This will be a “quick and dirty” case presentation.
Patient is a 53 y.o. woman from China, who speaks a little English. Her boyfriend is a long-time patient in my practice. She first presented with a toothache… actually multiple toothaches.
She had full mouth crowns done by a dentist in China about a year ago. They are all splinted in segments. Each arch is three segments – right, anterior, and left sides. It was done for “cosmetic reasons.”
Here’s the FMX:
(note the multiple apical lesions)
I made pre-op models and a Siltech matrix to help make the provisionals. Ultimately, the entire case needs to be re-done. But, the upper anterior segment was the most dire, so we started there. She will see an endodontist for the RCTs in the posteriors.
The first order of business was to remove the splinted crowns #’s 6- 10. They are porcelain fused to zirconia. So, you KNOW how much FUN that’s going to be. And, so it was…. not so much fun. I went through 6 diamond burs.
The restorability of #6 is questionable. But, I hate to extract a canine. I went ahead and did the endo on it. I’ll build it up and prep it at the next visit and see what I think. Given that I believe there is a biologic width violation on #’s 8 and 9, I might send her for crown-lengthening and keep #6.
I worked on her from 9am to about 12:30pm. Next, I’ll do the RCTs on #’s 8, 9, and 10. I’ll also do a post and core and re-prep #6.