Handling Indirect Restorations

An Alternative Technique

Seating small indirect restorations like inlays, onlays and crowns can be challenging. Picking up the indirect restoration with your fingers can end up as a nightmare with the restoration potentially ending up on the floor or into the mouth or ingested. Either way, the restoration is contaminated and you are back to square one. Worse still there is potential for accidental aspiration and lodgement into the lungs.

Existing popular options are Optrasticks by Ivoclar Vivadent and using a microbrush with unfilled resin, old composite resin, sticky wax or liquid dam that you find with in-office bleaching. With these options I have occasionally found it difficult to remove from the restoration after seating. Care must be taken to avoid unfilled resin, composite or liquid dam from running onto the intaglio surface and interfering with the fit of the restoration.

An alternative technique for handling indirect restorations involves using a microbrush with periphery wax. I can already hear some people asking "What on earth is periphery wax?". Periphery wax is a soft wax that is used to extend the periphery of an impression tray (usually stock tray) in order to record the full extensions in an impression. Since moving towards an almost full digital practice I have an abundance of periphery wax in stock. I find it extremely easy to remove from the porcelain surface after seating without leaving a residue. This particular wax has sufficient stickines to adhere to inlays, onlays, crowns and veneers. It is particularly suited to irregular objects as the wax can mould to an uneven surface easily.

Another alternative instead of using a microbrush is using a flat plastic instrument. What I have found is that the blue periphery wax can often leave a residue on the flat plastic that can be annoying to clean off.

 

Protocol

1. Obtain microbrush. The microbrush can be of any size. The Superfine (Purple) size has the advantage of improve handling of the wax. Bend the microbrush at the necessary angle.

2. Mould a small bead of blue periphery wax on the microbrush tip. Check that it does not move easily. Shape the end like a bulb.

3. Prepare the intaglio surface of the indirect restoration and dry completely.

4. Press the microbrush wax end to the surface of the indirect restorations. Check for good adherence. There is nothing worse than when you go to seat the restoration that it falls onto the ground :/

5. Now the restoration can be carefully delivered in any number of directions to the tooth without dislodging it. After seating the restoration, detach the wax from the restoration by applying an instrument to hold down the restorations whilst removing the wax end. It can often be removed by simply twisting the microbrush.

6. Continue removing excess cement and finish and polish the restoration.

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