What is the best restoration for this case ?

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This topic has 16 replies, 4 voices, and was last updated 12/08/2012 at 12:40 pm by siteadmin.

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19/06/2012 at 9:15 am #10639

siteadmin
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No relevant medical history.

No relevant medical history.

Patient is fairly conscious about oral hygiene.

23 year old female.

no pulp exposure.

There was an old leaky silver filling. I took it out and placed a temporary cement.

radiograph is normal.

perio is normal.

this tooth is lower left first molar.

upper left first molar has undergone RCT and I will be making a PFM crown there.

what is the best way to restore this tooth .

any help would be greatly appreciated.

Thanks in advance for all the inputs,

Regards,

veerend



19/06/2012 at 5:26 pm #15618

drmithila
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Ideally, since you have given her a temporary dressing, we must wait till the patient is completely asymptomatic.

Once it is established that the patient is asymptomatic, the best way to save the tooth would be to restore it with composite or miracle mix and put a CROWN on the tooth.

If ZOE cement was given as temporary then composite may not bond, so miracle mix can be put and a crown wil be the best to safeguard the tooth and ensure its long life



19/06/2012 at 5:28 pm #15619

drmithila
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Also if the crown structure seems to less to support a crown on its own, then an intentional RCT can be done followed by post and core with crown



20/06/2012 at 5:43 am #15622

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there were no symptoms to begin with. The filling was removed because it was failing.

Patient wants to avoid a crown and i contemplate puting an emax onlay



20/06/2012 at 5:25 pm #15623

Drsumitra
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Can you tel me lab details of those who do e max onlays? My lab doesn’t have information



20/06/2012 at 5:28 pm #15624

Drsumitra
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IPS e.max® Inlay-Onlay

IPS e.max® delivers the ultimate in metal free esthetics and strength utilizing both Pressable and CAD/CAM technologies.

Designed with versatility and simplicity in mind, IPS e.max lets you select from multiple framework materials including Zirconium Oxide, giving you the versatility you want while always veneering with the same ceramic giving you the simplicity you need. IPS e.max provides.

IPS e.max®Inlay/Onlay Tooth Preparation

IPS e.max® Inlay Tooth Preparation

IPS e.max® Onlay Tooth Preparation



21/06/2012 at 11:59 am #15630

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dental ceramists in bandra make it. contact nirav jain at : 9819719883



21/06/2012 at 5:31 pm #15631

Drsumitra
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CEMENTATION
The high strength of IPS e.max lithium disilicate offers dentists a choice to adhesively bond or conventionally cement their restorations.

Coordinated especially for Ivoclar Vivadent restorative materials, Ivoclar Vivadent recommends the following cements to maximize the performance and esthetics of IPS e.max restorations:

ADHESIVE RESIN CEMENTS
For maximum bond strengths and in situations where adequate retention is not possible in the prep design (e.g. veneers, inlays/onlays) adhesive cementation is recommended.

There are no minimum requirements for adhesive cementation. Adhesive cementation will provide higher-immediate bond strengths and a better marginal seal.

SELF-ADHESIVE RESIN CEMENTS
Self-adhesive resin cements combine an easy conventional cementation technique, with the advantages of "resin luting-composite"; increased strength, low solubility, high-level radiopacity and light-cure capabilities. Due to the lower bond strengths offered by this category of cements, it is strongly recommended that self-adhesive resin cements only be utilized in situations where a conventional cement would normally be used; retentive prep design, high-strength restoration with adequate thickness and tight fit.



23/06/2012 at 5:16 am #15641

nkdds
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Based on the images presented, a full coverage crown would be ideal, either PFM or E Max. What is the patients occlusal scheme? Since you are restoring the upper opposing molar, you can work out the occlusion easier.



23/06/2012 at 10:26 am #15642

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Many thanks for the reply dr neeraj khanna.

Occlusion of the patient is normal. there are no parafunctional habits.

The patient wanted to avoid a crown on the lower and hence I was contemplating an onlay/crownlay

regards

veeren



24/06/2012 at 1:30 pm #15643

drmithila
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So what has been decided as the final treatment option for this case?



25/06/2012 at 3:26 am #15647

siteadmin
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not yet decided.

contemplating an emax onlay/crownlay



25/06/2012 at 5:34 pm #15648

Drsumitra
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sir do put up pictures in case you choose to do e max onlay, as i have never witnessed the prep for it, images of the prep and the final product would be very helpful



05/08/2012 at 4:34 pm #15794

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Onlay in place



05/08/2012 at 4:38 pm #15795

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The anatomy is not exactly the way I wanted but good enough
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