Vertical preparation

It was 2014 and I read an article in Quintessence magazine by Prof. Dr. Ignazio Loi that completely changed my view of tooth preparation. It's not easy to change the "horizontal" stereotypes you've had in your head for years overnight, and I still remember coming into my office and telling my assistants: vertical time starts now :)

Of course horizontal preparation works. In the first ten years of my practice I prepared hundreds or rather thousands of teeth on the shoulder/chamfer and most of it works.

I think that with time I became more precise and controlled under the microscope, but there were more and more cases where I did not feel comfortable with the horizontal preparation, such as non-vital teeth with weakened ferula or complicated subgingival margins in composite fillings.

Sometimes, after 2,3,5 years, secondary caries developed at the crown/tooth junction. Especially in places with poor hygiene, such as the distolingual lower molars. All it takes is a small microleak, which is not detected by crown testing or x-rays, and the risk of caries combined with poor hygiene is high.

The vertiprep's gentleness on the hard tissues, vertical accuracy of placement and support of the soft tissues convinced me so much that I have not prepared a single shoulder since, and after ten years the gingival recession or secondary caries is zero.

CASE from 2015

One of the first cases and from today's point of view an ideal indication for vertiprep. 
- Agenesis 11 
- after perfect ortho preparation 
- mock up and its preparation
- correction of the gums with a diamond drill 
- introduction of Teflon 
- perfectly shaped and polished provisional 
- and satisfied patient

of course, the ideal is not to drill the tooth at all and if we have to do so as little as possible, and that is vertiprep and my opinion is that the gingiva is always better in the long run with vertiprep

gingiva ❤️ vertiprep