Overlay, Onlay and Advanced Adhesion

Module 1: Intro to BAARD, Tooth Structure, Biomechanics, & Biomaterials

Dr. Schiffenhaus will provide a discussion of his biomimetic and biomechanic rational for his prep design. First we must start with the why.... Why do we cover cusps with crowns? Why use partial coverage? Why use adhesive dentistry vs traditional approaches? And why restore with a biomimetic philosophy. In this section Dr. Schiffenhaus will answer these questions as well as give an important review of Biomechanics, Tooth Structure, & Biomaterials. Then Dr. Graeme Milicich will discuss the six fracture modes of teeth & how to restore them. These lectures will serve as the backbone for the rest of the course and you may never look at a tooth or how to restore it the same again.7 lessons.

Objectives:

• Learn the principles of biomimetic approach
• Understand properties of enamel, dentin, & DEC
• Understand properties composites & glass ceramics
• Learn the Compression Dome theory
• Understand principles of Biomechanic design

Duration: 2 h 59 min

Module 2: Ceramic Design Fundamentals

In this module students will apply what they have learned about engineering and biomechanics from the previous module towards how to prepare & design bonded ceramics. This module will build on the previous module and add further knowledge and evidence in how to design ceramic restorations to be more fracture resistant, function more harmonious with the natural tooth, and how to avoid catastrophic failures both biologically and structurally. Overlays, Onlays, & Inlays will be discussed in terms of design, pro's & con's, and indications/recommendations for use.7 lessons

Objectives:

• Learn the advantages of non-retentive ceramics & Why are such ceramics more fracture resistant & better for bonding
• Understand what preparation features decrease fracture resistance & increase stress concentrations
• Understand why is bonding so important for ceramic success
• Understand the importance of keeping ceramics above the height of contour
• Learn what impacts pulp survival following restorative treatment in regards to prep design
• Understand the role of adhesion & material thickness in fracture resistance
• Understand the Pro’s & Con’s of different margin designs
• Understand the compressive & tensile forces exerted on cusps during function
• Understand the principles & causes of peripheral rim fractures
• Learn how to decide when to keep or remove cusps
• Learn the various Onlay design fundamentals & prep parameters

Duration: 3 h 48 min

Module 3: Overlay & Onlay Preparation Philosophy, Technique, Protocol, & Demos

This module is where the "rubber meets the road" & why many took this course in the first place. Dr. Schiffenhaus not only reviews his preparation protocol but also his prep philosophy, fundamentals, & armamentarium. Here you will learn the burs, speeds, steps, & order in which Dr. Schiffenhaus preps his Overlay's & Onlay's. As with everything BAARD - it is very comprehensive showing the why behind each step & process. There are copious amounts of demo videos to help simulate an intense hands on course. This module will discuss the requisite armamentarium necessary for your preparation. You'll hear of the benefits of different types of handpieces compared and contrasted. You'll become familiarized with the workflow involved in managing caries and structural defects. Finally, you'll learn of the different cutting speeds and bur grits to achieve a smooth workflow.11 lessons

Objectives:

• Learn the components and fundamentals of an efficient ceramic preparation armamentarium
• Learn the benefits of electric handpieces
• Understand how to efficiently manage caries/structural defect removal and bonding in a ceramic preparation workflow
• Understand how bur grit and cutting speeds are best utilized to achieve smooth & flowing preparations
• Learn the preparation sequence of the BAARD Overlay & Onlay prep protocol

Duration: 3 h 48 min

Module 4: Advanced Adhesion & Immediate Dentin Sealing

Advanced Adhesion is at the CORE of BAARD. It may be the most important thing we do. Not only does it retain our restorations BUT more importantly it seals against microleakage & protects the pulp. In this module - Dr. Schiffenhaus first explains the fundamental problem in adhesive dentistry and how to optimize bonding to dentin. For indirect restorations, this is IMMEDIATE DENTIN SEALING with Resin Coating. Dr. Schiffenhaus comprehensively explains the fundamentals & advantages of Immediate Dentin Sealing. In this module Dr. Schiffenhaus also shows how to temporize & adhesively lute to IDS treated indirect preparations. Last, Dr. Schiffenhaus discusses Pulp Health & Post-Operative Sensitivity & Pain - why it normally occurs & why it shouldn't occur following BAARD protocols - in the rare case it does occur how to solve & manage12 lessons.

Objectives:

• Review the fundamentals of bonding to dentin.
• Review the current literature regarding immediate dentin sealing (IDS) versus traditional dentin bonding protocols.
• Learn the protocol for implementing IDS.
• Demonstrate IDS protocols on both a typodont and a patient.

Duration: 5 h 28 min

Module 5: Rubber Dam Isolation with Posterior Focus

Isolation is one of the most important aspects of Advanced Adhesive Dentistry. Essential armamentarium to immediately make your life easier when placing Rubber Dams is reviewed extensively. Through both lecture & demos the step by step set up and placement in the mouth is reviewed including adjuncts such as floss ligatures & teflon.5 lessons

Objectives:

• Understand the benefits of Rubber Dam Isolation for Operative & Adhesive Dentistry
• Review the essential armamentarium such as clamps, type of dam, frames, instruments, & adjuncts
• Understand rubber set up such has hole numbers and placement, clamp selection, the different methods of placing the dam in the mouth
• Learn how to achieve picture perfect inversion of rubber dam & finalize placement
• Learn how to use adjuncts such as accessory clamps, floss ligatures, & teflon for tough to isolate teeth

Duration: 2 h 42 min

Module 6: Biobases: Advanced Adhesive "

• Build Ups" & Deep Margin Elevation
• In this series of lectures, you will learn how to construct Advanced Adhesive "

Build Ups" - known as Biobases. You will be introduced to the concept of the hierarchy of bondability & composite properties to minimize shrinkage stress, maximize adhesion, and to create strong - robust - long lasting restorations for badly damaged teeth. To reinforce the dentin bond in areas where the hierarchy of bondability is low, the use of Ribbond as a stress breaker will be introduced, along with a recommended step by step protocol for placing Ribbond as part of your Biobase as well as EverX Fiber Reinforced Composite6 lessons

Objectives:

• Understand the difference between a Biobase and a traditional buildup.
• Understand the gradual change of dentin composition between superficial and deep dentin and how this relates to the hierarchy of bondability.
• Learn how Ribbond can reinforce the IDS layer to withstand polymerization shrinkage stress.
• Learn about the properties & indications for use of EverX Fiber Reinforced Composite
• See the placement of the Biobase and Ribbond in real patient demonstrations.

Review the steps for correctly constructing Biobases as well as Ribbond & EverX.

Duration: 2 h 37 min

Module 7: Case Review

This is a collection of live cases both photos and video that are reviewed by Dr. Schiffenhaus.4 lessons

Duration: 2 h 21 min

Module 8: Bonus: Direct Composite Case Reviews1 Lesson: Direct Composite Case Reviews

Duration: 22 min