Hi folks………sometimes I just start shooting photos and lo and behold something turns out of nothing.

THis lady came in and saw the associate who told her she needed a simple patch to her tooth til she could afford a crown.

She waited for me (2 months) and then when I saw her I had an hour and thought……..oh oh.

The DL cusp was broken on the lower right 2nd molar and tough to see (pt. cant open wide at all).

I first used the argon to find out where the tooth structure was and found it to be at the height of the osseous level.

I then prepared with the erbium laser with water to remove tissue tags at 30 Hz and 80 mj or so and thought all was ok til I removed the rest of the amalgam and then the last picture on the first page (pic #8) shows the darn ML cusp just came off as it was cracked as well (this always happens on those darn lower molars).

Now I got some fun…………

I didnt know what to do …..buildup, endo plus bu, pin retained laser etched core buildup and temp crown is what I decided to do after osseous recontouring with the laser on the lingual at 30 Hz and 120 mj with 600 micron tip to get 3mm of tooth .

I then placed 2 tiny pins and explained to patient that it may lead to endo.

Then we built up the tooth in resin , reprepped the tooth and placed a stainless steel crown on the tooth which was long to push the tissue back.

I went 30 mins overtime here and it was tough. I was over lunch time and didnt want to ask my awesome dental assistant to get the impression material.

We placed a temp and will re evaluate as to whether we need endo or not in 4 weeks.

Tissue will heal by then.

Kinda a cool case I thought……….

Glenn