Dentaltown August 2018 - 80

Case Study
A 51-year-old patient presented for a hygiene recare
and periodic exam. Upon radiographic examination, the
noted cervical decay on tooth #2 (Fig. 1) had advanced
from her initial new patient comprehensive exam. Fig. 1
also shows a 12-year-plus implant with a PFM crown,
placed by the patient's previous dentist.
Initially, the treatment plan was to replace the
restoration. I explained to the patient that we wanted
to remove the previous restoration and decay as conservatively as possible. However, because of the size
of the restoration, location of the decay and the tooth
(posterior second molar), and her clenching/grinding,
the tooth may have needed full coverage for occlusal
support (Fig. 2). Upon removal of the restoration and
decay, the clinical decision to fabricate a full zirconium
crown was based on lack of tooth support. The final
preparation demonstrated the optimum characteristics
mentioned on p. 81.
Upon delivery of the crown, I used Meron Plus AC,
a resin-modified glass ionomer cement by Voco that's
indicated for the cementation of crowns, bridge inlays,
and onlays made from ceramic, zirconium and metal.
At the seat appointment, after the temporary
was removed, the new zirconium crown was tried
Fig. 1

Fig. 4

80

AUGUST 2018 // dentaltown.com

Fig. 2

in and proper fit and occlusion
were verified. The interior of the
restoration was sandblasted (Fig.
3), and the tooth preparation was
cleaned with flour of pumice and
desensitized/disinfected (Gluma). A
Meron Plus AC application capsule was
activated, mixed and dispensed into the
interior of the restoration (Fig. 4). The
cement has a working time of about two
minutes at room temperature and sets in
the mouth in three to five minutes. After
approximately four minutes the material
reaches a gel-like consistency, making it easy
to remove any excess material with the aid
of a probe, curette or dental explorer. Fig. 5
demonstrates this gel-like consistency and, with a
curette, removal of excess material is fast and easy.
Fig. 6 shows the completed restoration. Most
notable is the acceptable aesthetics, contour and shade
match to the adjacent teeth, which is only accomplished
with a very skilled dental technician. The patient was
very happy with the results.

Fig. 3

Fig. 5

Fig. 6



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Table of Contents for the Digital Edition of Dentaltown August 2018

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