Category Archives: Sophomore Year

Balancing Dental School and a Family

Posted on April 22, 2009 by CheerioKing| Leave a comment

Over the course of this website’s history I have recieved several emails asking how I balance dental school and a family.  While I am no professional in the subject, I have been married for six years and have half as many kids, so my opinion and experiance will have to do.  I encourage any comments on this subject as well.

Dental School is just a step in life.  It ends.  It lasts for four years and then life moves on.  Your family on the other hand stays with you – or at least it should.  The first thing to do is to prioritize.  Family comes first.  This is up to interpretation of course.  During finals week my family might have dropped a few notches on the priority totem pole.  I have come up with a few items that have helped keep my family happy – most of the time.

  1. Time.  Your family needs a daily dose of time.  There is always 24 hours in one day.  Subtract the time spent at school, the needed study time, dinner time, etc. and use the leftover time to spend with your wife and kids.  Sometimes you won’t have any time at all.  During my second year I remember leaving early for school, coming home, eating, putting the kids to bed, talking to my wife for 10-15 minutes and studying until bedtime.  This was common during the first two years but was remedied by a simple thing seen in #2.
  2. Date Night.  My classmate (who helped write this article) who also has a family likes the following saying, “It is better to spend money on date night during dental school than to spend money on marriage counseling after dental school.”  If you go a week and have only spent 15-30 minutes a day with your family than a date night is a good time to relax and have fun.  My uncle went through dental school with a family and his motto was to study hard on weekdays and have fun on the weekends.  Date nights on a budget usually consist of going out to dinner, a movie, renting a movie, hanging out with friends, going into the city, playing rockband together, etc.  You don’t have to go all out each time, it is the quality of time spent together.  Find other families in your area and do a swap.  Each week one family takes all the kids for THREE hours while the other families go out.  Each week rotates between familes.  That means that if you get 4 families to participate you get to go out for three weeks in a row and babysit on the fourth week.  The babysitting part isn’t so bad because all the kids entertain each other.
  3. When you are spending time with your family are you there in mind or just body?  Sometimes when it was close to finals I would find myself hanging out with my family, but my mind was elsewhere.  I would be half listening to my boys or my wife – or sometimes not be listening at all.  When you are hanging out, take a deep breath, relax, and hang out.  Then get back to your studies or lab work, etc.
  4. Help out around the house.  My wife stays at home with our kids and her routine is pretty much the same.  Chores don’t change that much and don’t get more or less exciting.  If you come home after along day and you see a pile of laundry on the couch or the garbage is overflowing…take a minute to help out.  It only takes about ten minutes to do a few chores and your spouse will appreciate it whether they say so or not.  It is the small things that help a relationship.
  5. Communicate.  This is done daily and is self explanatory.  Dental school is stressful for everyone.  Your spouse wants to spend time with you, your kids miss you, and you miss your family.  I won’t get too mushy here, but express gratitude, tell each other you miss them during the day.  More communication can be done during date night.
  6. Marry an understanding person.  My wife is a strong women.  In fact she ran 3 or 4 eight-minute miles almost everyday up until about 6-7 months into her third pregnancy.  I can’t drive three mile without breaking a sweat.  She is very understanding and has made many sacrifices so I could pursue my studies.  Make sure to be understanding of your spouses sacrifices and spouses make sure you realize the sacrifices your spouse is making while in dental school.

None of this information is profound in anyway.  This is a little of what we have done in dental school.  A lot of this is different depending on the family dynamic and the relationships and personalities of each member.  Not all my time is spent with either school or family which makes prioritizing difficult.  I am a member of several clubs at school and am a scoutmaster for my church and I am looking at pursuing more education after dental school.  LIFE WILL ALWAYS BE BUSY.  Dental school is just one chapter in the whole scheme and it is very possible to get through dental school with a family.  Remember: Roughly 4,500 new dentists graduate each year, a decent percentage of them are married with kids and if they can do it, so can you.  I hope this helps and feel free to comment or ask specific questions and I will do my best to answer them.

colin, brannon, evrett

colin, brannon, evrett

→ Leave a comment

Posted in Fun, General Info, Sophomore Year

Tagged ,

Survivor – Second Year Dental Students!

Posted on April 21, 2008 by CheerioKing| Leave a comment

You don’t know what relief is until you have experienced one of two things: Hemorrhoid relief by Preparation H or finishing and passing second year of dental school. I think it is a coincidence that they both deal with either end of the gastrointestinal tract. I would also venture to say that dental school is worse because it can cause the former to flare up and there is no cream to soothe the pain and anguish that second year shovels at you. I can tell you that I have never sat so much in my entire life. I have also never missed weekends that much either. This last weekend was the first one our class could really enjoy without any pressing exams or projects due and it felt REALLY good. For those of you still facing the ‘beast’, just press forward. Study for everything and make sure you have enough time to study for everything. The hard classes this year were: Well, all of them. I still can’t technically say that I have passed second year. Not all of our final grades have been posted – knock on wood! Here is a small breakdown of the classes:

Pharmacology: The first test was a basic intro to a few drugs, some systemic overview of drug mechanisms, ie, receptors where the drug acts, what are the effects (alpha receptors, beta receptors, nicotinic, sympathetic effects, parasympathetic effects, etc.) and some basic drug information (volume of distribution, 1/2 life, clearance). There were also some drugs and their uses and effects. This test was fairly easy and many questions came from the backtests. The second test was the hardest by far. It seemed simple enough. Learn a drug name and it’s mechanism, indications, contraindications and side effects among other random facts. Start on this one early and find a system that works well for you. I choked a bit on this test which hurt my final grade. The final was also difficult, but easier than test two. The hard thing to overcome with this test is the intimidation factor. Just make sure you keep organized in the semester and it will be easier to study for. Many questions came from back tests. Book: NO
Pedodontics: Read the book. READ THE BOOK. If they say it in class it is fair game. I would either record the lecture or write down everything they say and study that well. Random trivia and facts is the key. I did learn a lot from this class – I only figured out that i learned a lot though after I assisted in the pedo clinic today. No I do not want to be a pedodontist – but it does look very fun to work in the pedo clinic. Playing mind games with kids to keep them happy seems like fun. Book: YES
Endodontics: Overall this class was very confusing at first. The lectures are confusing, there is tons of reading, and at times it will seem hopeless. Just learn a few simple tricks and it will become easier. I will go over these tricks later if I have time. Otherwise, give me ten bucks for my notes. :) Endo: YES
Perio: What can I say. it’s perio…If you don’t know what the PDL is by now – well, you’ll learn about it all over again. Book: NO
Anesthesia: Learn all about nitrous and injections. Then stick your neighbor with a needle. This was a fun class. Book: YES to BOTH
Radiology: This class was laid back. The lab was fun. We got to work on plastic dummies with fake teeth in the mouth. Book: NO
Oral Pathology: One of our most interesting classes. We learned about an oral condition and then were shown a gross picture of said condition. There is nothing like 12 x 12 projected images of hairy tongue or Stevens-Johnson syndrome to help you wash down your morning bagel and cream cheese. The tests are straight forward – the challenge is to organize your brain well enough to cram all the material into it while learning all the other classes. I wish we could spend more time in this class. Book: YES
Restorative IV: Dentures. Although this class is continuing on into the summer it also has been challenging. Impression after impression, stone model after stone model. I have to finish my denture tomorrow so it can be processed by the lab. Book: YES
I should have more time now to actually update this site more often. Although my schedule still looks busy, it isn’t as bad as second year. Now I have to go study for our 5th denture quiz on Wednesday…I won’t miss these…

→ Leave a comment

Posted in Sophomore Year

Tagged , , ,

Complete Dentures, Restorative Dentistry IV

Posted on March 31, 2008 by CheerioKing| Leave a comment

Not only is this class a beast, the quizzes are very hard to study for and perform well on. We have a quiz in a couple of days on anatomical locations in the mouth. I have attached a couple of sheets you can download and look at if you wish to see what a general quiz looks like for this class. Note that this does not include the book reading or the rest of the notes. Most of this table is from one lecture. It is mainly a review of anatomy. What makes the quizzes so hard is that you can’t get partial credit. It is basically word for word from the notes or you are toast. Getting -5 points here and a -10 points there can do a number on your quiz score. It gets worse when there is a big -30 for one of the questions along with some other marks. We have 6 quizzes total, each worth 5% of your grade. Complete Dentures Quiz

A sample question could be something like:

  1. Name the importance of the retromylohyoid space in relation to a complete denture.

For full credit you would have to write out the following:

The space is in the alveolingual surface and is bordered on 5 sides by: Anteriorally the mylohyoid ridge and lingual tuberosity. Medially by the anterior tonsillar pillar when the tongue is in a relaxed position. Laterally by the mandible and the pterygomandibular raphe. Posteriorally by the retromylohyoid curtain (superior constrictor muscle). Inferiorally by the alveolingual sulcus and mylohyoid muscle. This space is essential for the retention and stability of the complet denture.

Add 50-80 more facts into this ‘quiz’ and you are guaranteed to be busy for a while. What I have found to be helpful is to make charts like the one included in this post. Some other ideas that are useful are to make a chart but keep everything blank, an idea I got from a study budy of mine. The you can make a bunch of copies of this blank chart and either fill in the blanks from memory or make charts from your notes. It might be faster than typing them out. Another good program I have been using is called ‘Genius‘ for the Mac. It is essentially a free flashcard program where you enter in all the information, click on ‘Learn’ or ‘Review’ and it will test your knowledge of the material. You can put in fake questions, definitions, etc. to test yourself and learn the vast amounts of information required of you in dental school.

There might be other programs out there that you like better and I know there are ones that are Windows based. Do a google search for ‘free flashcard program’ etc. to find one that you like. The program I use keeps track of right and wrong answers and will requiz you on the ones you miss more often.

We have one quiz this week and then finals start next week and go for two weeks. We will have Periodontology, Pharmacology (yuck), Radiology, Endodontics, Pedodontics lecture, Pedodontics lab, Oral Pathology, and Anesthesiology. All of them are comprehensive except for Periodontology. Also in the week we will have some more lectures, an Endo take home practical (access and obturate a molar), another endo practical (access and obturate plastic teeth – as done in the NERB exam – great for someone like me who is going to take the Western Regional Boards…). So it will be busy to say the least but three more weeks and the hardest didactic year is over with. After that it is getting ready for NBDE Part I, transitioning into the clinics, and taking some more classes.

Pictures to come, along with more class reviews, and my methods for studying for the boards (fee free to share your ideas as well). In the meantime please feel free to comment on your finals for any of your classes. Writing things down is therapuetic.

→ Leave a comment

Posted in Anatomy, Restorative Dentistry, Sophomore Year

Tagged , , ,

Eva Grayzel: Oral Cancer Survivor

Posted on February 23, 2008 by CheerioKing| Leave a comment

One of our many classes during the brutal second semester of second year is oral pathology. Oral pathology is the class in dental school where you learn about everything that can go wrong in the mouth from pizza burns to much more serious diseases. The textbook we use is Oral & Maxillofacial Pathology, 2nd edition, by Neville, published by Saunders. If you are interested in some good bedtime stories then you can pick up a copy from amazon.

One of the obvious things we learn about is oral cancer. Some fun facts about oral cancer:

  • Oral cancer accounts for less than 3% of all cancers in the U.S.
  • BUT: Oral cancer is the 6th most common cancer in males and 12th most common in the ladies (in the US)
  • In other countries, like India for example it is the MOST common cancer.
  • ~94% of all oral malignancies are squamous cell carcinoma (SCC)
  • ~34,000 new cases are diagnosed each year and ~8,000 Americans die of this disease each year and out of those 34,000 diagnosed only 50% of them will still be alive in 5 years.
  • The majority of oral cancers come from three sources: tobacco use, alcohol use and the human papilloma virus (HPV 16).

The appearance of SCC can be seen at some of the following sites:

University of Iowa Oral Pathology

Oralpath.com

VCU Oral Pathology

UCSF Oral Pathology

Most often oral SCC presents on the lateral border of the tongue in smokers and the prevalence increases with age. Black males are affected most followed by white males. Which makes this article very interesting.

In class this past week we had the opportunity to put away our notes, sit back, and listen to Eva Grayzel, who is a Stage IV oral cancer survivor. She was also diagnosed at age 33. This does not fit the normal stereotype of male smoker in their 60′s. Her story was inspirational and helped me and most of my classmates to put into perspective the importance of being a health care provider. Eva had showed the lesion to two dentists and two oral surgeons over the period of 9 months and no one ever thought anything of it. Maybe it was because she did not fit the stereotype of oral cancer, maybe it was because her biopsies were given to a general pathologist and not an oral pathologist, who knows. She went undiagnosed for almost a year before it became so bad that it had become stage IV, which has a mortality rate of 50% or less, one of the lowest five-year survival rates among the major types of cancer, including breast, skin, testis, prostate, uterus, and urinary bladder cancers. In school I have been found getting caught up in facts and statistics and numbers, simply because this is what we are supposed to learn. For a test we are supposed to know that most oral cancers occur in black males who smoke and are in their 60′s. Otherwise we get the answer wrong. We get caught up in this information and listening to Eva helped me realize better how important it is to be a good clinician and to look at the patient as a person, not a number or a dollar sign.

One of Eva’s points was that every patient that comes through your office should be screened for oral cancer. It only takes a few minutes and your patient will appreciate the free screening. In our generation of dentists it is important to be able to provide not only oral health but total body health as it relates to the head and neck region. We don’t necessarily have to treat or diagnose the health problem, but we should be aware of what is not normal and take the proper precautions (like referring to a physician or oral surgeon, etc.). So what are Eva’s steps for a proper oral screening?

It gets a bit risque, but here goes:

SEXtet screening: Six Steps to a Thorough Oral Cancer Screening

  1. Neck Caress
  2. Lip & Cheek Roll
  3. Palate Tickle
  4. Double Digit Probe
  5. Tongue ‘n Gauze
  6. Tonsil Ahhhhhh

For more information you can visit www.sextetscreening.org

Eva also has her own website and travels nationally to speak to groups about oral cancer. The take home message from the lecture we received, and one that we should all remember is that oral cancer IS VERY CURABLE WITH EARLY DETECTION. This means to catch the lesion in a pre-cancerous state, like dysplasia. Anything abnormal on the tongue or oral mucosa could easily be biopsied with a small brush (there are brush biopsy kits available) and sent to your local oral pathologist. If you are a student, then commit to the simple 6 step test (there are also other tests endorsed by the ADA – I’ve seen them in JADA) and if you’re a current dentist and don’t offer this service than please seriously consider offering it. Don’t let one of you patients go through what Eva had to. Treat your patient as a human first and the money will follow, but I guarantee that your patients health will be more valuable.

→ Leave a comment

Posted in General Info, Practice Management, Resources, Sophomore Year

Tagged , , , , ,

Orthodontic Notes and Pictures of Appliances: Helical Spring & Double T-Loop Appliance

Posted on January 25, 2008 by CheerioKing| Leave a comment

I have written a lot about what we do in dental school. I have a feeling that many people still don’t know what we DO in dental school though. Sure my pictures show that I pull out a handpiece every once in a while, drill a tooth, take some impressions, go home, eat some food and end my day all cozied up next to a fire with Neville’s 2nd Edition of Oral & Maxillofacial Pathology. Many of you may be wondering if there is more to dental school besides falling asleep while reading about denture stomatitis. Well…there isn’t! I do have a treat for you today though. I am going to rewrite my notes for Orthodontics II in the next paragraph. Hopefully you can then see from another perspective (my notes) what we learn about. I should do this more as most of my notes need rewriting to begin with.

I am also writing this with another purpose. I have a test next week…(well two tests and a quiz) and I am tired of reading my pharmacology notes. I am also not tired. Here goes (pictures included):

Jan 16, 08 ORTHO

Adjunctive orthodontics – type of ortho performed as adjunct to other forms of dentistry.

  • does not give ideal class I occlusion
  • prepares restorative dentist to take over (to complete restorative care)

Functional Classification – as designed by Morton Amsterdam

  • Physiologic occlusion – type of occlusion that will satisfy all the needs of stomatognathic system and will not destroy itself while functioning
  • Pathologic occlusion – kind of occlusion that is in the process of destroying itself while functioning
  • excessive wear/tear of teeth
  • abfraction – enamel chipping class V area
  • TMJ dysfunction
  • pulpal reactions – hyperemia < -> pulpal inflammation
  • periodontal damage
  • Therapeutic occlusion – occlusion given to patient by the dentist, not ideal, but free from pathology

    • Various problems that can arise:

    Posterior bite collapse: (I had a sweet picture drawn in my notes, but for the sake of time I will describe what is happening). Imagine a lateral view of the posterior teeth. They are in proper occlusion. Lets say that a lower 1st molar is extracted because it was bombed out and full of caries. Over time the adjacent teeth that were surrounding this extracted tooth will start to drift. The adjacent molar and premolar will exhibit mesial and distal drift respectively and the opposing teeth will start to extrude into the empty space. This will ultimately lead to various problems including occlusal trauma, food impaction, and loss of posterior support. The last one is the most important because loss of posterior support will lead to the upper anterior teeth flaring out. If my memory serves me correctly (correct me if I am wrong Dr. John – a faithful reader doing an ortho residency) the flaring out of the upper anteriors will in time cause the crowns of the lower anterior teeth to drift lingually. This is called loss of vertical dimension.

    Another problem with a mesially drifting molar is that it will cause a bony defect in the mesial bone as it ‘drifts’ (really a tilting direction) forward. Again a picture is worth a thousand words, and while I do write and talk a lot I will save you the boredom and just tell you that a bony defect will occur. This leads to the sub-lethal condition known as gum disease and periodontitis.

    These problems can occur with the loss of only one tooth. So how would a dentist treat this problem? Some will say to refer it out and stick to bread and butter C&B! Not a superdentist! Just kidding. Here at temple we are taught a couple of things. I digress though…back to the notes:

    Ortho is a good treatment for intrabony defects. Some general rules are to always move tooth away from bony defect. Bone will reform as long as stable cementum is present. Some problems with uprighting a molar is that the movement will decrease the overbite and could create an open bite. Again no picture…but think critically. A tooth was extracted. Some teeth drifted into its abandoned post and some teeth extruded into the area. The teeth that drifted are now going to be uprighted and they will bump into the tooth that extruded into the area. The mouth will not be able to enter into centric occlusion and an open bit will result. There are a couple of ways to remedy this minor setback. You could crown opposing teeth. This is extreme if the teeth are healthy. The next two solutions are the best option:

    If the tooth is a terminal tooth you will not be able to push it back into bone (I forgot the term here…it IS almost 1am, so sorry)

    OR

    You could keep the crown the same height and tilt the roots forward and then move the tooth into place with lateral movement.

    Once the treatment is complete the space is just like the day when the tooth was extracted and the dentist can then place his restoration or implant or do whatever it is they do to make 1000 bucks.

    The next section of our notes was really short and the topic was tooth extrusion for endodontic therapy. A couple of blogs ago I wrote about our cast post and core projects for RDIII. This is the same idea. A tooth breaks off at the gingiva and there is not enough crown left for an ideal crown prep. You could do two things: Crown lengthening or tooth root extrusion. The latter choice is the best because it is more favorable to the crown:root ratio. Draw it out on paper, it works, I swear! My grandpa has this appliance in his mouth as of last Christmas. It is most likely out by now as the process only takes a few weeks.

    CIMG9358

    Here are some appliances we have made at Temple. The first is the helical spring and the second is a double T-Loop appliance. Enjoy the pictures.

    helical spring lateral view

    The spring engages the wire on the premolars and canine can unhook. It is mad tight! The picture below is an occlusal view. Notice how the wire follows the contour of the occlusion and has a slight curve to it.

    helical spring occlusal view

    The next pictures are of the double T-loop:

    double T-loop appliance

    The wires may not look parallel. This is because the wires are engaged and there is a considerable amount of force on the teeth right now making the wires look a little warped.

    double t loop appliance

    Here is the full mouth:

    orthodontics

    I hope you enjoyed todays segment. Remember that ortho is one of our easier classes so the amount of information given in one day in this class is a drop in the bucket compared to pharm. We had one page of easy notes for ortho…a good example for pharmacology is about 12-30!

    → Leave a comment

    Posted in General Info, Orthodontics, Sophomore Year

    Tagged , , , , , ,

    Second Semester, Sophomore Year

    Posted on January 15, 2008 by CheerioKing| Leave a comment

    Orthodontics II + Lab
    Endodontics I + Lab
    Periodontology II (our third one)
    Oral Pathology
    Pharmacology
    Pediatric Dentistry + Lab
    Oral Radiology + Lab
    Restorative Dentistry IV (removable) + Lab
    Anesthesia & Pain Control (mine or the patients?!?) + Lab

    I have never had to read so much in my entire life. I bet I will read more in this semester than I ever did in four years of college. Some of our Pharmacology notes for one day are 1/4 inch thick packet. It isn’t your run of the mill easy science class either. It is down and dirty tread water or die material! Some of our classes are fill in the blank, short answer which makes you have to really memorize the terms and know what is going on. I must admit though that as cool as you think I am for making this website, I am truly a nerd at heart, just like anyone else in dental school, and enjoy it. There, I said it. ‘I like to wipe with sandpaper’.

    We have more gaps in our schedule because of different lab times (ie. we have a block scheduled out for oral radiology but do not go every week as different groups rotate through and practice taking radiographs, same for anesthesia lab) so there is a little more time to study. It is much needed. Our restorative class has about 3-4 chapters per quiz, along with a lab manual reading, class lecture packet, and a list of definitions per quiz that is 3 pages long, all of which must be known by heart for the short answer quizzes.

    This is not to scare nor am I whining, dental school has been one of the most interesting learning experiences thus far in my short life (turned 28 years old on Jan. 10th – yes, PayPal me birthday money if you want, this site comes out of my own pocket) and I my fascination for dentistry has only grown. It propels me forward through the chapters and pages of notes that are piling up around my head. Since time is limited and sleep is rare I will keep this short and end it with some pictures that help motivate me to continue forward!

    Snowboarding is a favorite pastime, this is in blizzard conditions and my cowboy mustache (I was in Wyoming!) was a little frost bitten:
    Teton Village Snowboarding

    Take the ‘COOOL BUS’ wherever you go:
    Coool bus

    Wear warm clothes:
    CIMG9538

    Tetons:
    Tetons from Cabin

    Move out of Killadelphia before your kid becomes a thug:

    philly thug

    → Leave a comment

    Posted in Classes, General Info, Sophomore Year

    Tagged , , , ,

    Porcelain Crown

    Posted on January 2, 2008 by CheerioKing| Leave a comment

    One of the big projects we had this year was to make a porcelain crown from start to finish. We restored tooth #12, a maxillary 1st premolar. This was a tedious process that we had to work on during our own time during the lab.  Some of the steps were required to be completed by a certain deadline during the semester. The second semester of year two required more time management skills especially in lab where there were up to 4 or 5 projects that were going on at the same time. Other projects we had in our restorative class were our root canal projects and our daily work of crown preparations, along with our onlay.

    To start our porcelain crown we took an impression of the mouth. This was to provide for an over-impression for a temporary crown and for models for the articulator. We also made models after the tooth preparation to mount on the articulator for the wax up of the coping. The coping is the metal base that the porcelain is applied to. I have written a little about the project in this article.

    Here are the steps done to this point:

    1. Tooth prepped
    2. Models are mounted
    3. Wax up is complete and coping has been cast

    Ready to apply porcelain! When you get your metal back from the lab you will have to clean it up a little. You have some pink stones in your kit called aluminum oxide stones that you use to give the metal a uniform finish and thickness. With the technique base metal we used we could allow a minimum thickness of 3mm. I had a couple of areas of metal that were 1.5 mm thick and were hyper. I used aluminum oxide stones and some diamond burs to decrease the thickness and get a uniform thickness. I also used these stones to clean up the shoulder to give the porcelain a 90 degree butt joint. When the coping had a uniform matte finish I cleaned it off and prepared it for porcelain application in three steps:

    1. Aluminum oxide air abrasion
    2. Ultrasonic cleaning for ten minutes
    3. De-gas in oven at extreme temperatures (start at 1200 degrees F and remove coping at 1800 degrees F)

    When the coping has been de-gassed (this process removes H2 gas) and cooled you can now start to apply the porcelain. For the type of porcelain we used we were supposed to apply everything in TWO steps. The first step is the opaque layer. This layer is an opaque colored porcelain that hides the metal colored coping underneath. I have some pictures below of the opaque layer when it is applied:

    porcelain on sagger tray

    porcelain on sagger tray

    After the opaque layer is applied a coat of ‘dentin’ porcelain is applied. The porcelain comes in a powder which is mixed with liquid or distilled water and then painted on the tooth. You get the proper shape with a brush and a skilled hand and then you dry up the excess water with a small vibration and a paper towel. This sucks up all the extra water and the porcelain powder remains in place where you left it. It is much easier said than done. Here is some of the powder and liquid. I like the pink and baby blue colors:

    porcelain powder and liquid

    I think I spent a couple of hours with the second layer of porcelain trying to get it right. After this coat is applied you actually use a sharp scalpel to cut away some of the facial porcelain to add an enamel layer. The enamel layer is more ‘see through’ than the dentin layer to add the desired effect of a natural looking tooth. Here are some photos of the firing process and the final product:

    inside porcelain oven

    porcelain oven

    porcelain crown

    The final product is then smoothed with diamond burs, occlusion is checked, margins are checked, and when every contour, contact, and detail is checked you place it in the oven for the final roast. This is called the glaze bake and results in porcelain with a smooth glassy finish. This is the final product and is cemented in the mouth and ready to function.

    → Leave a comment

    Posted in Porcelain, Restorative Dentistry, Sophomore Year

    Orthodontic Soldering

    Posted on November 24, 2007 by CheerioKing| Leave a comment

    The first step in this is to place the molar brackets on the child typodont and then take an alginate impression with the brackets on. Remove the impression when it has set and if the brackets did not get removed with the impression, take them off the typodont and place them into the alginate. Next, pour the stone so it includes the brackets. What you will get is a poured up stone model with the brackets included. The idea is to keep the brackets from moving (IMMOVABLE) while you solder the wire in place. The next step is to bend the wire so the curve fits the lingual aspect of the anterior teeth. You want a smooth curve that touches all the anterior teeth. The idea is that this is used as a retainer to keep teeth from moving. (I think – someone correct me if I am wrong) We did this project in the middle of midterms and my concentration was on other classes. I also only have a few photos of the project.

    After the wire is bent and placed you can hold in with some plaster.

    plaster holding orthodontic appliance for soldering

    When everything is straight and aligned you can now solder. Use flux and make sure everything is clean. You can use a torch or a bunsen burner for the joint. Make sure your wire is closer to the bracket than my picture depicts. I took this before any adjustments were made to the wire. You want it nice and close so the solder flows between the bracket and wire. I only have pictures of this and not the final product. So sorry. Maybe someone else can post pictures of their solder joints?

    orthodontic soldering

    When you are done it should fit onto the junior typodont without any hassles. Make sure to polish the solder joint and make everything shiny before turning it in.

    → Leave a comment

    Posted in Orthodontics, Sophomore Year

    Great Looking 3-Unit Provisional – Not Mine

    Posted on November 22, 2007 by CheerioKing| Leave a comment

    I almost put this under the title “Tricks of the Trade – Alginate Over Impression.”  Every once in a while you see some work that brings a tear to your eye. A couple of weeks ago one such occasion occurred. My good friend from undergraduate and I are in the same class and we are next to each other in the alphabetical list so he also sits next to me in pre-clinic. He made the most beautiful 3-unit bridge. This unit, as seen in the picture, replaces teeth 9 (left central incisor abutment), 10 (missing left lateral pontic), and 11 (1st premolar abutment). We prepared the teeth in a previous practical and then the next week we had a practical to make this provisional.

    The method was quite simple. An alginate impression was taken before the practical and kept moist while the teeth had Vaseline smeared on them and the jet acrylic was mixed. The alginate impression was used for the over impression. Acrylic was placed inside the impression and placed back onto the prepared teeth. I like to use alginate as an overimpression because:

    1. It is inexpensive (compare to mach slo, etc) and you save yourself quite a bit of money.
    2. The alginate impression is moist and allows the acrylic to set up a little quicker. Jet takes a while and during a practical, time is ‘money’.
    3. It is quick (see #2)
    4. Alginate is accurate. It gives great results as you can see in the following pictures.

    I asked my friend how in the world he came up with great results (we used the same method), and he told me, “Sometimes things just fall into place.” How true is that. Without further boring you with more words, lets see the pictures:

    three unti bridge practical

    anterior temporary bridge practical

    three unit dental bridge practical

    For a DETAILED view, you must click on the picture. It enlarges it. Everything is perfect in this bridge. That’s what I call falling into place! Good job Class of 2010!

    → Leave a comment

    Posted in Restorative Dentistry, Sophomore Year, Tricks of the Trade

    Tricks of the Trade: Removing Articulating Paper Stains from Ivorine Teeth

    Posted on November 18, 2007 by CheerioKing| Leave a comment

    We learned early in our first semester that turning in a dirty typodont after a practical might receive a check. The grading forms don’t have a section under cleanliness so no one really thought to clean the mouth. Some people got their grading form back, freshly revised & edited, with a ‘written in’ requirement and a check next to the mysterious appearing mandate. Ever wonder why dentists are anal retentive sometimes? I think it goes back to our training. 1mm is VERY different than 2mm and in the case of this article: Shinier is better! As doe-eyed D1 students we learned quickly to clean our typodonts of all dust, wax and stains.

    Yet it has taken me quite some time to figure out the best way to clean off that red/blue stain of articulating paper from ivorine teeth. We equilibrate our typodonts periodically to make sure that there is no rock in the occlusion, that every supporting cusp fits snugly into the opposing arch’s central groove, and that there are no lateral interferences. This leaves our teeth just rough enough to get a little bit of this articulating paper color stuck into small micro grooves and it discolors the teeth.

    robinson bristle brush dentistThe solution: Robinson Bristle Brush followed by some rubbing alcohol. In the past I would just use rubbing alcohol, but it wouldn’t get in the grooves. The Robinson brush does the trick. Make sure you use it on a lower speed without generating much heat. Hopefully this trick helps you tremendously. I found out about it two weeks ago and mentioned it to a classmate of mine tonight. After he tried it in the lab and he was thrilled. (Only a dental student would appreciate such a simple pleasure as clean ivorine) He hadn’t heard of this trick yet. For those of you who already knew about it and have been holding out on us, I have one question: “Whats the deal?”

    :)

    You can also brush up the typodont gingiva under the acraluster wheel. It brings back the shine and we all know: The shinier, the better!

    → Leave a comment

    Posted in Restorative Dentistry, Sophomore Year, Tricks of the Trade