“Stacking the Deck” – Endo/Restorative
Jon Richards DDS MS
2 long appointments to get this result. It was clear from the very beginning that the existing temp crown had to come off and the D defect be addressed prior to tackling the case as whole.
The DB canal as treated through the vacant space of the D aspect of the crown prep. It was then termporarily restored with Fuji Triage. A conservative coronal access was then made and the MB1, MB2, and P canals were treated conventionally. Following obturation, an amalgam core was placed. The D margin is not far from bone, so it was trimmed flush with the root surface – not hard to see or do with the aid of the dental microscope. The restorative dentist can now choose to crown lenghten or place the margin on alloy. Not the most traditional apprach, but the restorative/tooth junction is closed and the removal of bone to accomodate a crown margin could be very destructive. The rubber dam was never removed throughout the course of treatment.
After the endodontic therapy was complete, I fabricated a new temp crown using a VPS matrix from the pre-treatment form. Its always nice to think ahead and take a record prior to removal of the crown just in case a new temporary crown is needed.