Zirconia is a wonderful restorative material with superior strength and esthetics. During the past 10 years, labs and dentists have increasingly incorporated zirconium crowns into their practices. But as tough as these crowns are, failure can occur, particularly because many labs didn’t follow protocol in producing the first zirconium-porcelain crowns. Unfortunately, the strength that makes a zirconium crown such an attractive option also makes it very difficult to remove with a conventional bur.
You might have successfully placed many, but then one Saturday you get the dreaded call—a patient has a fractured crown. Your stomach drops a little; you look in the chart and hope it was that PFM done in ’96 on tooth No. 2, not the zirconium-porcelain crown you placed on No. 12 in ’06.
Fears rush through your mind, sparks flying (literally); wearing out three or four conventional burs; applying so much pressure on the zirconium that you gouge the butter-soft dentin. On top of everything, the patient wants it off today. You’ve got a recipe for misery.
But I have found a way to eliminate the sparks, preserve my best conventional diamond burs and dramatically reduce procedure time. On the advice of a colleague, I tried KOMET’s ZR-Diamonds™ series ZR 943 bur with a patient who required several crown removals. Having created sparks of my own and gone through several burs per tooth in the past, I was ready to try any alternative that promised to be the right tool for the job. One ZR disc and eight minutes later, I had removed crowns from tooth Nos. 7, 8, 9 and 10. My assistant looked at me as if to say, “That was too easy.” It was then, and still is.
It saves you time and money
In the year since I began using it, the ZR 943 has saved my office thousands of dollars in conventional burs and chair time. This bur laughs at zirconia while it creates the perfect path for removal. Make a score line along the buccal and lingual surfaces, and then use your favorite crown remover to complete the job. Following anesthetic, removal now takes one to two minutes per tooth.
Know its strength
Understandably, a tool this powerful comes with a note of caution: If it removes zirconium with ease, imagine what it can do with an errant graze to tissue. But with a little practice and extra care, you actually reduce risk with the ZR 943 rather than increase it. You don’t have to apply heavy pressure when cutting these tough copings as you likely have with conventional burs. On the contrary, a light, sweeping touch is all it takes. After a few uses, you will become accustomed to this bur’s power.
It’s worth the switch
Changing operatory protocol and trying a new product is unfamiliar territory we all have to enter some time. I was skeptical when I first read about the ZR 943, but my doubt has been laid to rest. With the widespread use of all-zirconium crowns and zirconia’s continued use as a strong, viable dental material, I anticipate that these burs will be a must for your bur kit. Don’t be caught unprepared on a Saturday. Keep the sparks and your stress level down and have a ZR 943 ready to use on your next zirconia removal.
?????— 5 stars out of a possible 5
The Benchmark column is written by the directors of the Atlanta Center for Dental Excellence, an alliance of practicing clinicians dedicated to progress in dentistry. The ACDE advises dental companies on product development and marketing, and provides PACE-approved high-level continuing education. To learn more, visit theacde.com, or contact Molly Thompson at firstname.lastname@example.org.
Frank Clayton, DDS, is founder and president of the ACDE. He speaks to sales professionals on marketing to dental clients, and he practices general dentistry in Suwanee, Ga.
About the ACDE reviews
The clinicians of the Atlanta Center for Dental Excellence conduct independent, unbiased reviews of products and services based on actual ongoing use in an active practice. Evaluation criteria include overall quality, contribution to practice success and return on investment. In the five-star rating system, one star indicates a “poor” rating and five stars indicate a rating of “excellent.”