I have a great pleasure tonight in putting up a blog emailed to me by Pete Buchan. Pete is a fantastic dentist who is the principle of number 9 dental practice in Edinburgh. Although we will meet in person for the first time in a few weeks I’d like to think that thanks to the blog and our shared commitment to excellent dentistry we have become good friends.

Pete has been one of the most encouraging people of the blog and my dental aspirations since I started the blog and I’d like to take the opportunity to publically thank him!

Anyway it was with great pleasure that I opened this email:

I did this today and took some pics thought it might make and interesting post for your blog……

39 year old female with pain discomfort and tenderness in the upper right region.
OE 17 iis ttp and PA radigraph shows area on 17. Pre op radiograh attached.
She is keen to save tooth so we book appt for RCT.
Today I removed the FGC, and completed the RCT and recemented the same FGC.
So how do you do that?
1 Cut slot in FGC, and onto the occlusal surface, see photo.
2 Loosed FGC with an old couplins. to open up the crown, and wiggle crown off.
3 Do RCT.
4 Place FGC back on crown. Fill slot defect with composite, no bond, Check occlusion and bond.
5 Flick FGC back off, and cement with either temp cement or perm cement.
My plan is to restore the 17 with a Cerec crown but I want to wait 3 months for the tooth to be symtom free.
The benefit if this technique is;
1 Better visualiation and access for optimal RCT. RCT through the crown is allways harder than RCT not though a crown
2 Avoiding having to make a temp crown. Saves some time.
3 Could be left as a “long term temp” untill pt is in a place to afford a perm new restoration.
This technique doesnt work too well with PFM crowns.The porc just breaks off!!!
Pete
pre op rad

12435post op rad

Firstly just take a minute to admire the endodontic result but also think what a great little trick to help you do better root fills with crowned teeth! Once teeth are root filled I think you can justify a bit more tooth loss too so if the patient does want to change to a PFM crown or all porcelain restoration this technique is even more perfect.

I hope you find this as useful as I did, another little trick for our collections!

It’s great to have people to bounce ideas off, “a clinical tribe”, and I find the more you share the more you get back. The important thing is to have an open mind and enjoy hearing about other peoples techniques. On some dental forums people are so defensive about how they do things.

I’ve long since realised that what I do may not be the best and I can honestly say that while I don’t exactly love my work being critiqued I love the people who have the kohones to tell me it straight. There friendship and feedback then mean a lot to me. They are also much cheaper than most CPD!

All the best

Chris

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