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Case of the Fractured tooth!

Saturday, April 6, 2013

Thursday afternoon, a patient searching for a dentist in vancouver to repair her broken tooth while she's on a trip, calls our office.  Sara answers her call and books her an appointment.

The patient fills in the forms and is seated in the dental chair. After the interview, the exam and a radiograph, fair enough, the cusp is fractured! (tooth is confirmed broken) :-O


The suspect: A failing silver (amalgam) filling on tooth 4.6 (30 for US dentists, lower right first molar). This is generally why we recommend to change old failing amalgam fillings.

The solution: The tooth needs a ceramic-onlay to replace the missing cusp and the old amalgam filling. ie we have to fix the broken tooth.

The patient was frozen and the tooth was isolated with a rubber dam.


Fractured tooth


The old filling is removed and the tooth is prepared to recieve an onlay.
Note: The stain in the middle is caused by tertiary dentin and corrosion residue from the amalgam filling. It is solid and there is no need to remove it. Removing it would lead to pulpal (nerve) exposure and the need for a root canal treatment. So a root canal treatment was avoided here.


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Onlay prep


The tooth was scanned with the Omnicam - CAD capture camera and the margins were traced...
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Prep scan
 Then the ceramic onlay was designed and adjusted to fit the tooth...

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Onlay design
The designed onlay was then milled from a block of ceramic that matches the colour of the tooth´╗┐


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Milling preview

The milled onlay was then microetched and treated for the final cementation´╗┐

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Milled onlay

The onlay was then cemented... It disappeared in the tooth...´╗┐ Can you guess where it is?

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Cemented Onlay!

The patient was thrilled! She went on with her journey.

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Et voila!

Do you have a comment, a question or would like to schedule a consultation? Follow this link for our contact information: http://ariadental.com/contact.php

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1 Comments:

At May 16, 2013 at 8:59 AM , Anonymous Mark Bossert said...

Wow. Very illuminating to see how the new ceramic tooth repair disappears. Nice work!

 

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