Dentaltown November 2017 - 52

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winnfd
Member Since: 02/12/15
Post: 38 of 64

Hi John. On that one I would. There is clear separation of the B and lingual segments and
as I stated before, I suspect caries as well. And to answer your other question: I purposely didn't
mention the other areas. IMO, the tooth should have had a crown. The buccal and lingual walls
are thin and if Tom had excavated the DMR as he should have, there would be even less enamel
remaining.
I'm all for being conservative, but the tooth in question would ideally be crowned. I don't
know this patient or the type of practice Tom has so I'm not being negatively critical. It's good
work, but the DMR should have been excavated. That was in the best interest of the patient,
regardless of the number of margins, etc. ■
8/1/2017

kidesperanto
Member Since: 08/03/09
Post: 39 of 64

After a recent thread on this arguing such cracks, I'm pretty sure it's clear we are all mostly
full of it when we try to predict the health of a tooth based on the cracks we see with any
certainty. It's a total guessing game. You are both right and both wrong. Such is the way of
cracked teeth. ■

8/1/2017

Tom Mitchell
Member Since: 02/16/04
Post: 40 of 64

Here's some more photos of the case for you. The amalgam's broken away at that lingual
groove with decay.

With the old amalgam removed the decay at the lingual is obvious. The DMR looks ok to me.

This is the final prep. Yes, there's a crack at the DMR. Asymptomatic of course, so is it
significant? We've been reviewing research showing that bonded composites increase fracture
resistance to almost the same level as an unprepped tooth.

I doubt there's any more risk of progression of problems with this restoration than with any
other. If it's well sealed with high quality materials and the occlusion is idealized this should
hold up for a long time. ■

8/1/2017

winnfd
Member Since: 02/12/15
Post: 42 of 64

52

This photo does not help your position. ■

NOVEMBER 2017 // dentaltown.com

8/1/2017


http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown November 2017

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