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Dental drills that have more than one spray port may cut tooth surfaces faster than drills that only have one spray port. Ports are small openings in the drill that spray water to keep the tooth cool during the drilling process.

Adding small amounts of mouthwash to the water coolant spray in a dental drill can increase the cutting rate two or three times. The mouthwash reduces surface tension, and can improve cutting rates using both carbide and diamond burs.

The diamond dental bur was first manufactured in 1897 but its modern incarnation did not appear until 1932. At that time, a German industrialist developed a method for bonding small diamond pieces onto stainless steel. The bur did not become widely accepted until the introduction of the high-speed drill in 1957. The diamond chips are bonded to a stainless steel tip that is inserted into the drill. Diamond burs are allegedly more resistant to wear and last longer. The burs must be thoroughly cleaned and sterilized between use and a disposable bur has been developed.

There appear to be little or no differences between the cutting abilities of disposable diamond burs compared with conventional sterilizable burs. Researchers used a laboratory simulation to evaluate 10 samples of 16 types of burs from 9 manufacturers. Twelve of the burs were disposable. Using a standard handpiece, ten consecutive grooves were cut with each bur in a piece of glass ceramic surface. The surface was weighed after each cut to measure how much material was removed. Three of the four conventional burs removed less material in cuts 6 through 10 compared with cuts one through five due to clogging. The same was true for 8 of 12 of the disposable burs. Medium-grit disposable burs had similar cutting efficiencies to medium-grit conventional burs.

Computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry has been in use for more than 2 decades. Recent improvements in this technology have made CAD/CAM restorations a viable alternative for routine dental care. This technology is being taught in dental schools to prepare students for contemporary dental practice and is particularly useful in unique restorative situations that allow conservation of tooth structure. This case report describes the restoration of a central incisor that was previously restored with an unesthetic three-quarter gold crown. The tooth exhibited recurrent caries and an unaffected labial wall of supported enamel. A CAD/CAM three-quarter crown was planned to conserve tooth structure. After preparation, the tooth was scanned for a CAD/CAM crown in order to fabricate a ceramic restoration, which was then milled and bonded, producing an esthetic result. Typically, in cases of esthetic enhancement, a labial laminate restoration is fabricated, but in this situation, a different approach was necessary to make a design for the lingual surface of an anterior tooth. [ABSTRACT FROM AUTHOR]

Hard occlusal guards have been used effectively to treat myofacial pain originating from parafunctional activities. They can also protect the natural dentition when it opposes porcelain restorations, help to evaluate changes in occlusal vertical dimension during full mouth rehabilitation, minimize further tooth loss in patients with abfraction lesions, and redirect occlusal loads more favorably onto dental implant-supported prostheses. A simplified technique is described to fabricate a properly designed wax model of an occlusal guard that can be processed in acrylic in the same manner used to construct a complete denture. [ABSTRACT FROM AUTHOR]

Computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry has been in use for more than 2 decades. Recent improvements in this technology have made CAD/CAM restorations a viable alternative for routine dental care. This technology is being taught in dental schools to prepare students for contemporary dental practice and is particularly useful in unique restorative situations that allow conservation of tooth structure. This case report describes the restoration of a central incisor that was previously restored with an unesthetic three-quarter gold crown. The tooth exhibited recurrent caries and an unaffected labial wall of supported enamel. A CAD/CAM three-quarter crown was planned to conserve tooth structure. After preparation, the tooth was scanned for a CAD/CAM crown in order to fabricate a ceramic restoration, which was then milled and bonded, producing an esthetic result. Typically, in cases of esthetic enhancement, a labial laminate restoration is fabricated, but in this situation, a different approach was necessary to make a design for the lingual surface of an anterior tooth.

A resin acrylic and plaster solder index technique is a simple, accurate, secure, and cost-effective way to intraorally realign an ill-fitting fixed partial denture framework. Once the fixed partial denture framework is sectioned and segments are found to fit, an intraoral index preserves the correct relationship among segments and holds castings together securely enough to avoid separating until they can be embedded in solder investment and soldered in the dental laboratory. This technique is described here, together with a literature review and a discussion of the technique's advantages relative to other indexing techniques and materials.