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Case report - Saving heavily decayed teeth

Wednesday, April 3, 2013

A patient presented with 2 heavily decayed teeth. She thought that her teeth were hopeless and that they needed to be pulled.

Preop picture - heavily decayed teeth

Initial assessment: both teeth are heavily decayed and the premolar (smaller tooth) is fractured to bone level, i.e. we cannot isolate the tooth predictably to do a root canal or place a filling/crown.

1. First Step to saving her two teeth: perform Clinical Crown lengthening procedure.
  • Crown lengthening is a minor gum surgery that involves:
    • Detaching the gum from around the tooth to expose the bone,
    • Ensuring there is a 3mm clearance between the bone and non decayed tooth (or crown/filling margins)
    • Result: allow the gums to attach to the root of the tooth, and seal the sterile/clean bony tissue from the oral cavity (the mouth). 
2. Second Step:  Predictably isolate the teeth then treat them.
  • Root canal treatment on both teeth
3. Third Step:  complete the temporary fillings - with correct anatomical shaping & seeing the patient in 1 week to place the final crowns (to be made at the office using the Cerec 3D Omnicam)
  • Temporary fillings placed and shaped to the correct anatomy
  • Copack dressing was applied (Band-Aid for the gums)
  • Patient scheduled to place final crowns after proper healing has occured.
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1 Comments:

At April 3, 2013 at 7:22 PM , Blogger Sura Alwarid said...

Great work (as usual)!

 

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