Efficient, Effective, and Durable Disposable Diamond Burs
A graduate of the New York University College of General Dentistry, Dr. Andrew Mogelof is a Fellow of the Academy of General Dentistry and a member of many other professional dental organizations. He is chief of dentistry at the Lord Chamberlain Skilled Nursing Facility in Stratford, CT; a Mentor at The Kois Center in Seattle, WA; Certified Dental Consultant; Certified Fraud Examiner; and Chairman of Peer Review in his region. He maintains a private practice in Stratford, CT where he uses the newest technology and state-of-theart equipment to provide the best possible care to his patients
An 83-year-old patient presented with a fractured upper left first premolar. Digital x-rays were taken with a Gendex sensor, which revealed decay on the distal aspect of the tooth at the level of the nerve. The patient was injected with 1 carpule of Septocaine and epinephrine 1:100,000 anesthetic (Septodont) to prepare for removing the decay.
A pear-shaped 830-012M (Figure 1) disposable diamond bur (Patterson Dental) easily removed the previous amalgam, and all decay was excavated to determine the predictability of treatment. Although the decay was subgingival, the tooth was still restorable. After discussing the clinical status of the tooth with the patient and explaining the treatment options of either extraction or endodontics, possible crown lengthening, or post and core and crown, she elected to maintain the tooth.
The tooth was prepared using a chamfer diamond 856-016C (Figure 2, Patterson Dental) and an 811-037C (Figure 3) occlusal reduction diamond (Patterson Dental). A provisional crown was fabricated using Jet provisional crown and bridge acrylic (Lang Dental) and then cemented with Temp-Bond (Kerr).
Final Restoration
The patient was referred to an endodontist and, after successful endo treatment, the patient returned for continuation of the restoration. All unsupported and decayed tooth structure was removed, and 2 ParaPosts (Coltene) were placed in the buccal and palatal canals using CLEARFIL SE BOND (Kuraray), RelyX Unicem Self-Adhesive Universal Resin Cement (3M), and CLEARFIL PHOTO CORE (Kuraray). I used the same Patterson 856-016C diamond bur (Figure 2) to re-prepare the tooth, and the Patterson 811-037C diamond bur (Figure 3) was very efficient for occlusal reduction.
At the time of the final crown try-in, adjustment of the occlusion was completed using a football-shaped 368-023F (Patterson Dental) diamond bur with a fine grit (Figures 4 & 5), which provided a smooth surface, and the final polish was easy to attain. The 368-023F diamond also can be used for adjusting composite restorations because it does not gouge the restorative surface. The patient was very satisfied with her final restoration and commented that it feels just like her other teeth.
Conclusion
During these procedures I used a variety of Patterson disposable diamond burs, which are conveniently packaged individually. Each package is clearly labeled with the information that describes the bur, which makes for easy reordering. The grit was uniformly and evenly applied to each bur, and each diamond was color-coded by grit for easy identification. All the burs cut well initially and then, depending on the substrate that was being cut for removal, the tip of the bur lost its grit, which is to be expected. None of the diamonds became clogged or broke during use. Overall, the Patterson disposable diamonds are effective, efficient, and durable burs for restorative dentistry.
