View of the initial situation. Marco, 35 years old, presents an old infiltrated restoration on 1.2 and has the desire to improve his aesthetics.
Fig.1
The initial situation with old PFM crown in the second right upper premolar and old amalgam restoration in the first right upper premolar.
Fig.2
X-Ray with a periodical lesion on the second upper premolar.
Fig.3
Situation after removal of the old crown already “de-cemented”.
Fig.4
Caries on the distal margin after build up removal.
Fig.5
Surgical exposition of the margin.
Fig.6
Check for the biological width.
Fig.7
New endo treatment within suturing.
Fig.8
Old crown provisionally adapted.
Fig.9
Situation after 2 weeks.
Fig.10
Removal of the old crown, ready for the build-up and new provisional crown.
Fig.11
Preoperative Rx where you can see the quality of the new end treatment.
Fig.12
Isolation with rubber dam (clamp 212 SA).
Fig.13
Canals preparation with calibrated burs.
Fig.14
Final cleaning with subsonic instruments.
Fig.15
Etching of the existing coronal dentin and enamel (where present).
Fig.16
Rinsing for 20 second.
Fig.17
Application of Scotchbond Universal.
Fig.18
Light cure for 20 sec.
Fig.19
Fiber posts and Relyx Unicem with end tip ready.
Fig.20
Filling the canal with Relyx Unicem.
Fig.21
Insert fiber posts and light cure for 20 sec.
Fig.22
The final view with 2 posts.
Fig.23
Application of bulk fill flow, we fill the old preparation to reinforce the stump.
Fig.24
testo sotto immaginePreparation under rubber dam to better evaluate the finishing line. In surgical cases we use vertical prep.
Fig.25
After removing the rubber dam, here the new situation.
Fig.26
Choosing the better size of Protemp Crown.
Fig.27
Bicuspid S
Fig.28
We prepare the Protemp crown and reline it with ProtempGarant.
Fig.29
X-Ray.
Fig.30
View of the second right upper premolar and new direct restoration Filtek Universal A3 on the first right upper premolar.
Fig.31
Lateral view immediately after cementation with papilla still in the maturing phase.
Conclusions
When you have to treat a tooth with multiple problems doesn’t mean that you have to lose time. With new materials, it’s possible in 3 single appointments to finalize the case in a good way without stress and with total patient satisfaction that at the end of the story is the goal in our profession.
Bibliography
1) SILVA, M. A.; VITTI, R. P.; SINHORETI, M. A.; CONSANI, R. L.; JUNIOR, J. G.; TONHOLO, J. Evaluation of the Surface Roughness and Microleakage of Dental Composites Exposed to Different Beverages. J Contemp Dent Pract, New Delhi, v. 16, n. 10, p. 800-804, 2015
2) Ereifej NS, Oweis YG, Eliades G. The effect of polishing technique on 3-D surface roughness and gloss of dental restorative resin composites. Oper Dent. 2013 Feb;38(1):E1-12.
3) Kamonkhantikul K, Arksornnukit M, Takahashi H, Kanehira M, Finger WJ. Polishing and toothbrushing alters the surface roughness and gloss of composite resins. Dent Mater J. 2014;33(5):599–606.
