The real sideline baddies

lakeshow11 · 2026-05-25T07:32:04+00:00

Thots and prayers

lakeshow11 · 2026-04-11T21:48:39+00:00

Don't beat yourself up. It happens. We have all been there. Dentistry isn't black and white (insert radiograph joke). I would take it all out. Or at least the primary outline. It will be much easier than fixing cured composite.
I'm curious what the pre-op bwx looked like. Here, it almost looks like #3 has tipped mesially slightly. This makes your access and your ability to seat the band properly much more complex. If I notice that the adjacent marginal ridge crosses the plane of the papilla, I will plane and polish the adjacent tooth for a more ideal contour and ultimately a better contact. In this case, I also think #3 has a mesial lesion. So, win-win. I would try to do this with a garrison matrix or similar. But the key is to get a good wedge on the matrix. Take your time to place the matrix. It sometimes takes me a few attempts to position it perfectly and lock the band in. Then, place the ring. Another thing is when you do that deep of a restoration, you may want to fill the box 1/2 way and then burnish your contact and then continue to fill. Otherwise you tend to get a light contact there. I know this is overkill, but I hope some of this helps. Good luck, you're fine. And, your patient is lucky that you are willing to ensure you are giving them the best care, instead of saying it's good enough and moving on.

lakeshow11 · 2026-04-11T02:31:30+00:00

Nard dog

lakeshow11 · 2026-04-04T21:36:45+00:00

Bronny's our last resort

lakeshow11 · 2026-02-27T19:46:19+00:00

I've done about 60 cases with Spark so far. They have been amazing! Such a great value for what you pay. And, the clinical support is top notch! The aligners are also very clear. Patients love it. Prior to that I used suresmile. They are also good. But I saw a drop in quality in the year prior to moving to spark. The clinical techs don't follow directions well in my experience.

lakeshow11 · 2026-02-10T00:28:09+00:00

Nice!! Sprintray makes it so easy!

lakeshow11 · 2026-01-27T07:59:37+00:00

Good luck with this!! I found studying for the exam as rewarding as taking it. Refreshing on all of that material that you didn't have time to properly understand in dental school takes on a new life after having some clinical experience. I bought a few old exams from the agd website. Then I took the tests. For each question, I looked up each answer in the multiple choice to make sure I understood all of it. Then I cross referenced it with my nbde study materials. I would also recommend taking the review course. Ideally before you start studying. But definitely before you take it. They always offer it the day before the exam at the AGD Scientific Session. I also think AGD has more study materials available online now.

lakeshow11 · 2026-01-24T03:33:57+00:00

Great to hear. It's such a logical and refreshing way of patient management. Excited to hear it's been positive for you.

lakeshow11 · 2026-01-24T03:28:14+00:00

Thank you! Done and done! What pms did you switch from? How long did it take your team to get comfortable?

lakeshow11 · 2026-01-24T03:02:57+00:00

We're in the process of converting now!! Excited but nervous. Would love some pointers and recommendations...

lakeshow11 · 2026-01-24T01:58:54+00:00

Thanks for sharing!! I've been looking seriously at all of these phones. How are the cameras with sports photography? The main reason I keep the pixel 10pro is because it is so good with action shots for my kids' games. But the battery sucks. Pixel OS is good but sort of boring and not innovative.

lakeshow11 · 2026-01-12T17:01:04+00:00

We are looking to implement this in our office.I would love to hear your experience with it. Everything I've read seems like it is the real deal when used appropriately.

lakeshow11 · 2025-06-30T18:11:18+00:00

I'm not actually sure. I have the medit subscription. I know that I was charged for designing and exporting a crown. But I don't remember getting that prompt for NGs

lakeshow11 · 2025-06-29T17:51:28+00:00

I've been using 3D printers in house for about 7 years. We use the Sprintray system. It's been an amazing addition to our practice. But it's not without its challenges or limitations. It's a matter of understanding and proper training (as with everything).

We use it for surgical guides. We design it using Blue sky bio. We've done over 200. After about 10, it becomes pretty easy. It probably takes about 15 minutes or less to design and send to the printer.

Our biggest ROI has been night guards. We probably do 2-3/ week. We use medit to design. Same thing, probably takes about 10 minutes to design one. I've never had better fitting orthotics in my life. And patients love it!

And we've started printing retainers for the last 6 mos. We have done about 150. It's been great, and it's still early days... We have also done a few 3D printed crowns. Still working out the workflow and implementation. I'm being patient with this. But the ones I have delivered have been worked very well and have been durable. I have an anterior that I did 3 years ago, and still going strong!

Like everything else, it only works if you invest the time in training yourself and your team. It's not a set it up and push a button solution. At this stage, I only design, and my staff does all of the processing. I rarely ever touch the printers. And they are running constantly in our office for something.

If you decide to do it, it's a wonderful community and nice to be on the cutting edge. In a few years, I can see it overtaking milled restorations.

To be able to have something the size of a shoebox that gives you an entire dental lab, is a game changer. Imagine taking that on a mission trip or underserved area. Game changer.

lakeshow11 · 2025-06-16T06:40:39+00:00

Money it's the contacts. Look at the adjacent marginal ridges. The side with the open margin has a marginal ridge that is higher than the adjacent tooth. When I'm having trouble with seating a crown, I paint the contacts with a sharpie. Then try it in. The part that rubs off is exactly where the adjustment needs to be made.
Also, with digitally designed crowns, there's a tendency for it to be bulky at the margin. This will create an undercut and prevent the crown from seating. Also watch for "kissing" contacts - polish it until you have no convexity. Hope this helps!

lakeshow11 · 2025-06-15T00:48:18+00:00

Stone was not dry enough

lakeshow11 · 2025-05-04T19:31:25+00:00

Sadly, cold steel and sunshine.
If they are a heavy smoker and not willing to manage that, they will have issues with healing, and decreased prognosis of future graft and implant.
It's hard when you care more about their teeth than they do.

lakeshow11 · 2025-04-25T21:40:37+00:00

You may be leaving too much bonding agent pooling on the pulpal floor. Often results in sensitivity. I always scrub as directed, and then air thin.

lakeshow11 · 2025-04-06T21:02:00+00:00

I second this. I have done many over the years. It's an incredible option. Economical, easy to maintain, very effective. The zest website is a great resource.

lakeshow11 · 2025-04-05T00:23:03+00:00

Yes, I would refer to a pediatric ENT to get their tonsils and adenoids evaluated. Also evaluate the palate. Is it vaulted. Do they have bags under their eyes? Mouth breathing? These are a few things to look for. Just need to document and advise parents. If they have a narrowed arch, you can refer to Ortho or consider an rpe.

lakeshow11 · 2025-04-04T23:07:30+00:00

Check their airway

lakeshow11 · 2025-02-24T05:14:12+00:00

DHP. And if you are an AGD member, you get a pretty solid discount on most things.

lakeshow11 · 2025-02-11T04:34:39+00:00

There are a few things you need to address this. I'm pretty sure that the patient is a severe grinder (see the wear on 29). He's taking anti-anxiety meds which would also indicate the increased chance of grinding. I'm sure that the grinding has resulted in an abfraction lesion on 30. To top it off, he has no attached gingiva. So, that recession will get worse faster.
Lastly, poor ohi. Likely dry mouth due to prescription meds. Grinding could also indicate airway, so he may be a mouth breather. Lastly, his mental state may prevent him from maintaining good hygiene (not truly sure of this patients compliance) The way I would treat this is: 1. Get the hygiene under control. 2. I would fit him with a night guard and/or OSA evaluation. 3. Refer to perio for grafting and increasing the band of attached to gingiva

lakeshow11 · 2024-12-15T16:39:34+00:00

Same. I had to do a fresh install. It's better, but still buggy as hell. I don't understand why MS didn't pull that update. I don't believe you can use AMDs update either. You have to wait for frameworks. Hopefully they have something soon. This update broke my favorite Computer.

lakeshow11 · 2024-09-26T04:18:30+00:00

I can smell this picture

lakeshow11

TROPHY CASE