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Retreatment with preservation of crown

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From: Marga Ree To: ROOTS Sent: Friday, February 17, 2006 11:11 PM Subject: [roots] Retreatment with preservation of crown Not the most beautiful crown, but the patient was very happy that we could recement the crown after the retreatment. Removal of crown with crown remover, removal of post with US, easy retreatment, cementing of fiber post, used the crown as a mould for the new composite build-up. In these cases the most challenging thing is to keep the field dry, I use retraction cord impregnated with aluminum chloride, and finally Expasyl (the green stuff, works great), before I make the build-up and place the crown. I see him back in 6 months, and told him it might be necesssary to do surgery, if the complaints will not subside or the lesion will persist. - Marga

Geez Marga....this is fanstastic Tx. What did you obturate with? I would have placed some MTA....thinking if I need to do surgery...it's already there...I just gotta remove the amalgam and replace it with enough retention. - Joey D Thanks Joey, great point, why didn't I thought of this myself............ .maybe because I usually do MTA treatments in 2 appointments, and I wanted to finish this one in one appointment, because of the removal of the crown. - Marga Hey....I do MTA in one appt's...especially on rotten kids with big apices. ...and it seems to work anyway. - Joseph Dovgan Marga, you posted a case some weeks ago , where you used the metall lift . Any specific reason you decided to use the crownremover in this case? BTW excellent handled ( as usual). Best regards - Jörg Jörg, The metalift cannot be used on anterior teeth, because of the path of insertion of the crown. - Marga Oooops, I should have answered my question by myself! Still a long way to go. - Jörg Marga: I have to respectfully disagree on this point. The metalift can be used on anteriors, and I have done it successfully on many occasions. The trick is to make the initial penetration and subsequent tapping parallel to the long axis of the tooth in the cingulum area. Your case may have had an unusual path but we have been largely successful in the removal of both anterior and posterior crowns. - gary hei Gary! you forgot closing your sandwich technique here!! ;-) (I thought this could be of help in the future: http://searchwarp.com/swa34695.htm GARY, You are absolutely right, I was too imprecise in my response. I remember having read in the users manual that it is only possible in certain situations, like you described, when you can tap the precision channel parallel to the long axis of the tooth in the cingulum area. I tried this on 2 different occasions, but I was not lucky. The metal was way too thin to get a catch. If you say that it can be done, I will try it next time. - Marga Lol! To be clear, I have done far less on anteriors than posteriors for obvious reasons, but I have been successful. In cases with poor cingulum development, it may not work well. I don’t want to infer that it is universally applicable. The only thing I have found that is is a carbide bur slotting the crown and then a flat instrument expanding the crown, of course requiring a new crown. gary Previous page

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Ahmad Tehrani
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Glenn Van As
Jorg
Marga Ree
Mark Dreyer
Noemi Pascual
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