environment for the area
to recover that's right and Megan I'm glad to use that word provisional I think that we're not just
making temporaries here we are seeking to place importance on interim dentistry in fact we are
now starting to be provisional revolution we are we are okay starting right now okay well then roll
tape let's go no I'm going to get right into this what you see right here is the final product that
I'm trying to accomplish this is a completed three unit bio temp bridge provisional and I'm
getting ready to see it and today we aren't really talking about the fabrication of the bio temp in
general but instead I really want to focus on the finalizing of these embrasure areas I don't like
to think of any interim restoration as a temporary because we are always doing so much more than just
covering a prep or trying to save the space I really prefer to use the word provisional because
we are setting up this treatment for success at the final staged way ahead of time this is
why opening the embrasure area and allowing the tissue a chance to properly rebound is one of
the most important functions of interim dentistry I recently presented a bio champs hands-on course
to a mixed class of doctors and assistants using this very bridge and stone model combination the
main thing I witnessed is that most participants were very shy about really opening embrasure areas
and left quite a bit of flash and a lot of bulk excess reline material in the way of the tissue
this really doesn't allow for proper breathing underneath these restorations I started using
the phrase bold embrasures and I really think that's one of the key factors to success of this
three and it bridge provisional one really easy trick that I like to do just to start off with
when dealing with Provisionals that have politics is a small wrap of teflon tape now this not only
keeps the Pontic area clean but blocks out the deep embrasure areas so that none of the excess
real line can get pushed into them I'm going to try it back in here on the model or back in
the mouth just to make sure that there aren't any hang-ups by adding an additional layer of
this material I think everything looks good here so the bio temp can be placed back into the fast
dent and this is going to help me with the correct path of insertion I'll proceed from here right to
the realign stage and either ask the patient to bite or simply just hold the bio temp and
stent in place myself the Teflon can be removed during the gel State or even after the bio temp
has been removed from the preparations I'm really not concerned today with showing the bulk excess
removal of the realign but instead I'm focused on the opening of the embrasure first with a high
speed handpiece I really prefer this long thin diamond bur and I make very bold very aggressive
cuts into the embrasure and it really opened up the area where the tissue can breathe from here
this same diamond bur can be used to round out and soften the area I would really rather over
open embrasures versus under open an embrasure now this only took a couple minutes of preparation but
our outcome is a bold open embrasure that's fairly optimal for tissue to bounce back if the strength
of this bio temp is a concern then a little pre-planning by ordering either a wire or Kevlar
reinforcement is also an option I understand that not everyone is going to use a high speed
handpiece chairside to trim Provisionals so I'm going to open up and finalise this second abutment
from the lab bench with my slow speed handpiece I really only need to utilize for verse first
is a pointed carbide burr which is great for the ball to take down a thinner diamond is used for
refinement at a Robinson wheel is great for the final polishing stage but for our focus today
I'm going to use this double-sided diamond disc I think one of the most common problems with these
diamond discs is that they can easily warp and start to bend over time my best advice to prevent
this is to simply keep them in the container that they were delivered in of course make sure
that these are sterilized properly but keep them protected afterwards moving quickly through the
bulk removal of excess reline let's take this diamond disc and boldly open this embrasure
area the disc doesn't necessarily need to be on a very high rotation speed in fact a slower speed is
going to give you more control over the depth of this cut and prevent that disc from jumping around
and causing any mistakes as a good practice just when you think you've opened it up enough I want
you to go back in and refine just a little more followed up with the diamond to trim and then
smooth the area and this bio timber is ready for final polishing and eventually seating the
main lesson I want you to take away from today's focused explanation is the importance of planning
ahead during the provisional stage and providing the best environment for the treated area to
bounce back join me right back here on tier side live soon where I revisit this case once more talk
about how Pontic design can add even more success to this bio tent bridges outcome thank you so much
for watching take it away Megan no problem and so if people want to learn more about bio temps
I know you've done some chairside live episodes in the past discussing tips and tricks where can
they go to learn more well our viewers can visit blackwell dental comm and while you're there click
on the education tab and watch previous episodes of chairside lives where I go into more detail
about the how times Provisionals awesome well that about wraps it up for this first new format of
chairside live so thank you so much for watching and we'll meet you right back here next time
you