Single crown

Unsatisfactory restoration
Courtesy of Dr D. Colson, 2022
Highlighted picture of treatment

Treatment Summary

Patient Information

  • Age: 67
  • Gender: female

Diagnosis

  • Unsatisfactory restoration on 4.6 (LR6), 4.7 (LR7)

Total Treatment Visits

  • 2

Treatment planning

  • First Visit:
    The patient presented to the office with existing #47 MODB and #46 OD large amalgam fillings. It was recommended to remove the amalgams following the amalgam protocol. Due to the small amount of natural tooth structure remaining, it was recommended for the teeth to be prepared for crowns.
    The patient signed the consent form and agreed to proceed with monolithic Zirconia crowns. A preliminary alginate impression was taken in order to fabricate the temporary after preparation and 6 cc Xylocaine 2% with epinephrine 1:100,000 was administered. After the preparation, ozone air was infused over the teeth and the teeth were built up with Fuji II for more retention and light cured. Then Clearfill bond was applied and light cured.
    Expasyl was utilized to retract the tissues and then washed away to allow good visibility of the margins.
    The iTero scanner was used to capture the preparation of #46 and #47, inclusive of 1st and 4th arches and a bite registration. The teeth were temporized with Luxatemp A2, Fleck’s cement was used to ensure stability of the temporary until the cementation appointment three weeks later.
    The occlusion was adjusted and the restorations were polished. The shade for the crowns was Vita A3. The case was submitted to a designated lab for fabrication.
  • Second Visit:
    The patient presented for cementation of the crowns. No local was necessary for this appointment as the patient was comfortable. The temporary were removed and the crowns were tried in. It was checked for tight contacts, optimized occlusion and acceptable esthetics by the dental team and the patient. A bitewing xray was taken to verify the interproximal fit of the crowns. Once the above criteria was met, the teeth were micro etched and Universal bond was applied to seal the dentinal tubules, lightly air dried and light cured. The internal portion of the crowns were treated with Z Prime for 1 minute. The crowns were filled with Rely X Unicem translucent, placed intraoral on the preparations and the cement was light cured around the margins after flossing and brushing away excess cement. Once the cement was cured, the excess was removed. Again occlusion was checked with articulating papers thin and thick for centric and balancing side contacts respectively. The restorations were polished with Shofu porcelain polishing discs where the adjustments had been made.

Images

Initial and final

InitialFinal
After picture of treatment
Before picture of treatment
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iTero Scans

Initial Final
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Radiographs

Initial Final
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Progress Images

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Publication


A safe protocol for amalgam removal

Dr. Dana Colson & Associates