How to Handle Small Indirect Restorations

 

Have you ever tried to cement a small crown, onlay or inlay? It’s tough work holding onto it securely!

After polishing a porcelain restoration I find it unnervingly slippery. Dropping it on the floor or worse still down a patients throat is a nightmare situation. And scrambling to maintain isolation while decontaminating a crown is not my idea of fun.

A very simple and very helpful tip is to bond a microbrush with unfilled resin (adhesive in gen 4 and 5 bonding systems) directly to the occlusal surface of the restoration.

Bond a microbrush directly to the occlusal surface of the restoration

The restoration is now secure, can be prepared easily and is simple to cement. Once seated with resin just break off the bond microbrush with mild lateral pressure on the bonded tip. Comes off easily and then clean up can start.

The trick to doing this is to apply the bond stick intraorally after initial try in and contact adjustment. This means that the path of insertion of the stick is in the perfect position and not pointing back down the patients throat, trust me, that makes cementation pretty awkward.

I find myself doing this for the small crowns and onlays/inlays. I don’t find it necessary for more easily manipulated larger crowns

Similar products such as Micro Stix and Optrastick are supposed to do the same thing (at a higher cost). I have not used these myself however have heard they do not adhere particularly well. I’d love to hear feedback if you do use these. For now, I don’t see the need to change from a trusty bond stick.

David is a recent graduate dentist working in private practice in regional NSW, Australia. Read more at www.dentalheadstart.com/meet-david/

2 Thoughts on “Don’t drop that Onlay!”

  • I’ve used a variation of that technique for years. I bond though to the mesiobuccal. Easy to remove, allows for positive occlusal pressure to be applied quickly even whilst the restoration is attached to the stick.
    Clean up is easy

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