A dentist, father, old car enthusiast, education advocate, photographer and some more. My cases shown on Dental Soul can be used in your study club or classroom discussions only if they are shown as web pages from Dental Soul.
The patient came in with a fractured ML cusp of tooth #3. There was a small fistula on the palatal side of the tooth. Pt reported pain on chewing. There were no signs that indicated the need for RCT. Upon examination the ML cusp was loose. The treatment plan included a crown lengthening and build up and a crown.
I sensed that the fracture might extend deep where the fistula is. Under anesthesia, the loose ML cusp was removed. The fracture line extended deep subgingivally, but the apcial 1-2 mm of the fracture was superficial. I decided to go ahead with the crown lengthening and do a little odontoplasty where the fracture is superficial.
You can see the small red fistula on the palatal side of the tooth. I would not have done a crown lengthening if I felt that I had to remove all the tissue coronal to the fistula.
So, here it is ML cusp fractured. Note the superficial fracture on the mesial aspect of the palatal root.
After removing and contouring bone around the palatal root. The mesial aspect of the palatal root received a little bit of odontoplasty. Why? I don’t have to remove as much of the supporting bone. Reshaping of the root surface happens all the time when we do root planing. A little bit of intentional root reshaping should not hurt. I made sure that the distance between the bone and the intended crown margin was about 3 mm.
The returned for a PO check. IRM was placed to reduce sensitivity of the tooth. Now the tooth can be restored with a build up and a crown. The crown margin can be at the gingival level or a little subgingival.
Here, the tooth can be prepped for a crown within a few weeks because it is in the area where aesthetics does not matter.
Your comments and questions are welcome.
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Nice work Scott. I agree with you on the odontoplasty. Thanks for sharing your experiences.
Thanks
Busy day at the office?
It’s great that you can a little bit of odontoplasty to provide a smooth surface for the soft tissues to adhere to.
Great work.
Odontoplasty is something I have not thought about. Thanks.
Odontoplasty…
Same here
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