Hi Jeff: those are pretty strong words…..

I dont necessarily agree with all of them either.

THe restoration on the #20 does NOT presently involve the contact , so you are assuming that you need to remove the distal contact, who knows if it needs doing?

Secondly, if the contact is not involved then how are you going to get at the other one. Now granted you could think that you might want to take the restoration out on the #20 first and then see what happens and if you can get at the#19 to do it.

I dont like preparing an interproximal without protection for the adjacent tooth as for sure you will have scatter affect it, but I wouldnt go so far as your post. In addition there are alot of people out there showing that any generation after 4 th generation is a reduction in steps and in BOND STRENGTH as it degrades significantly after one year (one study suggested bond strength of some 6th and 7th generation bonds went down to 9MPa from a start of 27MPa). That is why some are advocating GI under resins to help with protection of composites from leakage.

Now finally I dont understand your last comment , was it necessary to place that in the post……..Extending a small amalgam into a MODB is an “extension for prevention” type of mentality isnt it? and who said that….

(wasnt it GV Black?)

Finally, we might also find that Mark restored it afterwards.

In closing I dont really have a problem with your post, I can see the value in looking at the other restoration and seeing if once it is removed that it might have decay extending into the contact and then remove that the conventional way, or with the Hoya Con Bios unique tips you could easily get access to it with a 400 micron tip.

I would have liked to have seen the interproximal protected and finally I would like to know how Mark diagnosed the caries in the first place (its such a small prep for radiographically diagnosed caries).

All the best, and my philosophy is to not throw rocks from glass houses……..

Its not your opinion that worried me as much even though I dont agree with some of it, as your last sentence that caused me some concern.

Glenn

Hi Guys,

Nice to have strong opinions here, huh?:cheesy:

In reference to the article that Ron posted…..

I understand and agree with Jeff’s post on accessing the distal decay on the pre-molar by first removing the amalgam and the decay on the mesial of the first molar, thus preserving more tooth structure on the occlusal of the Bi.  That’s what I would have done.

Jeff’s got a point about GI that’s got me thinking about it.  My understanding is that GI can leach FL 2mm beyond its margin, which might make it useful in decay prone areas (like the gingival box of a class II prep), or people.

Happy Easter/Passover All,

Bob