INCISAL ATTRITION-INCIPIENT: DEFINITION
Incipient incisal edge: defined as a restoration where the exposed dentin is smaller in diameter than a 330 bur.
INDICATIONS: See Indications for Incisal Treatment
TREATMENT PROTOCOL:
Treatment for these defects is identical to that for Conservative incisal edge with these exceptions:
- A fissurotomy carbide bur is used to prepare the tooth rather than a 330 carbide bur. There are two sizes of SS White Fissurotomy burs –NTF and STF and two shank lengths short and original. This Handbook recommends the original shape, STF with a full length shaft.The STF (Standard Taper Fine) bur keeps its sharpness well while the NTF (Narrow Taper Fine) bur dulls very rapidly and cuts slowly.The short shank is also too short to prepare molars.This same bur can be used to prepare Fissurotomy or PRR (Preventive Resin Restoration), simplifying inventory and enabling multiple applications for the same instrumentation.
- Some operators use other small burs such as 1/2, 31, or 329. These are rejected as problematic. All these inverted cone and round burs can potentially undermine enamel, and form sharp internal line angles which are difficult to adapt well to with resin and which generate stress, leading to premature fracture of the enamel rim.. The fissurotomy tapered round-ended bur design will generate good tactile feedback when enamel is encountered, and will produce round internal form and enamel walls of consistent width which will be esthetically consistent.
- Placement of heated resin requires the PICH Instrument to condense the resin to the base of the preparation; anything larger runs the risk of creating voids and bubbles. Once brought to the base of the preparation, larger instruments, particularly the HuFriendy 27/29, are needed. See Placement Instruments