Posterior Composites – Tips & Tricks

Episode #346 with Dr. Lee Ann Brady

Today, Dr. Lee Ann Brady from The Pankey Institute shares some of her favorite and must-try techniques for posterior composites. From her favored isolation systems to the many uses for plumber’s tape, she has a variety of advice to improve your dentistry today! To hear this expert’s tips, tricks, and techniques for creating the best, aesthetic composites, listen to Episode 346 of The Best Practices Show!

Main Takeaways:

Patients find Isolite to be a comfortable form of isolation.

ReLeaf isolation works best on patients with strong gag reflexes.

Rubber dams might make a comeback peri-Covid for aerosol prevention.

Ivoclar’s OptraDam is the kinder, gentler version of a rubber dam.

Retraction pastes are probably the best hemostatic agents in all of dentistry.

Pre-wedge every time for a successful matrix.

Teflon tape has multiple uses in dentistry.

Prep scrub every tooth you prep to prevent sensitivity and reduce bond degradation.

Be cautious about mixing and matching universal adhesives.

Composite warmers will transform your life.

To prevent cross-contamination between patients, don't reuse composites in the warmer.

Quotes:

“One of the biggest challenges we have when we do adhesive dentistry of any kind, direct or indirect, is managing contaminants, isolation — so, water, saliva, red blood cells, all of the contaminants that are automatically in the oral environment, and then some of the ones that we introduce through our handpiece. And they're actually not our friend when it comes to optimum adhesives, and we want to try to manage that.” (03:35—04:01)

“I love working with an Isolite. Most of my patients find it really comfortable once you get it in and get it in position. And they prefer it over having to hope they're staying open wide enough for you or worrying about their tongue. It actually really does do a great job at managing isolation from a standpoint of moisture in the oral environment, managing aerosols.” (04:31—04:55)

“I can't use [Isolite] on everybody. And so, the other device that you see listed on the picture is called ReLeaf, and it comes from a company named Kulzer. They're the people who make Ivory Rubber Dam materials. And I use ReLeaf for a couple of different scenarios. One is, somebody posted in the chat, ‘What about patients with a really strong gag reflex?’ This will work much better because you're not putting any pressure or contacting the tongue. And it also works really well for patients at high functional risk.” (05:24—05:58)

“If you get the ReLeaf, get one for your hygiene department as well, because it’s probably the best thing that we can think about from a standpoint of using an ultrasonic.” (07:43—07:57)

“Rubber dams are one of these things that most of us were super glad that we were able to leave behind when we left dental school. And then, there are other people who say, ‘I do all my dentistry under a rubber dam. I do think that thinking about going back to rubber dam isolation may be on people’s radar screen after we get back in our offices, simply because of the fact that it does isolate us from the patient’s oral environment, and it does prevent aerosols.” (08:42—09:12)

“[The Ivoclar OptraDam is] actually what I call the kinder, gentler version of a rubber dam. Why is it the kinder, gentler version? Well, a couple of reasons. Number one, everything all comes together so you don't need to know where the frame is and sterilize it and find the dam material. It also isn't a flat piece of rubber dam, so it literally is the shape of the back of the mouth. And because it’s not under tension, you don't need a rubber dam clamp. And if you don't use a clamp, you don't need palatal anesthesia on the maxillary, and you...