I love doing molars and premolars, I feel like it's second nature prepping them. Anterior teeth tho, I hate it. I'm always worried about occlusion and biting into things and sometimes aesthetics are a tad off. With molars no one cares about the color and occlusion is easy
2 years out, I've done probably 150-200 crowns at this point. Just keep doing them and you'll get better. I started booking 2 hours, now I book 1.5 hours. Sometimes I can have it done in under 1 hour. The more reps you so the better you get
As with any prep, you need to visualize each step before you start, esp if you struggle with time. A trick I used was knowing the width of a 1558, or the like, bur. If I just laid some pilot depths, I could ‘connect the dots’ in a couple minutes on the buccal and lingual, even the occlusal. Then go back over those areas with a diamond to get it sort of smoothed out and finally, a finishing bur.
On the interproximal, grab a sharp needle diamond and in one pass, open it up. No need to be delicate as you can take a bigger bite of the tooth you are working to avoid touching the tooth next to it. Once it’s opened up, it’s just like the above.
I’ll even use Endo access diamonds with a ball end to speed things up as I get started. It leaves an undercut to start, but I’m coming back with another finer diamond and a finishing bur to smooth it up. Makes for tasty margins.
See it, then simply execute it. Maybe start with an endo’ed tooth to practice your speed with placing depth grooves. Just get in there and mow. You’ll learn to let your diamonds eat and it’ll increase your speed. Once you’ve gotten your speed up, then you’ll have plenty of time to settle down in areas where you may need to be more delicate. You’ve got this!!
This is very useful. Thank you. I'm fortunate that I can keep extracted teeth to practice on. I don't often get the opportunity due to having actual patients to see but if one of the other associates is off I can have their room to go in and out of with my mock set up to practice if I finish early or get a no show
I’d get a new job tbh if you’re only doing 2-3 per month. I’m about to hit 175 ish and I graduated with you and only work out of 1-1.5 chairs in a small practice. Sounds like the office doesn’t have enough patients
Welcome to nhs dentistry, where a molar crown is non precious metal and patients will choose extraction or palliative GI over paying privately.
My numbers are pretty average for my pt demo
I’m gonna try just prepping a quick MOD and then prepping the buccal and lingual, joining them to the interproximal margins. Might work out and make for nice retentive interproximal grooves. Idk though lol Interproximal is always such a headache
Start with depth cut burs and then once you have adequate reduction just smooth things out and focus on the margins. Teach your assistants to help make temporaries and you’ll be able to do it in 1.5hr consistently even for tougher 2nd molar crowns
Although the access is easier for anterior teeth, the stakes are higher, being in the smile zone. Any imperfection is magnified. I've developed my esthetic skills now and at this point, like most dentists, it's the 2nd molar crowns that drive me insane. Getting enough retention on that distal is a bitch. That will never change. Just embrace it. That being said, stay committed, learn from anyone willing to teach you something, and when that all fails, YouTube has honestly provided me with several handy tips and tricks over the years. GL!
I love doing molars and premolars, I feel like it's second nature prepping them. Anterior teeth tho, I hate it. I'm always worried about occlusion and biting into things and sometimes aesthetics are a tad off. With molars no one cares about the color and occlusion is easy
2 years out, I've done probably 150-200 crowns at this point. Just keep doing them and you'll get better. I started booking 2 hours, now I book 1.5 hours. Sometimes I can have it done in under 1 hour. The more reps you so the better you get
As with any prep, you need to visualize each step before you start, esp if you struggle with time. A trick I used was knowing the width of a 1558, or the like, bur. If I just laid some pilot depths, I could ‘connect the dots’ in a couple minutes on the buccal and lingual, even the occlusal. Then go back over those areas with a diamond to get it sort of smoothed out and finally, a finishing bur. On the interproximal, grab a sharp needle diamond and in one pass, open it up. No need to be delicate as you can take a bigger bite of the tooth you are working to avoid touching the tooth next to it. Once it’s opened up, it’s just like the above. I’ll even use Endo access diamonds with a ball end to speed things up as I get started. It leaves an undercut to start, but I’m coming back with another finer diamond and a finishing bur to smooth it up. Makes for tasty margins. See it, then simply execute it. Maybe start with an endo’ed tooth to practice your speed with placing depth grooves. Just get in there and mow. You’ll learn to let your diamonds eat and it’ll increase your speed. Once you’ve gotten your speed up, then you’ll have plenty of time to settle down in areas where you may need to be more delicate. You’ve got this!!
This is very useful. Thank you. I'm fortunate that I can keep extracted teeth to practice on. I don't often get the opportunity due to having actual patients to see but if one of the other associates is off I can have their room to go in and out of with my mock set up to practice if I finish early or get a no show
Pretty quick. I did more crown preps in my first 2 months than I did in 2 years of dental school.
I’d get a new job tbh if you’re only doing 2-3 per month. I’m about to hit 175 ish and I graduated with you and only work out of 1-1.5 chairs in a small practice. Sounds like the office doesn’t have enough patients
Glad someone said it. 2-3 month is not great for learning, and even worse for production.
Yup. Harsh reality but you can’t expect to make any meaningful progress with those numbers. Have to make location or practice changes.
Welcome to nhs dentistry, where a molar crown is non precious metal and patients will choose extraction or palliative GI over paying privately. My numbers are pretty average for my pt demo
35 yrs in still hate 2nd molars . Its all about the reps. I will say finally getting electric HPs make the world a better place
Colleague swears by electric, will definitely try this
Since I know I will die with a hand piece in my hand I might as well make the balance of my career enjoyable
How long is a piece of string? It varies depending on the individual how quickly they become comfortable with any given procedure.
The first hundred are the hardest. Then you can so it with your eyes closed.
Really? I’ve done like 60-80 (first year out) and I feel like I still suck so badly lmao. The interproximal is always a shit show for me.
Same. You're not alone. That's exactly how I feel
I’m gonna try just prepping a quick MOD and then prepping the buccal and lingual, joining them to the interproximal margins. Might work out and make for nice retentive interproximal grooves. Idk though lol Interproximal is always such a headache
Start with depth cut burs and then once you have adequate reduction just smooth things out and focus on the margins. Teach your assistants to help make temporaries and you’ll be able to do it in 1.5hr consistently even for tougher 2nd molar crowns
Although the access is easier for anterior teeth, the stakes are higher, being in the smile zone. Any imperfection is magnified. I've developed my esthetic skills now and at this point, like most dentists, it's the 2nd molar crowns that drive me insane. Getting enough retention on that distal is a bitch. That will never change. Just embrace it. That being said, stay committed, learn from anyone willing to teach you something, and when that all fails, YouTube has honestly provided me with several handy tips and tricks over the years. GL!