A Predictable Resin Composite Injection Technique, Part 1

Transcription

1 Volume 33 No. 4 Pge 96 A Predictle Resin Composite Injection Technique, Prt 1 Authored y Dougls A. Terry, DDS, nd John M. Powers, PhD Upon successful completion of this CE ctivity 1 CE credit hour will e wrded Opinions expressed y CE uthors re their own nd my not reflect those of Dentistry Tody. Mention of specific product nmes does not infer endorsement y Dentistry Tody. Informtion contined in CE rticles nd courses is not sustitute for sound clinicl judgment nd ccepted stndrds of cre. Prticipnts re urged to contct their stte dentl ords for continuing eduction requirements.

2 A Predictle Resin Composite Injection Technique, Prt 1 Effective Dte: 4/1/2014 Expirtion Dte: 4/1/2017 ABOUT THE AUTHORS Dr. Terry is grdute of University of Texs (UT) Helth School of Dentistry. He presently holds positions s n djunct professor in the deprtment of restortive sciences t the University of Alm t Birminghm, ssistnt professor in the deprtment of generl prctice nd dentl pulic helth t UT Helth School of Dentistry t Houston, nd professor emeritus in the deprtment of conservtive dentistry nd endodontics t the VS Dentl College nd Hospitl, Rjiv Gndhi University of Helth Sciences in Bnglore, Indi. He is n ccredited memer of the Americn Acdemy of Cosmetic Dentistry, n ctive memer of the Europen Acdemy of Esthetic Dentistry, nd n honorry memer of the Indin Acdemy of Restortive Dentistry. He hs served s pst reserch ssocite for REALITY Re serch L nd clinicl ssocite for REALITY Pulishing. Dr. Terry hs received numer of professionl wrds s well s Fellowships in the Americn nd Interntionl Colleges of Dentists, the Interntionl Acdemy of Dentl Fcil Aesthetics nd is pst memer of the AGD. He is memer nd the US vice president of Interntionl Orl Design. Dr. Terry is lso n editoril memer of numerous peer-reviewed scientific journls nd hs pulished more thn 230 rticles on vrious topics in esthetic nd restortive dentistry. He hs uthored textooks in numerous lnguges including Nturl Aesthetics With Composite Resin (Montge Medi, 2004), Aesthetic nd Restortive Dentistry: Mteril Selection nd Technique (Everest Pulishing Medi, 2009), Esthetic nd Restortive Dentistry: Mteril Selection nd Technique, Second Edition (Quintessence Pulishing, 2013), Wht s in Your Mouth?/Wht s in Your Child s Mouth? (Quintessence Pulishing, 2013), Smile! Your Guide to Esthetic Dentl Tretment (Quintessence Pulishing, 2014), nd Wht s in Your Mouth? Your Guide to Lifelong Smile (Quintessence Pulishing, 2014). He hs lectured interntionlly on vrious sujects in restortive nd esthetic dentistry nd is dentl mterils clinicl reserch consultnt for industry mnufcturers. Dr. Terry is the founder nd CEO of design Technique Interntionl nd the Institute of Esthetic nd Restortive Dentistry. He mintins privte prctice in Houston, Tex. He cn e reched t (281) or vi e-mil t dterry@dentlinstitute.com. Disclosure: Dr. Terryi reports no disclosures. Dr. Powers grduted from the University of Michign with BS in chemistry in 1967 nd PhD in dentl mterils nd mechnicl engineering in He received n honorry PhD from the Nippon Dentl University in Dr. Powers is the senior editor of THE DENTAL ADVISOR nd clinicl professor of orl iomterils, deprtment of restortive dentistry nd prosthodontics, t the Uni versity of Texs School of Dentistry t Houston. Dr. Powers hs uthored more thn 1,000 scientific rticles, strcts, ooks, nd chpters. He is couthor of the textook Dentl Mterils Properties nd Mnipu ltion, nd is co-editor of Crig s Restortive Dentl Mterils nd Esthetic Color Trining in Dentistry. He serves on the editoril ords of mny dentl journls nd hs given numerous scientific nd professionl presenttions in the United Sttes, Mexico, South Americ, Europe, nd Asi. He received the E. B. Clrk Awrd from the Society for Color nd Ap - pernce in Dentistry in He received the 2013 Interntionl Assocition for Dentl Reserch Distinguished Scientist Wilmer Souder Awrd. He cn e reched vi e-mil t jpowers@dentldvisor.com. Disclosure: Dr. Powers is senior vice president of Dentl Consultnts, Inc (pulisher of THE DENTAL ADVISOR) nd is senior editor of THE DENTAL ADVISOR. INTRODUCTION The injectle resin com posite technique is unique nd novel indirect/direct process of predictly trnslting dignostic wx-up into composite restortions. There re myrid of 1

3 Before Imge. Preopertive fcil view of the mxillry nterior segment. A 63-yer-old ptient presented with incisl wer nd frcture on the mxillry nterior teeth. Ptient requested conservtive esthetic enhncement without orthodontic tretment. After Imge. The composite trnsitionl restortions estlish the optiml esthetic prmeters for nturl smile. pplictions for this technique using highly filled flowle resin composite. The clinicl pplictions in clude emergency re pir of frctured teeth nd restortions, fricting provisionl restortions, 1 trnsitionl composite restortions (Clss III, IV, veneers) nd peditric composite crowns, resurfcing occlusl wer on posterior composite restortions, estlishing incisl edge length prior to esthetic crown lengthening, nd developing composite prototypes for copy milling. In ddition, this technique cn e used to estlish the verticl dimension of occlusion nd for ltering occlusl schemes (nterior guidnce nd posterior disclusion) prior to finl restortions. Furthermore, this noninvsive technique is n integrl tool for enhncing communiction etween the ptient nd restortive tem during tretment plnning. Developing trnsitionl resin composite restortions using the injectle technique is n excellent method to increse the ptient s understnding of the plnned clinicl procedure nd nticipted finl result. 2 Trnsitionl composite prototypes llow the ptient nd restortive tem to estlish prmeters for occlusl function, 3 tooth position nd lignment, 4 restortion shpe nd physiologic contour, 5 restortive mteril color nd texture, lip profile, phonetics, incisl edge position, nd gingivl orienttion. This process lso elimintes confusion nd misunderstnding etween the ptient nd the restortive tem during the tretment plnning stge. 2 This in - jectle technique cn lso e used in the development nd mngement of soft-tissue profiles nd in the design of the definitive restortion. 6-9 The clinicin nd technicin cn use this reversile nd preprtion-less technique s guide for developing prepproved functionl nd esthetic finl restortion. This process ids the clinicin nd technicin during the design nd friction of the definitive restortion y providing visuliztion for the ptient nd the restortive tem s well s the ility to communicte extensive detils concerning the tretment pln nd the friction of finl restortions. 10 In some cses, these trnsitionl restortions cn e worn for months or even yers y ptients during longterm interdisciplinry rehilittion. 1 This technique cn e performed introrlly without nesthesi. A cler vinyl polysiloxne (VPS) impression mteril is used to replicte the dignostic wx-up. The cler mtrix cn e plced introrlly over the unprepred teeth nd used s trnsfer vehicle for the flowle composite resin to e injected nd cured. After djustment nd polishing procedures re completed, the trnsitionl composite restortions cn e further modified to stisfy the functionl nd esthetic needs of the p tient. This procedure cn reduce the potentil for ptient disstisfction nd litigtion since the process is reversile, cn e performed without preprtion, nd llows the ptient to ccept the visul nd functionl result efore the definitive restortions re fricted. In ddition, this simple procedure helps to regulte the dimensions of the preprtion design, ensures uniform sptil prmeters for the restortive mteril, nd increses the potentil for more conservtive preprtion design. 1 2

4 c Figures 1 to 1c. Clinicl evlution reveled multiple distems nd cervicl corrosion on the centrl incisors from lemon sucking. Figures 2 nd 2. () Development of dignostic wx-up tht estlishes new prmeters (ie, esthetic, functionl) for the finl restortions, nd () cler vinyl polysiloxne mtrix ws fricted to replicte the dignostic wx-up. Figure 3. Before the restortive procedure, hyrid resin composite ws plced in the cler mtrix nd positioned on the mxillry right centrl nd light cured. This technique llows the sptil dimension of lrge distem to e controlled during the composite injection procedure. This rticle presents cse report in volving the use of the injectle resin composite technique to develop trnsitionl res in composite restortions. CASE REPORT A 63-yer-old mle ptient presented with concerns regrding incisl wer nd frcture of his mxillry nterior teeth (Before Imge). Clinicl evlution reveled multiple distems nd cervicl corrosion on the centrl incisors from lemon sucking (Fig ures 1 to 1c). Additionl occlusl findings indicted insufficient cnine guidnce nd posterior disocclusion. Clinicl Protocol After occlusl evlution, new occlusl scheme ws developed with dignostic wx-up (Figure 2). A cler VPS impression (EXACler [GC Americ]) of the dignostic wx-up ws tken using nonperforted plstic try (RSVP Try [Cosmedent]) (Figure 2). Ech tooth ws pumiced nd clened with 2% chlorhexidine (Con sepsis [Ultr dent Products]). Also, prior to the restortive procedure, hyrid resin composite ws plced in the cler mtrix nd positioned on the mxillry right centrl nd light cured. This technique llowed the sptil dimension of lrge distem to e controlled during the composite injection procedure (Figure 3). Ech tooth ws then seprted y pplying Teflon tpe (Du Pont), or smll mount of glycerin, to the djcent teeth (Figure 4). This proximl dpttion technique llowed for optiml integrtion of flowle resin composite in the interproximl region while preventing dhesion of the mteril to djcent tooth surfces De pending upon the durtion of tretment, the method for onding requires either selective spot-etching or complete etching of the tooth surfces to e restored. 1,2 A 37.5% phosphoric cid semi-gel (Gel Etchnt [Kerr]) ws pplied to the enmel surfce for 30 seconds (Figure 4), rinsed for 5 seconds, nd then gently ir dried. A single-component dhesive ws pplied with n pplictor to the enmel surfce (Figure 4c), llowed to dwell for 10 seconds, ir dried for 5 seconds (Figure 4d), 3

5 nd then light cured for 10 seconds using n LED curing light (Silverlight [GC Americ]) (Figure 4e). The cler VPS mtrix ws plced over the rch nd n opcious A-2 shded flowle resin composite (G-ænil Universl Flo [GC Americ]) ws initilly injected through smll opening ove ech tooth, followed y trnslucent B-1 shded flowle resin composite (G-ænil Universl Flo) (Figure 5). The resin composite ws cured through the cler mtrix for 40 seconds (Figure 5). The excess polymerized resin composite ws re moved with sclpel (No. 12 BD Brd-Prker [BD Medicl]) (Figure 6). The incisl composite sprue ws removed with 30-fluted tpered finishing ur (Figure 6). The gingivl tissue ws retrcted with gingivl protector, nd the tooth-resin composite interfce ws finished using tpered finishing dimond (Figure 6c). The initil hyrid composite mockup on the mxillry right centrl ws re moved with the No. 12 sclpel lde (Figure 7). The proximl surfces nd contours were smoothed with tpered finishing dimond nd finishing strips (Figures 8 nd 8). This restortive procedure ws completed for ech tooth efore restortion of the next tooth. After isoltion of the djcent centrl with Teflon tpe, the dhesive surfce preprtion (Figure 9) ws completed using the totl-etch technique. The sme shde comintion of flowle composite mteril ws injected through smll opening in the mtrix ove the tooth (Figure 9), llowing the mteril to completely cover the conditioned enmel surfce. The resin composite ws then light cured through the cler mtrix for 40 seconds. After the incisl composite sprue ws removed, the ex - cess polymerized composite resin ws removed with the No. 12 sclpel lde (Fig ure 10). After ech composite injection, the sme re stor tive procedure ws completed for ech tooth in the nterior segment. Continuing Eduction c d e Figures 4 to 4e. () Before the dhesive surfce preprtion, ech tooth is seprted y pplying Teflon tpe (DuPont) on the djcent teeth; () 37.5% phosphoric cid semi-gel (Gel Etchnt [Kerr]) ws pplied to the enmel surfce for 30 seconds, rinsed for 5 seconds, nd gently ir dried; (c) single component dhesive ws pplied with n pplictor to the enmel surfce, llowed to dwell for 10 seconds; (d) ir dried for 5 seconds; nd (e) light cured for 10 seconds using hlogen LED curing light (Silverlight [GC Americ]). c Figures 6 to 6c. () The excess polymerized composite resin is removed with sclpel lde (No. 12 BD Brd- Prker [BD Medicl]); () the incisl composite sprue ws removed with 30-fluted tpered finishing ur; nd (c) the gingivl tissue ws retrcted with gingivl protector, nd the tooth-composite resin interfce ws finished using tpered finishing dimond. Figures 5 nd 5. () The cler silicone mtrix ws plced over the rch nd n opcious A-2 shded flowle resin composite (G-ænil Universl Flo [GC Americ]) ws initilly injected through smll opening ove ech tooth, followed y B-1 shded flowle resin composite; nd () the resin composite ws cured through the cler resin mtrix for 40 seconds. Figure 7. The initil hyrid composite mockup on the mxillry right centrl ws removed with sclpel lde (No. 12 BD Brd-Prker). 4

6 Figures 8 nd 8. The proximl surfces nd contours were smoothed with tpered finishing dimond nd finishing strips. This restortive procedure ws completed for ech tooth prior to restortion of the next tooth. Figures 9 nd 9. () After isoltion of the djcent centrl with Teflon tpe, the dhesive surfce preprtion ws completed using totl-etch technique; nd () the sme shde comintion of flowle composite mteril ws injected through smll opening in the mtrix ove the tooth, llowing the mteril to completely cover the conditioned enmel surfce. The composite resin ws cured through the cler mtrix for 40 seconds. Figure 11. The lingul toothcomposite resin interfce ws finished using 30- fluted pyrmidlshped finishing ur (Neumeyer H274 [Brsseler USA]). Figures 10 nd 10. () After the incisl composite sprue ws removed, the excess polymerized composite resin ws removed with sclpel lde (No.12 BD Brd-Prker); nd () the gingivl tissue ws retrcted with gingivl protector, nd the tooth-composite resin interfce ws finished using tpered finishing dimond. Figure 12. Proximl surfces nd contours were smoothed with finishing strips (KerrHwe). Figure 13. The incisl nd proximl contouring nd smoothing were ccomplished with finishing nd polishing disks (OptiDisc [KerrHwe]). Figure 14. The fcil surfces were polished with silicone points (ET Illustr Polishing Points [Brsseler USA]). An optimlly finished trnsitionl restortion should provide smooth surfce tht will prevent plque ccumultion nd resist stining. 14,18 The trnsitionl composite restortion should lso possess proper mrginl dpttion nd integrity 14,19 with the idel contours nd emergence profile for improved tissue comptiility. 14 For this p tient, the gingivl tissue ws retrcted with gingivl protector (8A TNPFIA6 [Hu-Friedy] nd/or Zekry Gingivl Pro tector [DMG Americ]) to prevent tissue lcertion, nd the tooth-resin composite in ter fce ws finished using tpered finishing dimond (Figure 10). The lingul tooth-resin composite interfce ws finished using 30-fluted pyrmidl shped finishing ur (Neumeyer H274 [Brsseler USA]) (Figure 11). This ur hs n idel shpe tht conforms to the pproprite curvture of the 5

7 Figure 15. The gingivl region ws polished with silicone hollow cups (ET Illustr Polishing Cups [Brsseler USA]). Figure 16. A got-hir wheel nd dimond polishing pste were used to further refine the surfce luster of the composite resin. Figure 17. High surfce gloss ws ccomplished with dry cotton uff pplied with n intermittent stccto motion. c Figures 18 to 18c. The trnsitionl resin composite restortions were inspected in centric reltion, protrusive nd lterl excursions. Notice the improved posterior disclusion nd nterior guidnce. c Figures 19 to 19c. The completed trnsitionl resin composite restortions with optiml ntomicl form. The composite injection technique llowed the estlishment of hrmonious proportions of the trnsitionl restortions nd the surrounding iologic frmework. tooth surfce nd restortion. The interproximl surfces were smoothed with luminum oxide finishing strips (Finishing nd Polishing Strips [KerrHwe]), which were used sequentilly from fine to extrfine (Figure 12). The incisl edges of the resin composite were contoured with finishing nd polishing disks (Opti Disc [KerrHwe]) (Figure 13). Pre-polish nd high-shine silicone points (ET Illustr Polishing Points [Brsseler USA]) were used to smooth nd polish the resin composite surfce (Fig ure 14). The gingivl region ws smoothed nd polished with prepolish nd high-shine silicone hollow cups (ET Illustr Polishing Cups [Brsseler USA]) (Figure 15). The cup provides dditionl flexiility t the cervicl curvture of the tooth. The fcil surfce ws polished to high luster with synthetic dimond pste using got-hir wheel, nd the finl surfce gloss ws ccomplished with dry cotton uff using n intermittent stccto motion pplied t conventionl speed (Figures 16 nd 17). The trnsitionl resin composite restortions were completed nd inspected in centric reltion, protrusive, nd lterl excursions (Figures 18 to 18c). The composite prototype chieved using this noninvsive injectle technique estlished the optiml esthetic prmeters for nturl smile (Figures 19 to 19c nd After Imge). 6

8 IN SUMMARY The injectle resin composite technique is vlule communiction tool for incresing the ptient s understnding of the clinicl procedure nd nticipted finl result. This process llows the functionl nd esthetic concerns to e resolved y the entire restortive tem efore finl restortive tretment is initited. The future clinicl pplictions of this novel technique my provide clinicins nd technicins with lterntive p proches to vrious clinicl situtions while llowing them to deliver im proved nd predictle dentl tretment to their ptients. Although the long-term enefits of this novel in jectle composite technique re mins to e determined, the clinicl results chieved in the pst 7 yers y the uthor re extremely promising. Prt 2 of this discussion will illustrte nother revolutionry ppliction of the injectle resin composite technique for use with the primry dentition descried s the Terry Injectle Primry Composite Crown. ACKNOWLEDGEMENT The uthors would like to cknowledge the following technicins for the lortory design of the dignostic wx-up: Bssm Hddd, CDT; Victor E. Cstro, CDT; nd Mrk L. Stnkewitz, DDS, CDT. REFERENCES 1. Terry DA. Developing functionl composite resin provisionl. Americn Journl of Esthetic Dentistry. 2012;2: Terry DA, Leinfelder KF, Geller W. Provis ionliztion. In: Aesthetic & Restortive Dentistry: Mteril Selection & Technique. Houston, TX: Everest Pulishing Medi; Heymnn HO. The rtistry of conservtive esthetic dentistry. J Am Dent Assoc. 1987;115(specil issue):14e-23e. 4. Gürel G. The Science nd Art of Porcelin Lminte Veneers. Hnover Prk, IL: Quin tessence Pulishing; Brtieri LN, Berry TG. Esthetics: Direct Adhesive Restortion on Frctured Anterior Teeth. São Pulo, Brzil: Quintessence Pulishing; Donovn TE, Cho GC. Dignostic provisionl restortions in restortive dentistry: the lueprint for success. J Cn Dent Assoc. 1999;65: Preston JD. A systemtic pproch to the control of esthetic form. J Prosthet Dent. 1976;35: Yuodelis RA, Fucher R. Provisionl restortions: n integrted pproch to periodontics nd restortive dentistry. Dent Clin North Am. 1980;24: S S. Antomiclly correct soft tissue profiles using fixed detchle provisionl implnt restortions. J Cn Dent Assoc. 1997;63: Terry DA, Geller W. Esthetic nd Restortive Dentistry: Mteril Selection nd Technique. 2nd ed. Chicgo, IL: Quintessence Pulishing; Terry DA, Leinfelder KF. An integrtion of composite resin with nturl tooth structure: the Clss IV restortion. Prct Proced Aesthet Dent. 2004;16: Terry DA. Restoring the interproximl zone using the proximl dpttion technique Prt 1. Compend Contin Educ Dent. 2004;25: Terry DA. Restoring the interproximl zone using the proximl dpttion technique Prt 2. Compend Contin Educ Dent. 2005;26: Terry DA. Nturl Aesthetics with Composite Resin. Mhwh, NJ: Mon tge Medi Corportion; Stewrt GP, Bchmn TA, Htton JF. Temperture rise due to finishing of direct restortive mterils. Am J Dent. 1991;4: Berstegui E, Cnld C, Bru E, et l. Surfce roughness of finished composite resins. J Prosthet Dent. 1992;68: Yp AU, Su CW, Lye KW. Effects of finishing/polishing time on surfce chrcteristics of tooth-coloured restortives. J Orl Rehil. 1998;25: Goldstein RE. Finishing of composites nd lmintes. Dent Clin North Am. 1989;33: , Yp AU, Ang HQ, Chong KC. Influence of finishing time on mrginl seling ility of new genertion composite onding systems. J Orl Rehil. 1998;25: SUGGESTED READING Terry DA, Geller W. Esthetic nd Restortive Dentistry: Mteril Selec tion nd Technique. 2nd ed. Chicgo, IL: Quintessence Pulish ing; Terry DA. Wht s In Your Mouth? Chicgo, IL: Quintessence Pulishing; Terry DA. Smile! Your Guide to Esthetic Dentl Tretment. Chicgo, IL: Quintessence Pulishing;

9 POST EXAMINATION INFORMATION To receive continuing eduction credit for prticiption in this eductionl ctivity you must complete the progrm post exmintion nd nswer 4 out of 5 questions correctly. Trditionl Completion Option: You my fx or mil your nswers with pyment to Dentistry Tody (see Trditionl Completion Informtion on following pge). All informtion requested must e provided in order to process the progrm for credit. Be sure to complete your Pyment, Personl Certifiction Informtion, Answers, nd Evlution forms. Your exm will e grded within 72 hours of receipt. Upon successful completion of the postexm (nswer 4 out of 5 questions correctly), letter of completion will e miled to the ddress provided. Online Completion Option: Use this pge to review the questions nd mrk your nswers. Return to dentlcetody.com nd sign in. If you hve not previously purchsed the progrm, select it from the Online Courses listing nd complete the online purchse process. Once purchsed the progrm will e dded to your User History pge where Tke Exm link will e provided directly cross from the progrm title. Select the Tke Exm link, complete ll the progrm questions nd Sumit your nswers. An immedite grde report will e provided. Upon receiving pssing grde, complete the online evlution form. Upon sumitting the form, your Letter Of Completion will e provided immeditely for printing. POST EXAMINATION QUESTIONS 1. The injectle resin composite technique is n integrl tool for enhncing communiction etween the ptient nd restortive tem during tretment plnning.. True. Flse 2. This injectle technique cnnot e used in the development nd mngement of soft-tissue profiles nd in the design of the definitive restortion.. True. Flse 3. This injectle technique cn e performed introrlly, without nesthesi.. True. Flse 4. The long-term enefits of this novel injectle composite technique re proven nd supported y widespred reports in the literture.. True. Flse 5. In ddition, this simple procedure helps to regulte the dimensions of the preprtion design, ensures uniform sptil prmeters for the restortive mteril, nd increses the potentil for more conservtive preprtion design.. True. Flse Generl Progrm Informtion: Online users my log in to dentlcetody.com ny time in the future to ccess previously purchsed progrms nd view or print letters of completion nd results. This CE ctivity ws not developed in ccordnce with AGD PACE or ADA CERP stndrds. CEUs for this ctivity will not e ccepted y the AGD for MAGD/FAGD credit. 8

10 PROGRAM COMPLETION INFORMATION If you wish to purchse nd complete this ctivity trditionlly (mil or fx) rther thn online, you must provide the informtion requested elow. Plese e sure to select your nswers crefully nd complete the evlution informtion. To receive credit you must nswer 4 of the 5 questions correctly. Complete online t: dentlcetody.com TRADITIONAL COMPLETION INFORMATION: Mil or fx this completed form with pyment to: Dentistry Tody Deprtment of Continuing Eduction 100 Pssic Avenue Firfield, NJ Fx: PAYMENT & CREDIT INFORMATION: Exmintion Fee: $20.00 Credit Hours: 1 Note: There is $10 surchrge to process check drwn on ny nk other thn US nk. Should you hve dditionl questions, plese contct us t (973) o o I hve enclosed check or money order. I m using credit crd. My Credit Crd informtion is provided elow. o Americn Express o Vis o MC o Discover Plese provide the following (plese print clerly): Exct Nme on Credit Crd Credit Crd # Signture Expirtion Dte This CE ctivity ws not developed in ccordnce with AGD PACE or ADA CERP stndrds. CEUs for this ctivity will not e ccepted y the AGD for MAGD/FAGD credit. / PERSONAL CERTIFICATION INFORMATION: Lst Nme First Nme Profession / Credentils Street Address Suite or Aprtment Numer ANSWER FORM: VOLUME 33 NO. 4 PAGE 96 Plese check the correct ox for ech question elow. 1. o. True o. Flse 2. o. True o. Flse 3. o. True o. Flse 4. o. True o. Flse 5. o. True o. Flse (PLEASE PRINT CLEARLY OR TYPE) PROGRAM EVAUATION FORM Plese complete the following ctivity evlution questions. Rting Scle: Excellent = 5 nd Poor = 0 Course ojectives were chieved. Content ws useful nd enefited your clinicl prctice. Review questions were cler nd relevnt to the editoril. Illustrtions nd photogrphs were cler nd relevnt. Written presenttion ws informtive nd concise. How much time did you spend reding the ctivity nd completing the test? Wht spect of this course ws most helpful nd why? License Numer City Stte Zip Code Dytime Telephone Numer With Are Code Fx Numer With Are Code E-mil Address Wht topics interest you for future Dentistry Tody CE courses? 9