Dr David Huson
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Biomimetic Restorative Dentistry | #staybonded
Minimally Invasive | #biobase #alldayeveryday
General Dentistry | #endodontics #dsd #photography

David Huson
🐌 E N D O . R E S T O. 🌺 .. I have been stru 🐌 E N D O . R E S T O. 🌺
..
I have been struggling to find inspiration to post within my own daily dentistry. Oftentimes, thinking it has to be "different" or "creative". With so much amazing dentistry constantly blowing my mind on the 'Gram; one can experience a sense of inadequacy etching itself inwardly. However, a weekend of personal introspection and reflection unrelated to dentistry but rather spiritual growth has framed me in a more willing space to be consistent rather than "all-or-nothing". (If that makes any sense 🤦🏻‍♂️🤷🏻‍♂️)

I am a huge fan of endodontic-restorative workflows; obviously, rehabilitating with biomimetic protocols.

The following patient presented with poorly localized pain in the fourth quadrant. I advised him that I would go about stabilizing the situation by maintaining the vitality of either tooth that did not exhibit irreversible pulpitis through testing. Dx was challenging here. In hindsight, I was fortunate that things worked out as they did. I treated him as an emergency right before Christmas; with his return recently for completion of the endo. and biomimetic reconstruction of LR6. Symptoms have settled relating to the LR7; LR6 is on the mend and trusting that it'll serve him well. Hopefully we can tidy things up on that makeshift overlay surface LR7 - from the emergency session; and match those curves with some ceramic intaglio 🥑

"There'll be another in the fire
Standing next to me
There'll be another in the waters
Holding back the seas
And should I ever need reminding
How good You've been to me
I'll count the joy come every battle
'Cause I know that's where You'll be" 

Song: Another In The Fire (Hillsong United)

Gabriel's first day at big school! 👴🏼

#dentistry #dailyinspiration #biomimeticdentistry
#dentistryworld
#dentallife #teeth #tandarts #tandheelkunde #zahnartz #zahn  #emergency #painrelief #endodontics  #restorativedentistry #adhesivedentistry #バイオミメティック歯科 #歯科  #odontología #aislamientoabsoluto #rubberdamology #christfollower #dadlife #firstdayofschool
🙏🏼 T H A N K • Y O U • 1 K 🙏🏼 Thi 🙏🏼 T H A N K • Y O U • 1 K 🙏🏼

This post was largely inspired by the amazing lecture I heard at BRD Online 2020 Conference regarding the technique of Deep Margin Elevation @davidgerdolle @karmadentistry 

The following patient cracks me up with his sense of humor; a real awesome character. Endodontic treatment completed elsewhere and presented to me after cracking the second patch filling on this UL7 / 27 while eating peppermint crisp ice-cream.

As the defect was significantly subgingival; I raised a full thickness flap on both buccal and palatal aspects before placing @nictonerubberdam (heavy; for better tissue retraction). As this was the most distal tooth; I had to figure out a way of stabilizing the dam without the clamp getting in the way of the matrix setup. Bring in the unnamed Ivory clamp I inherited. It acts in a distal stabilization fashion; placed on the UL6 / 26. In an effort to minimize the amount of gadgets going on this poor tooth; I bought the Garrison DME bands; but those requiring a tensioning handle and dial rather than Tofflemire @ivodentsa @dr_mattnejad @garrison_dental

I employed the matrix-in-a-matrix technique @pierrepaoli_guttageek ; feeding Teflon / PTFE in an apical direction to further approximate the DME band and create a better emergence profile to, hopefully, facilitate healing of the flap and to be kinder to the embrasure and recovery of the papillae (hopefully, forgive me). Palodent sectional matrix with apical extension was used for this @dentsplysirona.za 

Due to the vertical, distal surface of the first molar; it was unadvisable and virtually impossible to establish contact. I will encourage that we treat the PARL on this tooth before proceeding with a biomimetic solution to reconstructing this tooth and give its contribution to the interproximal contact and #flossinvitationzone @dmdsunny 

@identistry @badentistry
@dental_mentor
@dentistry.world @dentistry_arts @dental_d_me 

#biomimeticdentistry #biomimetic #adhesivedentistry #minimallyinvasive #tooth #teeth #tand #tandarts #zahn #zahnartz #doktergigi #repair #restoration #reconstruction #whitefilling #composite #resinart #dental #dentist #capetown #smile #brokentooth
🛠 D I S M A N T L E 🛠 @pierrepaoli_guttagee 🛠 D I S M A N T L E 🛠

@pierrepaoli_guttageek - this was some ride. Iatrogenic injury during re-endo. on acutely painful LR6 / 46. 

• Removal of old PFM (no picture)
• Removal of metal core and post
• Desobturation (no solvents were used @dublin_endodontics )
• Perforation of ML with D1 🤔
• About a 100 precurved handfiles (C+; K-files and even Hedstroem @dentsplysirona.za )
• Patience and much prayer 
• HyFlex GP remover 🙏🏼
• The last time I WVC with TotalFill BC sealer in MB and D @fkgdentaire
• Biodentine @septodont in ML perforation repair
• Overfill 🤦🏻‍♂️ Brave sharing post-operative PA @paurelie83 

🐣🐤 R E M A K E //
R E M O D E L🐥🥚 

@pierrepaoli_guttageek @alexmaydmd @peter_farkas_dmd 
@david_alleman 
@dr.patrick.calalang
@guspetris.op 
@dr.sung_dds
@drfranbrelsford 
@drsimonedeliperi 
@jorgearavenadiaz 
@jorgelunaddsmddsd 
@oseias80 
@drjorgefermin 

everX Flow and everX Posterior core further reinforced with polyethylene fiber @ribbond and sealed off with Omnichroma @tokuyama (Darn @'s and #'s are not linking at the time of reaching this point 🙄)

Semi-direct composite crown hand-made; by myself, with love and more everX Flow and Tetric N-ceram A1 composite (all I had left). Nuked for 3 minutes at 500 watts. 

Clearfil SE Protect for the win when bonding. Some photographs during DWT.

"The Lord gave and the Lord has taken away; may the name of the Lord be praised." Job 1:21

O God, You are the Giver of all good things. Help me to recognize Your generosity in even  small ways and to trust You in seasons of loss and hardship. Amen.

#bespoke #crown #handmade #biomimetic #biomimeticdentistry #dentistryworld #restoration #dentist #odontologia #odonto #tand #tandarts #zahn #zahnartz #doktergigi #teeth #endodontics #retreatment #perforation #repair #rubberdamology #rubberdamfam #faithoverfear #capetown #capetowndentist
D I R E C T • R E S T O R A T I O N "Do you eve D I R E C T • R E S T O R A T I O N

"Do you even AquaCare, bro'?"

@georgethedentist 💙 I loved that line of yours. Air abrasion can be fun and messy. I love doing it.

Proverbs 5:21-23

#biomimeticdentistry #biomimetica #biomimicry #composite #directrestoration #direct #restorativedentistry #adhesivedentistry #enamel #bonding #rubberdamology #rubberdamfam #odontology #odonto #odontologia #tandheelkunde #tandarts #tand #teeth #tooth #dentistry #dentista #doktergigi #zahn #zahnartz #zahntechnik #realeverydaydentistry #getbonded #staybonded #aislamientoabsoluto
C O M P R O M I S E D T R E A T M E N T Failing C O M P R O M I S E D 
T R E A T M E N T

Failing veneer on the UL1 / 21 with several composite "patches" on the palatal aspect; recurrent decay. Historic endo. treatment; asymptomatic. Patient is concerned about catastrophic failure and has been placed on a public health waiting list for a crown on this tooth.

Offered to strengthen this tooth by means of BRD principles.

• Rubber dam isolation was unusual - patient has a 4-unit PFM bridge from 16-to-13; broken-off UR2 / 12 awaiting restoration at the dental school and a significantly deviated midline. Did not want to split dam.
• Structural analysis carried out with CDD. Noted a Crack running from the mesial enamel into dentine but very little tooth structure in an anterior-posterior direction; so planned to reinforce with polyethylene fibers following bonding instead of removing this crack. Created reliable 
• Pumice slurry with bristle brushes and AA (Aquacut) 
• Matrix adaptation - initially, TOR system with Teflon wrapped Palodent wedge on the distal and broken wooden wedge in the mesial...
• ...scratched that; tried to get fancy with my Unica anterior kit; but failed and got frustrated - used it anyway 🤔
• Total etch and rinse; drying not desiccating
• CHX (PacDent) scrub with sterile cotton pellets for 1 minute
• OptiBond FL with variation in "wicking off" adhesive instead of air drying
• Photo-initiation for 40 seconds; then, DWT for 5 minutes
• My interpretation / understanding of "Deli-bites" building the mesial and distal walls with GC Essentia Universal
• Ribbond 4mm along crack mentioned earlier in conjunction with everX Flow; 2mm strands of Ribbond placed in intra-canal space created; as inspired by @jorgearavenadiaz
• Whether it's right or not; placed a bit of everX Posterior, too, as I was a bit unsure of my venturing out of the realm of posts here 🙈
• Final layer of GC Essentia followed by glycerin and removal of oxygen inhibition layer with pumice slurry again and Diacom Polishers. 

It ain't pretty; but I hope it'll buy her some time. 

#getbonded #staybonded #biomimetic #biomimeticdentistry #biomimetica #rubberdamology #rubberdamfam #carillas #odontology #odonto #odontologia #doktergigi
The past week and a half has been tough acknowledg The past week and a half has been tough acknowledging where my own pride has been bruised by the words and actions of others beyond my control. 

Enjoyed constructing these biobases for a really appreciative and gracious patient. This bonding protocol was a peaceful way to round off an emotionally taxing few days.

🔍There is some adhesive flash photo-bombing one of the images. And, a severed floss ligature following some aggressive post-bonding polishing.

"The eye of their God was watching over [them]...and they were not stopped." Ezra 5:5

'As we seek to follow God, wherever He places us, we may face opposition along the way. That's when we need to keep following Him. He will guide us and carry us through.' 

#getbonded #staybonded #biomimetic #biomimeticdentistry #biomimetica #biobased #adhesivedentistry #restorativedentistry #dentistas #dentistry #dentista #odontologia #odontoporamor #aislamientoabsoluto #tandarts #tandheelkunde #zahnartz #zahntechnik #teeth #tooth #rubberdamology #rubberdamfam #deepblue #dentalphotography #dentalart #scripture #faith #acceptance
One of "those days" 👀 Had high hopes of documen One of "those days" 👀 Had high hopes of documenting a direct case I was busy with; air-conditioning packed up and I fought with every matrix system in my armamentarium to try DME yet another UL7. In the end, customized a Kerr tofflemire band with scissors and wedged the heck out of it going through 3 different shades of dam. My wife and sons who had come to collect me; were still parked outside my practice at 7PM. My sons said, "Daddy, we thought you were kidnapped?!" 😅🙃 

But, none of that is documented here, though. This? This is just current Friday mood 😴😴😴 Bonding protocols and the fun part of my day.
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.
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“Do not store up for yourselves [material] treasures on earth, where moth and rust destroy, and where thieves break in and steal.
Matthew 6:19 AMP

#getbonded #staybonded #bonding #restorativedentistry #minimallyinvasive #biomimetica #biomimetic #biomimeticdentistry #odontologia #odontologiaestetica #zahnartz #tandarts #tandartspraktijk #zahn #tooth #teeth #dentistry #dentistas #isolation #rubberdamology #rubberdamfam #blackonblack #black #paintitblack #rollingstones #fullmetaljacket #stanleykubrick #outro
Make of me, Father, a willing servant in times of Make of me, Father, a willing servant in times of weakness and times of strength.

The mesial angulation/tilting of the LL7 / 37 contributed to an over-erupted position in an already unfavorable occlusal plane. She is a longstanding, single upper denture-adorner; where, at our initial meeting, it was revealed that previous adjustments made to the denture acrylic had led to a hole being created in the prosthesis. Planning occlusal recalibration within whatever means are viable. New denture: loading. 

Biobase created through structural analysis; juggling Williams probes and calipers (couldn't quite coordinate any artistic shots there; but stoked I managed to capture the "cusp blazer" @pierrepaoli_guttageek .) CDD faintly depicted within parameters in one of the photos. (And, all over my tray and pretty much everywhere else at my work station.)

Some lovely photo opportunities during DWT - it warms my heart and might even bring a tear to my eye when I hear how my new dental assistants confirm that 5 minute timer with one another. 

The patient tolerated the bilateral anaesthesia in combination with across-the-tongue dam way better than I expected #ohbehave

Send me some colourful floss @dentistry.by.drpaul from @gcaustralasia so I can get my colour floss ligatures game on 🤓😜

"Now faith is the assurance (title deed, confirmation) of things hoped for (divinely guaranteed), and the evidence of things not seen [the conviction of their reality—faith comprehends as fact what cannot be experienced by the physical senses]."
Hebrews 11:1 AMP

#odontologia #odonto #odontology #dentistry #dentista #dentistryworld #dentistrylife #overlays #overlay #dentalphotography #teeth #biomimetic #biomimeticdentistry #biomimeticstudyclub #biobased #adhesivedentistry #minimallyinvasive #restorativedentistry #rubberdamology #rubberdamfam #ocean #waves #water #faith #hope
When the journey seems long and dreary, dear Lord, When the journey seems long and dreary, dear Lord, help me to remember You are travelling with me. 

Patient presented with a "loose filling" (UL7 / 27). No significant symptoms in spite of the radiographic appearance you'll see (PARL associated with the MB root of the UL6 / 16, too, caries communicating with pulp; subgingivally orientated.

Two-stage endo.-resto. simply because I work slowly and time was an issue. (There'll be a third appointment, too...perhaps, I'll attempt a semi-direct overlay.)

Structural analysis performed prior to endo. with the view of final overlay restoration in mind. (And, removing structurally compromised tooth structure reduced stress on MB instrumentation.) 

Reproducible glide path with 6; 8 and 10 K-files and C+ No. 8 and 10
ProTaper Gold Sx 
Wave.One Gold Glider
Wave.One Gold Small (20/07) in the MB and DB and Primary (25/07) in the palatal. (Yes, I ran out of correctly-sized paper points. I channelled my inner @paco_fitt here.) #reciprocation Eddy Sonic Activation of 3.5% sodium hypochlorite; EDTA in the mix, too. @vdwdental

Rewalling subsequent to endo. with a combination of polyethylene fibers @ribbond immersed in everX Flow and everX Posterior @gcunitedkingdom @terrygreyling used in combination. OptiBond FL, again. Matrix-in-a-matrix with Teflon packed between for sectional marginal approximation. Some Filtek Bulk Fill place in a rewalling fashion for the mesial.

"My Presence will go with you and I will give you rest." - Exodus 3:7-12

#biomimeticdentistry #biomimetic #biomimicry #dentistas #dentistry #dentista #dentistryworld #dentalart #dentistrylife #biomimeticstudyclub #biomimetica #biobased #endo #endodontia #endodontics #composite #rubberdamology #rubberdamfam #nictone #restorative #restorativedentistry #savingteeth #faithoverfear
A challenging case...well, for me; at least. Some A challenging case...well, for me; at least. Some photographs of both the prep. and bonding appointments. 

IPS e.max bonded on UL1 / 21 and UR3 / 13. Replacements of my own work following craze lines visible to me at a 1 year review due to unfavorable contacts that I only learnt about in hindsight. Attempting to reconfigure the guidance with the expert help of @mc__botha and the gracious support of @ddi_lab

I carried a great deal of the emotion stemming from a difficult patient interaction of yesterday - and the personal battle of learning from my own shortcomings through this case - sadly, home with me. I could have been gentler and less harsh with my sons and my wife.

But, God. His grace. His mercy. 

12 "Not that I have already obtained all this, or have already arrived at my goal, but I press on to take hold of that for which Christ Jesus took hold of me. 13 Brothers and sisters, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, 14 I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus." Phillipians 3:12-14

#emax #bonding #adhesivedentistry #smile #dentistry #dentistrylife #dentalphotography #crowns #odontologia #odontologiaestetica  #dentistas #dentistaporamor #coronas  #rubberdamology #rubberdamfam 
#審美歯科 #手術歯科 #faithoverfear #scripture
Finally, took a leap of faith in putting myself ou Finally, took a leap of faith in putting myself out there after learning so much from the absolutely amazing clinicians around the world I have had the privilege of engaging with via Instagram. Some very good friendships formed here; I'm certain for years to come 💙 #bromance

Patient presented with cold sensitivity UL7 / 27 (most distal tooth in the quadrant making my life interesting negotiating the distal margin with the clamp arm 💪 #gamestrong

Some old dentistry crying out for revision. Patient has a bad back and got me juggling every piece of fabric I have in my office to reupholster my chair 👀 Crack on the Netflix and let's go...

• Rubber isolation (non-latex Perfection Plus +)
• CDD ("Seek"; Ultradent) following amalgam removal
• My best shot at deciphering structural analysis - CRE and CD(?) 
• ...About 30 re-applications of CDD; gradually modifying; intermittent pumice and AA from the very first Aquacut unit (which, probably needed its own extractor fan and could be nearly as old as me)
• Use of calipers and William's probe to continue checking structural analysis parameters
• Trying to keep C-factor in mind and enamel bevelling
• Was a little concerned about the thickness of the MB cusp; but after an internal struggle about what some of my mentors would do; I elected to keep it
• Etch; CHX rinse; and OptiBond FL (saving Clearfil SE Protect for really special cases along with my NicTone 🙈)
• Matrix-in-a-matrix and Teflon for marginal approximation at this stage; just to keep my IDS in check 
• IDS with everX Flow further impregnated with polyethylene fibers (Ribbond 4mm; and 2 separate 3mm segments) - my concerns about the MB cusp crossed my mind again - thereafter, a touch of Clearfil Majesty Posterior (sadly, I ran out of Clearfil Flow @pierrepaoli_guttageek cried myself to sleep that night)
• Oxygen inhibition layer circumvented with photo-initiation through glycerin and subsequent pumice and AA to clean this off
• Rushed refining prep. geometry but was stoked I got to use my new bestie; "the cusp blazer" a la @drschiffenhausdmd @pierrepaoli_guttageek

#rubberdamology #odontologia #dentista #aislamientoabsoluto #biomimeticdentistry #biomimetic
The Lord provides on a day of waiting around... Pa The Lord provides on a day of waiting around... Patient presented with poorly localized pain on the lower right-hand side of the mouth; describing how it had been radiating into her ear during the night. Clinical assessment revealed very poor plaque control and a number of rather unfavorable restorative treatments that were causing iatrogenic injury. Although asymptomatic, I described to her that the 44 would require a new restoration - ideally, indirect - and before proceeding, a re-treatment of its short apical fill would be recommended. She was in agreement. ° Sectioned composite resin catastrophe 😱
° Extraction of symptomatic 45 💉⚒ and compression of bleeding socket
° Rubber dam isolation @coltene_us #hygenic ° Removal of previous GP 🧪 chloroform and barbed roach ~ Standard irrigation protocol 💦 with 3.5% sodium hypochlorite and 17% EDTA ♧ Ultrasonic agitation 💨
° C+ files to negotiate apical third ~ No. 10 C+ pictured at length @elizmapieterse  @dentsplysirona.endodontics
° WaveOne Gold reciprocation in X.smart Plus motor @dentsplysirona.za ° Thermafil No. 35 and TotalFill BC sealer @fkgdentaire @lesley.marshall.1232760 combination #forgiveme @advanced_endodontics_pretoria ◇ All I had available 🙈
° X • Post (No. 2) with Rely X Ultimate @3m
° #smartdentinreplacement build-up and Tetric N-Ceram @ivodentsa @ivoclarvivadent_int 
Inspired by mentor; friend and endoboss 🤙@andre.brand.351

So, I wasn't happy with the inadequate distal marginal adaptation of the composite. This was largely due to my ineptness in managing the matrix here 👉 Would be great to get advice on which system would have been advisable to use in this instance and how best I could have achieved the distal lingual composite build-up? (As mentioned, I have fervently encouraged the patient to pursue an indirect restoration with her dentist of donkeys' years.) #dentistry #dentalife #dental #dentist #isolation #rubberdam #rubberdamology
#rubberdamfam #irrigation #lockdown2020
#emergencydentistry #painrelief #extractions #retreatment #endo #rct #endodontics #endodontia #puff #extrusion #tryingtosurvive #faithoverfear #compositebonding #distal #matrix #fiberpost #godisgood
Weekend vibes - Grandpa and 2 of our boytjies livi Weekend vibes - Grandpa and 2 of our boytjies living dangerously 😱🤦🏻‍♂️🤫 (Don’t tell Mom!) Plus, random chill spot and family time by the seaside.

#honda #motorcycle #80smotorcycles #grandpa #seaside #notrousers #raphael #sebastian #gabriel #waves #dreadstylesforwomen #dentistlife #familylife #dadgoals
Hugely grateful to Dr Mark Bowes @docmarkbowes and Hugely grateful to Dr Mark Bowes @docmarkbowes and Helen Bowes for their graciousness in having me attend the recent Digital Smile Design course - super warmly received 🙏🏼👌🏼Tremendously helpful and informative! 
As always, top drawer care and execution by @enamel_dentistry @implantaestheticacademy 🔥🤙🏼 #digitalsmiledesign #DigitalDentistry #dsdapp #restorativedentistry #biomimeticdentistry #additive #planning #digitization #mentorship #futureisnow
Thank You Lord Jesus for strengthening me and bles Thank You Lord Jesus for strengthening me and blessing me with this opportunity to run my first marathon! Could not have done it without the love, support and encouragement of friends Simon Paton Brendan Bracken Jonathan Briedenhann and, of course, my incredible family! 
#capetownmarathon2019 #capetown #family #friends #42.2KM #forrestgump #blessings #nextevent #runninggoals #marathon #marathontraining #1000kmchallenge2019 #runningdentist
Many thanks to the inspiring Dr Sam Thandar and hi Many thanks to the inspiring Dr Sam Thandar and his remarkable wife, Tatum, @thincclinic for very kindly hosting me in their lovely home and for inviting me to attend the Digital Dentistry Society Conference South Africa 2019 in Johannesburg. Awesome to meet Dr Darryl Darcy and his wife, Amy, too 💯💪🏻 And, what a pleasant surprise to find out my uncle, Dr Roy Richard Huson @silveroaksdentalclinic was there, too! Spent the day with him and later shooting the breeze; discussing a DSD protocol @o.r_tambo_airport waiting for our flights home. @enamel_dentistry @marcsher @nvdentistry #digitaldentistry #digitalworkflow #aestheticdentistry #restorativedentistry #digitalsmiledesign #cadcam #cerec #r2gate #3shapedesign #dentistry #3dprinting #millingmachine #emax #zirconiacrown #zirkonzahn #stl #dicom #ai #futureisnow
Proud father-son moment this Monday morning with m Proud father-son moment this Monday morning with my eldest son; Sebastian Kopano Huson, chilling upfront as an ideal patient; demonstrating the digital “impressions” / scanning. These kids loved it! The things they’re gonna see in their lifetime of dentistry’s evolution. 
#3shapetrios #3shapedesign #optragate #ivoclarvivadent #odontologia #odontology #digitaldentistry #digitalworkflow #painfreedentistry #minimallyinvasivedentistry #dadgoals #fathersongoals #myboy #sebastian #oralhealtheducation #dentalcheckup #prouddad #drdavehuson
Connecting with Specialist Periodontist Prof. Step Connecting with Specialist Periodontist Prof. Stephen Chen - President of the International Team of Implantology - following his intriguing and meaty lecture on “Saving or Replacing Implants”. Wrapping up the second day of the program at the 2019 South African Congress in Cape Town. Super humble and approachable 👍🏻👍🏻 #internationalteamofimplantology #iti #oralimplantology #straumannimplants #odontologia #odontology #dentalimplantsurgery #periodontology
...like, 2 minutes before Gabriel thought it was a ...like, 2 minutes before Gabriel thought it was a good idea to pee from the tree... #squadgoals #daddyandtheboys #wintersdayparkvibes
Cracking some monkey bar pull-ups with Raphael Pho Cracking some monkey bar pull-ups with Raphael Phodisho Huson #bootcamp #nopainnogain
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