From: Terry Pannkuk
To: ROOTS
Sent: Wednesday, January 27, 2010 8:04 AM
Subject: [roots] Core versus Hole

I try to get my referrals to let me do the cores by showing contrasting examples like this.  I treated the lower
second molar on this patient 7 months ago.  She came back for another tooth with an interesting photo view of the
core I placed last July versus the core done by someone else on the maxillary molar.   You can see both teeth in
the photo view, one with the mirror reflection and the other directly viewed (with a bit of saliva). :)

It's also a good photo to have in your patient education series when a patient asks why their previous dentist
did the core for free :):):):):):):):)  - Terry



Very nice work Terry! May I ask what materials you use for the core build up and your step by step process?
- Jonathan

I learned this from Ron Fransman.  I build up the internal core with Clearfil Photobonded Luxacore, then placed the
surface with Filtek (shade match) then slightly tint with 6 endo file (brown tint) and use a brush to smooth.
If the porcelain is thick they usually look really good,  If the porcelain is thin, not so good.  I'm finally
getting pretty good at recognizing plunging cusps and looking the existing anatomy ahead of time to figure out
how to not build it too high.  Taking a quick photo of the surface before you access the porcelain is a pretty
good idea if you remember.  Sometimes I start accessing the case, then think, "Damn, I forgot to get a prephoto" :)

Ron and Marga are masters and mastresses at this,  I'm always trying to get better on the next case.  :) - Terry