I am BAAAAACK!  Looks like I have thousands of views, so let's get this blog active again.

I will be posting many more cases that we can discuss!


Let's look at some RCT cases.
A. Pt presented with severe recurrent caries on teeth #19, 21, and moderate recurrent caries on #20.  He is really interested in saving these teeth. He is fully dentate, and the only other area of caries is on #2. 

Tooth #19 is unrestorable due to gross caries. The other teeth, should be savable pending clinical presentation.

So removed crown on #20, and noted open chamber with pulpal necrosis.  So, performed RCT on #20. 

This is tooth #21, and as you can see there was severe caries, some of which you can still be seen on the above photograph. 

Removed remaining caries from both teeth #20 and 21, and temporized the teeth.  If you note, the margin of our restoration is close to crestal bone, thus, I wanted to give the body time to restore gingival health as well as biological width.  On the next visit, retouched the teeth to prepare them for Bruxzir crowns. Impression taken on #20 and #21.

At this visit, I seated the crowns and extracted #19 without Bone Graft (Pt was not interested in it and does not want an implant at the site).  What can we learn from this case? Well, clinical presentation is very important. As you can see, I still have plenty of tooth structure to support and retain our crowns. We were able to have 2 mm (except the distal of #21, which had 1.5 mm) of circumferential Ferule effect around the teeth.