The Reverse Preparation Technique

For more on this topic, go to www.dentaleconomics.com and search using the following key words: Reverse Preparation Technique, crown and bridge, Axis Dental, bur kit, PFM.

Most dentists I talk to say the majority of their production comes from crown and bridge procedures. I know GPs who refer endo, dentures, perio surgery, oral surgery or pedo. But I don't know any who refer crown and bridge. Most GPs enjoy the process, and setting fees is simple enough when they know it is a profitable procedure.

As with most things in dentistry, though, we can get better results if we do things just a little better. Clinical improvement can be tough to achieve when things are going well in a practice; when we are in that “groove.”

Spending my days in a dental lab, I see about 80% under-reduced preparations. They are predictably under-reduced as well, most often on the occlusal surface and in the gingival third.

About seven years ago, I tried to create a prep technique that would meet some lofty goals. I wanted it to be universal so it could be used for cast gold, all-ceramics, and PFMs. I don't like having to own different bur kits for different types of restorations. Also, I didn't want the prep technique to take much longer than the existing technique I was using. I wasn't willing to spend twice the time I had been to implement the new technique. Finally, it had to make prepping easier. I did not want to complicate the process by having to use 13 burs to prep a PFM.

I wanted a prep technique that was faster, easier, and of higher quality. It took two years of research, but I finally developed a prep sequence that gives me great results in slightly less time. Plus, it is easy to perform well. In fact, having a set prep sequence that produces predictable results means I don't have to be “on top of my game” to create a great prep. There really is no skill involved if you follow the technique. It does not require you to be brilliant daily.

It is called the Reverse Preparation Technique. Axis Dental makes the bur kit. The technique is so named because it begins with preparing the gingival margin. This is the opposite of how most dentists were taught in dental school to prepare teeth. From looking at many models of crown preparations, it is apparent that preparing a consistent gingival margin is difficult to accomplish regularly. By using a round diamond to prepare the gingival margin first, it ensures that you prepare an almost ideal gingival margin.

The bur kit (LS-7551) is available from dental dealers, or call Axis Dental at (888) 654-2947. The updated Reverse Preparation Technique is discussed in my DVD, “Rapid Anesthesia, Reverse Preparation & Two-Cord Impression Techniques.” View it online at www.glidewell-lab.com or call (800) 854-7256 to get a copy. CE credit is available.

Dr. Michael DiTolla is the Director of Clinical Research and Education at Glidewell Laboratories in Newport Beach, Calif. He lectures nationwide on both restorative and cosmetic dentistry. Dr. DiTolla has several free clinical programs available online or on DVD at www.glidewell-lab.com. For more information on this article or his seminars, please contact him at www.drditolla.com.