I Can’t Believe This Sticks – EXTREME BONDING EXPOSED – PDP077

How to do Deep Margin Elevation? What are the most important factors in achieving high bond strengths for our restorations? I sometimes look at modern onlay preps and think, 'God MUST exist', because I think it's a miracle how these flat, table-top onlays stay on! I am joined by a world-famous educator in Biomimetic and Adhesive Dentistry: Dr David Gerdolle David Gerdolle, based in Switzerland, introduced me to contemporary ceramic onlays 8 years ago. It took me 3 years to convince myself the techniques would work in my hands! In this episode I want to fast-forward your progress so you can gain more perspective on adhesive restorations and DME (Deep Margin Elevation). https://youtu.be/cOkEAaawgdI Super pragmatic and scientific bonding principles! Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: How can you show patients what shorter anterior teeth might look like to them discing them down? Use a black Sharpie marker, colour in the part of the edge (maybe 0.5-1mm) that you’re considering removing. Take photograph and show it to them! It helps if their mouth is open for the photo so we see the dark backdrop of the oral cavity. With the knowledge of Dr. David Gerdolle and biomimetic dentistry, we discussed how it is possible to bond a material to the tooth structure in those 'table-top' style, flat onlays.  It doesn’t happen magically. It’s about the nitty gritty detail, the micro steps and respecting certain criterias. “If you don't remember anything of your bonding protocol, just remember that, it has to be clean and rough” - Dr. David Gerdolle Clean and Rough, that's it right there! In this episode, we also talked about: Failures in using biomimetic dentistry and what we can learn from that How these restorations have resistance form Bonding protocol step-by-step for adhesive dentistry Deep Margin Elevation - how to do it As promised, DM me on Instagram @protrusivedental for the PDF copy of the steps of deep margin elevation.  If you enjoyed this episode, then do check out Dr. David Gerdolle for more courses. You might also enjoy Ceramic Onlays from Preps, Temporisation and Bonding Protocols by Nik Sethi! Click below for full episode transcript: Opening Snippet: We have to compensate with the thickness of the inlay so that when we see fancy inlays, 0.3, 0.5 thickness of ceramic on Instagram, it can work if it's bonded on enamel. So if it's Niroshan case, bonded on enamel, which is very stiff, it's okay we don't need two millimeters that most of the time, which is that on dentine. Jaz’s Introduction: I know I’ve covered the theme of onlays before, it’s not new for us. But do you remember the first time you saw one of those onlays, the lithium disilicate onlays, which are like bonded on essentially what looks like a quite a flat tooth. And the first time I saw it, I was like, no way, this is not going to stick. I don’t believe it, I don’t buy it. I’m going to stick to my conventional crown preparations. But you know what, seeing these more and more now is great. And in my hands, they do work. And it needs a proper discipline and protocol, which we’re going to discuss today with someone who’s absolutely awesome. It’s David Gerdolle. And it was David Gerdolle around about eight years ago, I attended one of his Dentinal Tubules lectures live in London. And I just couldn’t believe it. That’s the first time I thought, whoa, this is crazy. This is insane. How could this ceramic stick to the tooth, it just didn’t make sense to me, right? But what I learned from that day has stuck with me for such a long time forever as part of my clinical protocols. And that is the following A) you just need a clean substrate and B) you need to have enamel. If you’ve got enamel circumferentially, these onlays can be extremely successful. And to take that a few steps further. I’ve got David on today to share some steps,