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    A interesting E.max question?

    Discussion in 'All Porcelain-Press' started by TheLabGuy, Nov 9, 2016.

    1. TheLabGuy

      TheLabGuy Just a Member Full Member

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      Had a Doc call me today, the majority of his restorations are e.max. He's had to go in at a later date (sometimes a couple years later) and do a root canal. What he's found is that when he cuts an access hole for the Root Canal Therapy into the e.max crown, he is creating a micro fracture and ends up having to replace the crown. Any suggestions on a bur, or a technique he could do to avoid this?
       
    2. 2thm8kr
      Devilish

      2thm8kr Beanosavedmysociallife Full Member

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      If it's from a digital file, he could just pay the lab guy to make another one so it's ready to seat. Then he could cut off the crown, do the perio and cement a new crown without an access hole in it. Increase the root canal fee to capture the expense.
       
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    3. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      This is one disadvantage of any monolithic restoration unless it's gold.

      Another approach would be a pfz since the zir would be thinner.
       
    4. RCKSTR
      Relaxed

      RCKSTR Active Member Full Member

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      emax doesnt like heat. Slow and lots of water.
       
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    5. TheLabGuy

      TheLabGuy Just a Member Full Member

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      That's what I suggested, was slow it down, plenty of water. I do like the suggestion of offering a crown (since we do scan everything) in cases like this from the old file.
       
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    6. CatamountRob
      Dead

      CatamountRob Banned Member Full Member

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      Does he, or she, bond them?
       
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    7. TheLabGuy

      TheLabGuy Just a Member Full Member

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      Cements - RelyX luting I believe
       
    8. 2thm8kr
      Devilish

      2thm8kr Beanosavedmysociallife Full Member

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      At the least, the doc could offer that to the patient for the lab cost of the crown. Options, what every (most) Americans want.
       
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    9. CatamountRob
      Dead

      CatamountRob Banned Member Full Member

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      That would help with the 2 crown scenario.
      I wonder if they would be less apt to fracture if they were bonded rather than cemented?
       
    10. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      You can always put a hole in all your crowns. Maybe 2th can show you how to do it.:cool:
       
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    11. TheLabGuy

      TheLabGuy Just a Member Full Member

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      OH i'm sure they would be less resistant, but how much, not sure and whether it would be significant, not sure either. The problem with bonding, is isolation, gotta have it.
       
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    12. Gru
      No Mood

      Gru Well-Known Member Full Member

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      Not only slow it down with lots of water, but new diamond and light pressure. Saves the diamond and crown. If he sees a spark/ flash, it's done.
       
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    13. MasterCeramist

      MasterCeramist Active Member Full Member

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      Tell him to use a fine grit diamond also go slow let the bur do the work with lots of water.
       
      Last edited: Nov 9, 2016
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    14. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      It might be interesting to note if the GC Lisi is any easier to grind through.

      Maybe you can experiment with a highspeed?
       
    15. CatamountRob
      Dead

      CatamountRob Banned Member Full Member

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      Grinding on LiSa?
       
    16. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      Yes exactly.
       
    17. JMN
      Curious

      JMN Christian Member Donator Full Member

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      Didn't know this was your thing guys. Here y'go, grind yer drives.

      [​IMG]
       
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    18. JohnWilson

      JohnWilson Moderator Staff Member Full Member

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      Endodontists have the heaviest hands in dentistry in my opinion, their goal is not to save a restoration but to save a tooth.
       
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    19. JMN
      Curious

      JMN Christian Member Donator Full Member

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      Thanks for the view adjustment. Had never thought of it that way.
       
    20. Gru
      No Mood

      Gru Well-Known Member Full Member

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      Fair enough. With this knowledge the dental lab's goal should be to not pay for the replacement that was destroyed through no fault of their own!
       
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