Hello Tuesday Warriors,
Is it the day for dentoheroics or what? This dentist's relative's tooth featured localised advanced cervical abrasion on the palatal aspects of 23 and 24, leading to an unsupported ledge and subsequent fracture of the cusp, which was further compromised by the fact that this tooth was endodontically treated with a large access. Separately, there was a large buccocervical restoration extending to the gutta percha. All in all, one tooth with a very guarded prognosis. After shade selection with the horizontal shade tab position (less visual fatigue), the margin was exposed via gingivectomy using the dual-wavelength diode laser, Gemini, from Ultradent. This was such a nice laser to use. The old composite was removed and the residual tooth structure and ferrule assessed to be borderline restorable. To gain increased core support, a Voco Rebilda 1.2mm glass-fiber post was sized for placement in the palatal canal. After micro air abrasion with 27 micron aluminum oxide, the canal was flash etched (3s) before copious water irrigation and paper point action to leave a moist dentin surface. A self-etch approach was taken on residual dentin to preserve as much of the mineral structure/residual flexural strength as possible using Clearfil Universal Bond Quick (CUBQ). This was also placed down the canal space. After air thinning and paper point action, Clearfil DC Core Plus was placed down the canal using a Centrix tip before seating the post (9mm length intracanal) fully and building up the rest of the core. Note that CUBQ is set/dark cured by Clearfil DC Core Plus. After margin refinements, the gingiva was troughed at 1.1W continuous using Gemini dual-wavelength mode. The final impressions were taken using a light and heavy body PVS (Flexitime, Heraeus).
Let's keep those fingers crossed,
Clarrie x
#Gemini #Ultradent #Dentoheroics #LetsSaveThatPlease #FerruleFrenzy #Clearfil #UniversalBondQuick #SelfEtch #DCCorePlus #Heraeus #Flexitime
