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Preserving patient’s own crown

February 4, 2016 By Dr Pierre Pizem Leave a Comment

37 pre operative 37 Core Paste 37 Post operative

Patient came in for a recementation of her lost crown on her mandibular second molar. This (previously sandblasted) crown still had a nice fitting and a nice 5 mm hight of sound tooth above the gum line structure was still remaining.
Tooth was not symptomatic, but, prior to recementating this patient’s crown, we tested its pulp vitality with a pulp tester and came up with a pulpal necrosis diagnosis. We explained the patient the risks of cementing a crown over a tooth presenting with a ”dead nerve”. Patient was willing to keep his crown for a few more years, and, in order to do so, she accepted to come back for a root canal treatment as well as an adapted core build up to the existing crown.
When patient came back, during the same setting a root canal has been performed , innerside of the sand blasted crown has been coated with a thin vaseline layer to allow for easy removal of the crown once the core build up has set. Core build up procedure has been performed with a self cure flowable Core Paste material. Core Paste XP has been inserted directly into the pulp chamber as well as within the crown itself, the crown has then been placed onto the abutment. After 5 minutes, the crown has been removed , both the abutment and crown have been rubbed  with pumice stone to remove all petroleum jelly remnants. Crown has then been recemented permanently.
Endodontic procedure instrumentation has been performed with Mani stainless K files and ProTaper Universal (Dentsply). Chelator: RC Prep. PUI Irrigation: NaOCl 5%. pulp stones removal with Ultrasonic tip: BUC One from Spartan. P5 (Dentsply) Sealer used: Pulp Canal Sealer. Obturation technique WVC. X Ray Sensors used: CareStream Kodak 6100

Filed Under: General

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