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New Patient arrived with post/core/crown in hand and wanted the unit cemented back in as he was leaving town.
Post/core/crown had been placed about 1 year ago and has come out on several occasions. He decided to try a new office.
I discussed tx options, including; new post/core/crown, gingival recontouring and crown/veneer options on Max. Anterior. He elected to have gingival recontouring and recementation of tooth # 22 only.
did not get a picture of Perio probe (should have) but probing was 2.5 mm. Gingivae was hyperplastic.
Topical anesthesia only. 10hz, 70mj (.7 watts) air only with erbium, 30° tip. I also laser etched the exposed surface and disinfected the post chamber with a 300 micron endo tip.
Post/crown was recemented with Fuji Plus and cleanup was completed. Viscostat was used for haemostasis.
Patient was happy with result. I would like to have been able to recontour the gingiva around the 21 also but he was not interested at this time. I believe he will come back for the treatment once he returns from his trip.
Hi Andrew
I would bet on it coming out which is why I offered him a new post/crown as an option. While there was good marginal contact along the interprox and lingual there was about a .5 mm opening on the facial, which you picked up on.
Hawk Eye!Even if he gets a few months out of it hopefully he will appreciate that he didn’t have to go out of town looking like a Canucks defenseman and remember what I offered him at today’s appointment, rather than blame me for it coming out again.
Paul nice case. Great emergency treatment. In cases like these I always tell them it will fail! When it fails the next time it will be worst. Less tooth structure to work with or even a fractured root. That they need to make plans for the future on how they want to deal with their problem. What I have seen in the past is when it fails they try to make it MY problem. The old pass the Monkey. I like to give them the Monkey from the start and let them know it is thiers for all time.
Like I said nice case and watchout for Glenn. He is going to start the scope stuff with you real soon. It may already be too late.
Off topic, these types of patients drive me nuts. They do not want to accept any responsiblity for their care. It is always nice to find out early they will be a PIA. In a case like this I credit the account and discharge them from the practice. Not worth the gut lining. I don’t run into this problem as much anymore. I do not accept insurance for my exams. We let the patient deal with it. It trends to weed out the trouble patients and keeps me out of the middle of the patient insurance relationship.Hi Fellow Forum Folks,
Here’s an emergency that I dealt with recently. Patient arrived late for his “emergency treatment”. 20 minutes after his appointed time and just 10 minutes before we are to finish the day. Don’t you just love it when they claim an emergency situation and then show up in a nonemergency fashion….What is it that Rodney Dangerfield says? I just don’t get no respect. Or more like, dentists don’t get the same respect as physicans. You know, the real doctors!? But that’s another discussion for another time.
Anyhow, upper right lateral crown broke off with a minor shearing subgingival fracture. 2 pins placed along with erbium pulpal floor decontamination, build up with paracore, 980nm diode gingival troughing(future osseous reduction needed) and recemented for the time being until prep appointment. Advised need for possible endo.
Andrew