Dentaltown November 2022 - 26

message board
RCT completed by the endodontist I work with, then there was still more decay in the crack
leading to the ML.
I'm in the middle of replacing a crown right now that is 14 years old. I'll post pictures when
I fi nish. ■
9/14/2022
307Doc
Member Since: 01/18/20
Post: 5 of 27
NORTHBOUNDandDOWN
Member Since: 03/21/11
Post: 6 of 27
Midoc
Member Since: 07/22/03
Post: 7 of 27
Midoc, how do you decide where to stop chasing the crack? ■
Midoc, you recommend crowns even when the crack is associated with only one marginal
ridge on a minimally restored tooth? I'd never leave the offi ce if I did this. ■
In an ideal world, I would stop when there is no visible crack that won't be covered by the
9/14/2022
9/14/2022
margins of the crown. All cracks leak and I don't want any cracks leaking under the margins of
my new crown.
That being said, the decay patterns inside cracks are a generally slow-moving process. If you
look at the #31 I posted, how long do you think those cracks have been leaking? My bet is they've
been leaking the entire 30+ years the crown has been in place.
So I'll go " slightly " sub-g in an effort to get to the end of a crack, but I won't chase it very
far. Say about 1 mm or so.
Beyond cracks at or beyond the crown margin, I aggressively check the dentin around cracks
with both a straight explorer as well as a medium sharp scaler. The explorer is a 6L.
If I have solid crown margins, then I'm less aggressive about removing any amount of soft
dentin. If have a crack past the crown margin that I'm leaving, then I'm more aggressive about
removing any amount of decayed dentin.
Here is a great paper that shows we have basically no idea where the bacteria stop based
on clinical fi ndings and that bacteria can live up to nine months after a restoration was placed
(beyond nine months wasn't tested).
https://sci-hub.se/10.1016/j.jdent.2020.103430 ■
9/14/2022
Go deeper into the conversation online!
What you've just read is only a sampling of a great thread. There are plenty more
photos, case examples and Townies sharing advice on how to work through
tricky treatments like the one OP shared. Go to dentaltown.com/messageboard
and search " Ridge Fractures. " This thread will be among the top results.
26 NOVEMBER 2022 // dentaltown.com

https://www.sci-hub.se/10.1016/j.jdent.2020.103430 http://www.dentaltown.com/messageboard http://www.dentaltown.com

Dentaltown November 2022

Table of Contents for the Digital Edition of Dentaltown November 2022

Dentaltown November 2022 - Intro
Dentaltown November 2022 - Cover1
Dentaltown November 2022 - Cover2
Dentaltown November 2022 - 1
Dentaltown November 2022 - 2
Dentaltown November 2022 - 3
Dentaltown November 2022 - 4
Dentaltown November 2022 - 5
Dentaltown November 2022 - 6
Dentaltown November 2022 - 7
Dentaltown November 2022 - 8
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Dentaltown November 2022 - 21
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Dentaltown November 2022 - 25
Dentaltown November 2022 - 26
Dentaltown November 2022 - 27
Dentaltown November 2022 - 28
Dentaltown November 2022 - 29
Dentaltown November 2022 - 30
Dentaltown November 2022 - 31
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Dentaltown November 2022 - 33
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Dentaltown November 2022 - 37
Dentaltown November 2022 - 38
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Dentaltown November 2022 - 40
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Dentaltown November 2022 - 49
Dentaltown November 2022 - 50
Dentaltown November 2022 - 51
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Dentaltown November 2022 - 53
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Dentaltown November 2022 - 55
Dentaltown November 2022 - 56
Dentaltown November 2022 - 57
Dentaltown November 2022 - 58
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Dentaltown November 2022 - 60
Dentaltown November 2022 - 61
Dentaltown November 2022 - 62
Dentaltown November 2022 - 63
Dentaltown November 2022 - 64
Dentaltown November 2022 - Cover3
Dentaltown November 2022 - Cover4
Dentaltown November 2022 - Glidewell_1
Dentaltown November 2022 - Glidewell_2
Dentaltown November 2022 - Dental Arts_1
Dentaltown November 2022 - Dental Arts_2
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