Dahl technique Doc Terry style by Dr. Ahmad Fayad

Posted on January 16 2024

Introduction:

40 year old female on a tight budget and is slowly losing her teeth. She was referred to me by another patient who had the same style buildups. Decided to do the Dahl technique, Doc Terry's style. I do mine a little different, but there are many ways to do this technique. 

 

Before

Years of neglect due to high costs of treatment.


Thin edges, recurrent decay, RCT on the UR2, loss of vertical dimension. Molars need work as well, but I wanted to start with the Dahl technique to get her confidence back.

Before

Most of the damage is on the upper arch, her lowers look OK for now.

Before

Acid erosion plus neglect. Let's cover those teeth with composite.

Before

 

Smile shot

 

Rubber dam

 

 

Central incisor

The average length of the central incisor is 9-12mm. We need to build her a few mms of composite.

Greater Curve Band in place

Cleaned up decay and slapped on a Greater Curve band. I fill these in one increment to avoid voids. The Filtek Z250 has a deep cure of 4mm, and I also do circumferential curing when I remove the matrix band.

Central incisor

Central now measures about 8.5mm (the ruler is not really touching the gingival margin).

Central incisor

 

Central incisor

I am not aiming for perfection at this moment.

Before

This one really needs some attention.

 

Greater Curve Band in place

Greater Curve band provides an airtight seal.

Occlusion

Don't over work yourself on this part, just get contacts on most of the anterior teeth at this moment.

Final shot

Now looking at it, I could have perfected a few line angles, but she was thrilled. I got her back to fix her posterior teeth at a later day. I am usually drained by the time I have done 6 teeth.

After

 

Conclusion:

1. I honestly think this is a valid treatment option to present to patients who cannot afford expensive indirect restorative dentistry.

2. Patients rarely complain about the new bite, so don't beat yourself at the end to perfect occlusion. The bite gets tighter and self-adjusts itself with time as composite wears. Plus, the grinding stops immediately.

3. I agree porcelain has more luster and looks better, but I find composite has a more natural look than porcelain... who agrees? (Maybe it's the way it absorbs light?)

4. I would love to try the injection techniques, but I don't trust flowables long term.