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Patient has pain, occasionally, when chewing,
in upper left posterior region.
X-ray pictures show tooth 2.6 (upper left first molar) with
a small silver amalgam restoration . No fracture, no caries,
no pathology is apparent in these x-ray pictures. |
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Photo shows 3 hairline cracks
in enamel. Biting pressure on this corner of the |
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| tooth produced a sharp, brief pain.
Pressure on the rest of the tooth produced no pain. After anaesthetizing
the tooth, I cut away the amalgam and the cracked corner of
tooth. Metal band is in place to confine and shape the restoration.
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A direct-bonded composite resin restoration
was placed. It was adjusted to be comfortable in occlusion (i.e.when
biting, all other teeth should touch normally).
It was tested with dental floss to be sure the restoration is
smooth between the teeth.
This restoration has the potential to give a good, long-term
result, but if it doesn’t, stronger materials are available.
Indirect, laboratory-processed inlay or onlay could be made,
but at greater cost, involving 2 appointments. Cad-cam technology
is available to carve a restoration from a premade block of
material, to be then bonded to the tooth. |
Treatment
by Dr. Mel Perlmutter, March 11, 2004 |
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