Onlay/Inlay/Porcelain Crown/Veneer Bonding

1. Calibra kit, curing light, Cementation pouch
2. Bur bloc, high and slow-speed handpieces (not to open), polishing cups
3. 3-way syringes (2), saliva and high volume (if necessary) suctions, 2-3 cotton rolls, 1 2x2
4. Cut a piece of dental floss and tie two knots in one end
5. If doctor is busy, remove Fermit using explorer by inserting explorer between tooth and Fermit or directly inserting into the middle of Fermit
6. Lightly blow air or water into the cavity.  If the patient feels sensitive, load syringe with needle and Mepivacaine or Xylocaine (red)
7. Take out Viva Stick and bend it 120° at a particular area (joint).  Also take out model, arrange the model the same way the patient's mouth, and insert onlay/inlay into the prepared cavity.  If you know the orientation well, stick the Viva stick to middle of occlusal surface of onlay/inlay.  Otherwise leave the task to the doctor
8. Follow Calibra instruction: use minimal amount of Silane to treat the rough surface of onlay/inlay.  Too much of it may dissolve Viva Stick.  It will make Viva Stick not sticky anymore
9. Special attention: no catalyst for crown bonding, squeeze base directly into inner surface of crown, spread base with plastic instrument to cover the margin.  If we bond several crowns, ask the doctor about the sequence; for onlay/inlay bonding, catalyst: base=1:2, less or no catalyst (discuss with doctor in advance).  Do not pre-dispense the two components.  They may set in room light.  Mix (not too long; bonding material will set soon) and apply to the inner (rough) surface of onlay/inlay quickly, but gently.  Pay attention to applying bonding material to the margin of onlay/inlay.  Before application, make sure that Viva Stick still attaches to onlay/inlay securely. Pass onlay/inlay quickly to doctor.  Pass amalgam condenser or bite sloth for seating. 
10. Use curing light.  Cure 5 seconds each buccally and lingually.  The doctor removes partially set bonding with explorer. 
11. Pass knot-tied dental floss to doctor no matter whether he forgets this important step or not, immediately after the restoration is seated.  The doctor uses the floss to remove excess bonding cement between the teeth before it completely sets.  It is extremely difficult to remove cement when it sets
12. Light cure 20 seconds each buccally and lingually for final setting of bonding material.  Articulating paper, please.  Polish if necessary

Xin Wei, DDS, PhD, MS 1st edition 11/13/2011, last revision 11/13/2011