Jeffrey Caso There is a new instrument in my dental arsenal. On my quest to battle the single most difficult thing for me in dentistry I have found something that is making me sleep better at night. Let’s face it, residual interproximal cement is a problem…a big problem. Nothing can sabotage a great CEREC restoration faster than leftover cement that leads to inflammation, bleeding, discomfort and potentially recurrent decay. Most of the time we know it’s there; we take a post-op film and see it. Removing it can be very difficult. To add insult to injury it’s at the end of a lengthy appointment where the patient is fatigued and anesthesia is waning. The doctor is equally as tired and time pressures elsewhere make this about as stressful as it can get.
Dental manufactures have done a great job tweaking their products to be more easily cleaned up. If they make the process too easy, we will lose bond strength. It’s an adhesive cement. It’s supposed to stick to most things. Cord, Teflon tape, interproximal brushes, floss…the list goes on and on. No matter what you do some cement can remain.
I recently had some subgingival cement that was not budging. I think that if the access were better the cement would break free much easier. I was just given an instrument to try in hygiene. It’s a product that so many hygienists are raving about. It’s a scaler from Paradise Dental Technologies called the Montana Jack (Patterson order # 561-4318). At first glance it looks like a straight sickle scaler but when you look closely you can see there is a curve and it is very thin and sharp.
Getting access was a breeze because it is so thin and it is super sharp which helps to cleave the cement off easily. I was also able to feel the cement line at the margin and burnish it down. This instruments tactile feel was amazing. The only caution is to use just moderate pressure because sometimes the cement is just too strong for anything but the drill.
This instrument is now a permanent part of my CEREC armamentarium. Give it a try. You won’t be disappointed.
