Doc, I don’t want to loose this tooth yet !

A new patient presented to the office for a limited exam. Her chief concern was that she lost her crown on tooth #11. Her dentist advised her to get the tooth extracted and get an implant. She was not ready for an extraction and came in for a 2nd opinion

#11 crown broken at gum line.

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We took some limited X-rays and rightly so the tooth was fractured at the gum line with very limited tooth structure left above the gum line. I echoed what her dentist suggested and advised extraction and implant for best long term prognosis. The patient again resisted to the idea of an extraction and asked if she had any other options. There was about 1- 1.5 mm of ferrule on the lingual so I suggested the option of a post and core and crown with guarded prognosis and no guarantee on how long this crown would last. When doing treatment plans like these it is very important that expectations are set with the patient. Pt was well informed that if this crown fails within a year no refund will be given but if the patient was willing to move forward with extraction and tooth replacement (implant / bridge ) we would credit the treatment cost towards future treatment. The patient was extremely pleased with the option and the security of future treatment.
We put a Para Post and did a build up around it. A crown was designed with the Cerec Omnicam and milled with Triluxe Forte

Para Post and Build up

 

Vita Triluxe Forte Try in

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However we still needed some additional staining to obtain the chroma of the adjacent teeth. Total treatment time was 1 hour and 15 minutes.

#11 Stained and Glazed to match the neighboring teeth

The patent was very happy with the final result and has already referred 2 new patients to our practice.
How would you have handled this case?

If you want to learn more about Anterior Cerec Esthetics here is an exclusive link for blog readers for a discount of $895  to my 2 day course in October at the 3D Dentist training Center in Raleigh, NC. This discount is for the first 6 registrants only.

2017-05-30T08:51:46+00:00

About the Author:

Dr. Dhaval Patel has been practicing in Roseville, CA since 2006. He started using CEREC in 2008 and has quickly ascended to one of the top CEREC dentists in the US. His case studies have been published in numerous dental journals.

Dhaval brings a real world approach to his training and speaking. As a owner of a private practice that works with HMO, PPO, and FFS patients – he uniquely understands the challenges associated with providing high quality CEREC in an efficient manner.

3 Comments

  1. Andres Powditch May 29, 2017 at 7:04 pm - Reply

    as informed and “guaranteed” to the pt the wsy you did it…..I find it PERFECTISIMO.
    Congrats on showing real diary challenging solutions.
    BTW seeing now in DDA in Berlins SironaDentsply Training center the new 4.5 and 4.5.1 features…..it only gets better and better….looking foward to the 5 click cerec.
    saludos and felicitaciones !!!!!

  2. Dhaval Patel June 13, 2017 at 1:19 am - Reply

    Thank you Andres for the kind words.

  3. Karl August 11, 2017 at 2:34 am - Reply

    My name is Karl, live in Pennsylvania Lost half of a bicuspid ,I am a very informed dental patient, I want my dentist to use Calcimol for the base to calm and protect the nerve, then hemo to seal the tubules and finally self etching composite to build up the tooth. My dentist said there is not enough tooth to put a band on it and said he would have to do it free hand. I said I do not want an implant or extraction, the base is still intact, just the half the tooth is left Will this work, want to keep the tooth even what’s left. By the way, very important, does Calcimol stay firm unlike Dycal that goes soft with age, and does Calcimol sooth the nerve, where Dycal sometimes irritates the nerve, I have very sensitive teeth and can feel everything. Thanks please answer, would be a great help, if you could email the answers, I want to take care of it soon (wish I lived near your practice, You do great work! I saw the pictures.

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