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Medical Forum / General / Dentistry / February 2007

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Dental filling and enamel crack

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kingdowdenis@yahoo.com - 07 Feb 2007 09:46 GMT
Does dental drilling and filling cause crack lines on enamel?
Mark & Steven Bornfeld - 07 Feb 2007 14:35 GMT
> Does dental drilling and filling cause crack lines on enamel?

    This is a good question.  I've certainly heard things that suggest that
drilling can cause at least superficial cracking.  This is used by some
of the microabrasion and laser people to claim superiority, but I can't
say that they don't cause microfractures either.
    In any case, the majority of these microfractures don't seem to ever go
anywhere.  When teeth crack, it's almost always when a tooth has been
prepared (cut down) more than the remaining tooth structure can support.
 IOW, some of the rules for preparing teeth for fillings first codified
by G.V. Black well over 100 years ago still seem to be more important to
the integrity of the tooth and filling than how precisely the tooth is
prepared.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Newbie - 07 Feb 2007 15:12 GMT
>Does dental drilling and filling cause crack lines on enamel?

It can, but not with careful technic and good bur selection.
John & Ninetta - 07 Feb 2007 23:10 GMT
>>Does dental drilling and filling cause crack lines on enamel?
>
> It can, but not with careful technic and good bur selection.

Its funny, but in dental school, I must have used the same 556 bur (after
sterilizing, of course) for like 5 fillings.  How stupid was that!  I didn't
know any better.

J Suljak DDS
Alexander Vasserman DDS - 08 Feb 2007 09:16 GMT
> >>Does dental drilling and filling cause crack lines on enamel?
>
[quoted text clipped - 5 lines]
>
> J Suljak DDS

Well in dental school we had to buy our own burs at $2-$10/bur for a
student that got expensive, patient's paid the school but we were not
reimbursed for the burs. So we used the burs until they were dull or
broke. Only for an exam we would use a brand new bur. What else do you
expect from a poor student?
At the same time I have never seen a crack line develop from using a
dull bur. And diamond burs are different because diamonds don't dull
per say the diamond coating separates from the steel shank, or if the
diamond is used without water it burns to charcoal. So basically the
diamond takes layers down without creating crack lines. If something
breaks off as you are cutting it, usually it already had a crack and
was meant to break off anyway.
Newbie - 08 Feb 2007 17:30 GMT
>>>Does dental drilling and filling cause crack lines on enamel?
>>
[quoted text clipped - 5 lines]
>
>J Suljak DDS

They just didn't teach us any better and we were poor (not wealthy) students.

I quit using 556, 557, 1556, and 1558 burs when I noticed micro-fracturing
shortly after using 2.5X magnification.

Now routinely use 331 and 331L for most preps, yep even for endo access.
Tried 245's for a while, didn't really like them,  but they didn't cause micro-fractures.

A fresh bur always cuts better ;-)
Alexander Vasserman DDS - 09 Feb 2007 10:21 GMT
> >>>Does dental drilling and filling cause crack lines on enamel?
>
[quoted text clipped - 15 lines]
>
> A fresh bur always cuts better ;-)

I've been using "great white #2" (not the #2 round) for preps that
puppy cuts like butter.
Newbie - 09 Feb 2007 16:09 GMT
>> >>>Does dental drilling and filling cause crack lines on enamel?
>>
[quoted text clipped - 18 lines]
>I've been using "great white #2" (not the #2 round) for preps that
>puppy cuts like butter.

Thanks, will give it a try.
Dartos - 07 Feb 2007 15:55 GMT
It can.

The type of bur, speed, water spray, aggressiveness of use, thickness
of enamel, etc. all have a part in this.

One real advantage of lasers over a handpiece (lots of the rest of the
hype is just hype <g>).

D

> Does dental drilling and filling cause crack lines on enamel?
 
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