Caries bonding labial porcelain veneer - Courtesy ROOTS
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From: Terry Pannkuk
Sent: Thursday, May 06, 2010 1:56 PM
Subject: [roots] Coulda Used a Laser, but didn't
Typical Depression Era Dentistry: I got a call from a referral yesterday.
He saw this elderly woman, struggled doing the endo on #27 and when he was
finished didnít have time to do #26 which he had planned at the same time.
She was distressed by the experience so he sent her to me. He told me
there was a lot of decay and that I might want to use the electrosurg to
perform crown-lengthening. He also told me if I felt it wasní't restorable
to extract it. I was already thinking of all the cool Canadian crap that
could be used on this case: lasers..Isolites..bioceramics.medical grade pot.
but I decided to just go mainstream.
I was also told I didnít have to worry about protecting the porcelain veneer
which Immediately fell off when I started probing with the explorer
(Good thing I didnít have to worry about that.
I placed a dam with multiple holes second bi to second bi and clamped #26
deep on the gingiva. In about 5 seconds zipped the lingual gingiva down
with the electrosurg exposing circumferential dentin. Thank God there
wasn'ít an amalgam in #25 or the pulp would have been cured beef jerky!
The root canal procedure was routine. I bonded a fiber post; maybe it
should have been metal; especially if the prep is going to have a shoulder
instead of a long bevel. I figured the occlusion would be protected,
sheí's very petite, and besides the labial porcelain veneer had stayed on
for years with just caries bonding. A copper band matrix was used,
contoured it down, replaced a small labial pothole with RelyX cement,
and contoured it down to look like a tooth.
At the end of the procedure she asked me if I did crowns too;
I said, No, your general dentist should do the
hard stuff like that - Terry