Yesterday, when I arrived at the office, my office manager told me that she felt tooth #7 “crack” and now it’s loose. At the end of the day, I took a look. I was able to remove the crown / post with my fingers. And, then I saw this:
Can’t have this smile greeting patients at the office!
There was no way I could recement the crown, even temporarily. It was about 4pm, so we made a quick call to our periodontist. He could fit her in first thing in the morning (today – my office is closed on Fridays).
The periodontist was able to remove the tooth and place an implant. My assistant and I met Jo-Ann at the office at about 10am. The periodontist’s office is right down the street from mine.
Courtesy of Dr. Russell Gornstein, periodontist.
Here’s what we did:
This is how she presented just minutes after having the implant placed. The periodontist placed the temporary abutment.
Occlusal view of the temporary abutment upon arrival at my office.
Blocked out the proximal undercuts of the adjacent teeth with Opal Dam (Ultradent). Placed Teflon plumbers tape in the screw access. I also roughed up the abutment with a diamond bur to increase retention of the provisional material.
Filled the pre-op alginate impression with Luxatemp (DMG America) and let it set for 3 minutes to lock on to the abutment.
Drill through the provisional to access the screw. Here I can see the Teflon tape.
Teflon tape removed and access hole “cleaned up” with a diamond to get good access to the screw with the wrench.
I unscrewed the abutment and removed the provisional attached to the abutment. The first image on the left shows the voids and rough “margin” of the Luxatemp provisional. The middle and right images show the result after adding flowable composite to fill in the gaps and create a nice emergence profile. It also creates a smooth interface for the tissues to heal.
Provisional crown and abutment re-seated in the mouth and hand-tightened.
Teflon tape placed into the screw access and then sealed with flowable composite.
Booya! Not a bad looking provisional!
And, that’s how we spent our “day off!” 😎
Copyright protected by Digiprove © 2019 The Dental Warrior®