A interesting E.max question?

TheLabGuy

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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?
 
2thm8kr

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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.
 
rkm rdt

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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.
 
TheLabGuy

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emax doesnt like heat. Slow and lots of water.

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.
 
CatamountRob

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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.
Does he, or she, bond them?
 
2thm8kr

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

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Cements - RelyX luting I believe
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?
 
rkm rdt

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

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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?
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.
 
Gru

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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.
 
M

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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.
 
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rkm rdt

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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?
 
JMN

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Grinding on LiSa?

Yes exactly.

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

300px-Apple_Lisa.jpg
 
JohnWilson

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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.
 
JMN

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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.
Thanks for the view adjustment. Had never thought of it that way.
 
Gru

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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.

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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