From: Marga Ree Sent: Wednesday, October 04, 2006 2:30 PM To: ROOTS Subject: [roots] endo, post and recycling of a 20 year old crown This patient has been in our practice for more than 20 years. In 1985, all old amalgams were removed and replaced by PFM crowns. Apart from 2 Class V restorations on the buccal side of tooth 34 and 36, it has been functioning without any problems till last week, when the crown on # 35 snapped off, see picture. I did the endo today, and after removing the dentin and amalgam from the crown, and judging the remaining ferrule, I decided to recement the crown after finishing the endo. I placed a fiber post (a tapered FibreKleer by Pentron) with LuxaCore, and made the build-up of the same material. I used the existing crown as a mold, after lining the inner surface with vaseline. After removal of the crown, I removed the surplus of composite core material that had been flowed in the interdental space. I checked the occlusion, and after a minor adjustment, the crown was recemented. Despite the fact that the esthetics are not optimal, this patient has been very satisfied with the PMF crowns. Nowadays we would make it differently, with occlusal porcelain and no bevel on the buccal side. But, it is very rewarding to see that your work is still in place and functioning well after 20 years. Hopefully it will last another decade !! - Marga
Marga, well done, endo-post look great. Maybe you could have just cemented the crown with the buildup material, no Vaseline, no recement ? - Danny Thanks Danny, The reason I like to do this in 2 steps is extra control. You cannot prevent that composite will also flow over the cervical dentin, below the crown margin, and in the interdantal space. When I have removed the crown, I check the margins and remove the surplus of composite with an US tip. I check the build-up, adjust it if necessary, I check the fit of the crown, the occlusion, and when everything is OK, I cement the crown - Marga CLAP....CLAP.....CLAP...I like your work.... I really appreciate your online classes ...and your judgement in your cases... Tks for sharing it with us in the same day you have done!!! May I have you authorization to show it to my students??? - Marcia Vieira With the marginal fits you have on those, they’ll go another 20. hope to see you and paul in vegas in a couple of weeks - Gary Do those upper molars jave single canals? - Jason Highly likely Jason, see rads - Marga
Marga, I have in the past occasionly had trouble removing a crown when vaseline was used as a seperator. I now flash the inside of the crown with a very thin layer of baseplate wax, seems to be easier to remove the crown - DanS
