Outline for: The 3-Day Conservative Indirect Restoration Program

Day 1 – Directed Discussion:
1. Orientation and outline of course.
2. What IS conservative restorative dentistry? Tooth structure versus long term success.
3. What are the choices for direct and indirect? Affordability reimagined.
4. Indirect restoration materials choices? Advantages and disadvantages.
5. Adhesion to dentin and enamel. Adhesion to restorative materials. Literature review.
6. Appropriate treatment planning for indirect restorations.
7. Preparation design principles for ceramics – cuspal coverage.
8. Preparation design principles for indirect composite – cuspal coverage.
9. Seeing what you need to see while doing preparation.

Day 1 – Lab exercises:
1. Demonstration of material-specific ceramic preparations on typodont teeth with prior restorations.
2. Executing “standard/ideal” inlay/onlay preparation on typodont teeth. One-on-one help with POV.
3. Demonstration of materials-specific ceramic preparations on typodont teeth with various problems that need to be solved.
4. Executing modified preparations on typodont teeth. Problem solving situations. One-on-one help with POV.

Day 2 – Directed Discussion:
1. Questions from Day 1.
2. Review of design principles and problem-solving for both ceramic and composite indirect restorations in various clinical situations.
3. Introduction to working with mounted natural teeth. Video of mounting methods.
4. Importance of use of rubber dam for isolation at impression stage and cementation stage. Developing 1 minute rubber dam methods.
5. CAD/CAM methods and blank selection based on desired esthetics. Literature review of research on marginal accuracy and fit.

Day 2 – Lab exercises:
1. Selection and mounting maxillary and mandibular natural teeth that need restoration.
2. Isolation of teeth. Treatment plan for specific selected teeth.
3. Executing inlay/onlay preparation for ceramic restoration of maxillary tooth. One-on-one help with POV.
4. Refinement of preparation with carbide burs.
5. Optical impression of prepared maxillary tooth.
6. Executing inlay/only preparation for composite restoration of mandibular tooth. One-on-one help with POV.
7. Optical impression of prepared mandibular tooth.
8. Evaluation of impressions/digital models.

Day 3 – Directed Discussion:
1. Questions from Day 2.
2. Review of impression methods and determination of success.
3. Digital refinement of impression.
4. Digital design of restoration.
5. Principles of block selection and milling both ceramic and composite restorative materials.
6. Discussion of specific materials and methods used for bonding both ceramic and composite restorations.

Day 3 – Lab exercises:
1. Demonstration of digital modifications to prep and restoration design.
2. Block selection for CAD/CAM fabrication of restoration.
3. Demonstration of milling and adjustment for ceramic inlay/onlay.
4. Demonstration of fit check for ceramic inlay/onlay.
5. Demonstration of cementation of ceramic inlay/onlay on prepared natural tooth in typodont.
6. Students digitally design restorations using digital model from Day 2.
7. Students mill COMPOSITE blank to final restoration.
8. Students check fit of composite inlay/onlay to prepared tooth in typodont.
9. Students cement composite inlay/onlay to prepared tooth in typodont.
10. One student will select blank and mill ceramic inlay/onlay for maxillary prepared tooth in typodont, check fit and cement using ceramic methods. As the milling time is longer, this will only be done with the most optimum preparation from the class. The milling will be done while all students check fit and cement composite restorations.