Restoration of root caries with Glass Ionomer & The GI/Composite Sandwich

Select two teeth, preferably with existing root surface caries, and mount them in plaster.  Notch the roots of the teeth if they are tapered.  Use a piece of utility wax in the base of a paper cup to support the teeth adjacent to each other with a normal proximal contact relasionship.  Pour plaster around the roots up to a level about 4 mm apical to the c.e.j. or apical to existing caries if present.  Allow the plaster to harden and trim to the shape of an alveolar ridge with a lab knife or model trimmer. This will allow access to the cervical areas of the teeth for preparation of the root surfaces.

The first preparation should involve a proximal root surface at the distal of the most anterior tooth.  Use the end of the 330 bur to cut into the dentin of the root surface much like starting a class III preparation.  Penetrate lingually at least to the depth of the 330 bur flutes.  Move the bur apically so that the end of the bur creates a lingual wall and the side of the bur creates an axial wall.  Final dimensions can be 1.5 to 2.0 mm from the occlusal wall to the gingival wall and the same from the buccal surfce to the lingual wall.  The axial depth should be 1.0 mm.  All walls should intersect the surface of the root at 90 degree angles.  Refinement of all walls can be accomplished with a Wedlestaedt or bin-angled chisel.  Retention grooves should be placed at the axioocclusal and axiogingival line angles with a 1/4 round bur.