The Wheel Diamond - The most underrated of all burs By Scott Perkins, DDS
Houston, Texas

The wheel diamond is one of the fiercest cutting burs I have ever used. It allows you to overcome the irresistible force of the large, muscular combative tongue and the immoveable object that is the closely approximated ramus by allowing a vertical approach when accomplishing occlusal reduction during a crown preparation procedure.

How many times have you and your assistant struggled over the combative tongue trying to approach a tooth with your handpiece oriented in a perpendicular direction? Have you ever witnessed your assistant wrestling the tongue back with a mouth mirror as the tongue heaved and strained involuntarily? Has your assistant ever lost the battle sending the tongue bulging into the path of your diamond or carbide bur, which then rips a gash into the fragile sublingual mucosa? Or how about pressing your handpiece into the ramus because the combined length of the highspeed head and the bur are so long that you can’t possibly accomplish your buccal cut without being obstructed? Have you ever had to work around this by asking the patient to close a little more or cocking their jaw laterally? Who needs those kinds of headaches? The wheel diamond eliminates these needless struggles making life easier for you and your patient.

Especially in the case of multiple crown procedures, the wheel diamond allows you to achieve occlusal reduction on multiple teeth. Once occlusal reduction is accomplished, the circumferential reduction is easily accomplished with tapered diamonds or my personal favorite, the SSWhite GW#2 bur.

One of the most maddening of procedures is cutting through the incredible hardness of a Procera coping. A carbide bur is soft compared to these aluminous copings. When attempting a cut through a Procera coping with a carbide, the first thing you will notice is a miniature lightening storm created as the bur comes into contact with the coping. You will quickly observe that instead of the carbide cutting through the coping, the coping cuts through the carbide. Your carbide is rapidly defanged. You throw the bur away and reach for another. You decide to try a tapered diamond but the diamond particles are shattered off of the bur shank. You destroy countless burs and precious time trying to cut through the coping while the patient fatigues from stretching their mouth open wide while you work. Enter the voracious wheel diamond. By virtue of it’s wide diameter, it brings 50 times the number of diamond particles into contact with the coping, some are knocked off but there are many more to take their place. The wheel plows through the coping cutting a wide swath through it. The toughness of the coping is breached and the crown is quickly removed allowing increased patient comfort and unparallel efficiency in accomplishing the crown removal process.

In the case of an endodontic procedure in which you are going to accomplish endo and crown preparation at the same appointment, the wheel diamond is by far the most logical choice for occlusal reduction. It creates a flat table with a remarkably smooth finish that allows you much greater access for file entry into the canal orifices by virtue of a shallower angle of attack. In addition, the flat occlusal surface allows much more accuracy in measuring files because your rubber stops sit on a flat surface instead of a cone shaped cusp tip, slanted inclined plane or rounded marginal ridge. In addition, your visual access is much greater. So, in effect, you have accomplished simplifying the endodontic procedure and increasing quality in one fell swoop.

A solidly built high-torque handpiece is also an important element for rapid cutting of the tooth.		Pirahna Single Patient-Use Diamonds. The diamond wheel is a coarse grit (140 microns). The ISO for this product is 909-042.

In the case of reducing endodontically treated teeth for use in overdentures, the wheel diamond produces a beautiful result in an extremely efficient manner.

The Piranha round wheel diamond is a disposable bur, which differs from a re-usable bur in a very important way. A re-usable diamond bur has the diamond particles embedded in a deeper matrix that holds the diamonds onto the bur shank. In a disposable diamond, the matrix is shallower so that more of the diamond particle is exposed; therefore, there is more diamond particle to come into contact with tooth structure. This is why disposable diamonds cut so incredibly fast. They don’t last for many uses or hold up to auto-claving very well because they lose their diamond particles faster. Diamond burs don’t ever really dull, they just lose their diamond particles as they become dislodged from the matrix they are embedded in.

The wheel diamond delivers more bang for the buck than any other bur I know of with the possible exception of the GW#2 bur. It is a valuable component of my bur armentarium saving me money in terms of numbers of burs used up as well as decreased chair time and labor. It also increases patient comfort and decreases assistant and doctor stress. I can’t imagine working without it. DT

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Scott Perkins, DDS, is a solo, private care clinician who practices in downtown Houston, TX. He has authored several articles on achieving extreme efficiencies in clinical dentistry.

To order Dr. Perkin’s step-by step procedural tapes on his famous 15-Minute Crown Procedure and/or the 15-Minute Molar Endo, please call 713-658-1708 or order at his website: www.scottperkinsdds.com.