The next patient had large gingival embrasures and some attachment loss and was unable to finance veneers or crowns. For this patient bonding was a viable option which he preferred since it required minimal amounts of tooth reduction.

No anesthesia was required. A round bur was used to remove an oxidative layer on the tooth and a small amount of plaque and calculus. The area was etched and then bonded.

The finishing touch was a small amount of polishing. The patient was satisfied with the final result and may consider returning for additional bonding procedures in the future. Patient was advised to keep the area clean and OHI was given.

H.A., New York University College of Dentistry, Patient 2

Female patient presents to the dental office for bonding of upper anterior teeth (#8 and #9) and prepping of #21 and #23 for a Maryland bridge. Prepped #21 and #23 with cingulum rests using an inverted cone bur. At first a chamfer bur was used but it was not sharp enough and did not have rests that were well defined. I thus determined that a sharp inverted cone bur would be better. I then took a 3 way impression of the lower arch for the Maryland bridge and the preps came out very well defined. I also took a bite registration using yellow PVS.

We examined the lower RPD with the lab tech to determine if we could easily reline or rebase the RPD for a better fit, as well as add teeth onto it in the areas of #28 and #29. Lab tech said it would be easier to just make a new RPD so we took alginate impressions of the upper and lower arch.

I started the bonding of #8 and #9 using 1 step etch and bond and A1 composite. The shade looked nice on the natural tooth structure. The contact area was somewhat thick so as I pulled floss through at the end some of the tooth bonding chipped and will be fixed during the next visit.

N.S., New York University College of Dentistry, Patient 1 – part 5