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Registered On: 14/05/2011
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 Tooth Preparations

A very small percentage of the restorations placed in 2010, about 2%, were inlays and onlays (Limoli and Associates, personal communication, January 2011). Both authors are known to encourage use of these conservative restorations (when indicated), particularly when the facial and lingual portions of teeth are intact and the intracoronal portion of the teeth is either destroyed by dental caries or has a previously placed defective restoration. Most of these types of restorations are placed by those practitioners using CEREC from Sirona Dental Systems (Patterson Dental) and E4D from D4D (Henry Schein) in-office milling devices to be discussed later in this article. However, we encourage more dentists who do not useCAD/CAM devices to provide onlays, because of their simplicity and conservative nature. 
In spite of our desire for more onlays and the resultant less tooth reduction, the easiest indirect tooth restoration is reported by experienced practitioners to be the full-crown. However, these restorations are the most aggressive. The full-crown preparation concept is changing, as full-zirconia restorations are becoming more popular. Full-zirconia restorations do not require deep preparations as with PFM or the popular all-ceramic options. Because many dentists purposely or inadvertently prepare teeth to a minimal degree, the acceptability of these minimally prepared teeth may be one of the reasons for the growing popularity of the full-zirconia restoration.

Diamond Rotary Instruments 
These instruments significantly vary in price from just more than one dollar (for the so-called single use diamonds) to 10 times that cost (for diamonds intended to be used many times). Our research has shown that some low-cost brands of diamond instruments prepare teeth very similarly to higher cost instruments. Two well-proven, low-cost diamond brands are NeoDiamond (Microcopy) and Diamond Burs (Spring Health). Nevertheless, some dentists prefer to use the more expensive multiple-use diamonds that are also effective and may provide more options. Example companies include: Axis Dental, Brasseler USA, KOMET USA, Premier Dental Products, SS White Burs, and others. CR works with all of these companies and has found many different diamonds to be successful.