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Restoring the severly compromised tooth

July 5, 2011 by Ian Kerr

This case is a good example of what I do on a daily basis. The tooth in question is a lower premolar which has suffered extensive decay but is currently not causing any pain. (It should always be remembered by dentists and patients alike that tooth aches is a hopeless early warning system and almost always comes too late. The absence of pain does not = the absence of problems!)

As with every case such as this we have an extensive discussion regarding treatment options which on this occasion would range from trying to restore the tooth through to removing it and either accepting the gap or have a denture, bridge or implant retained crown. When discussing restorative options the phrase I use most is “delay the loss of the tooth for as long as possible”. I am not keen on the phrase “saving the tooth” as this can be seen to imply that it is a once only treatment that then keeps the tooth for life: this is rarely the case. There are never any guarantees in this sort of work only varying degrees of predictability. The predictability of this case is highly dependent on the patients ability to control their decay in the future.  It is inevitable that the tooth will be lost at some stage in the future but if we can delay this by several years then this delays all the other treatment options. Dentistry is a one way street so we need to walk our patients down it as slowly as possible!

The technique I used here is a root canal filling and a fibre reinforced direct restoration. I used the SAF system to clean the canal as it was a very wide oval shape that does not lend it self to cleaning with conventional rotary instruments. I then used the everStick posts from StickTech which are placed directly and adapted to the shape of the canal.  It is the case of the “Self Adapting File” meets the “Self Adapting Post”

This is a single visit procedure and one that is completed without any discomfort for the patient.

Decay under old filling

 

decay seen from another angle
Root filling and core in place   
Restoration in place

If you would like to know if we can help you keep your teeth for longer then please do not hesitate to give us a call on 01580 752202 and we will be happy to help.

Filed Under: Blog Tagged With: Clinical Cases

About Ian Kerr

Dr Ian Kerr BDS qualified in 1989 from Newcastle University Dental School and has worked ever since in both private practice and hospital settings. Following a short stint in a busy general practice in the North East Dr Kerr went to live and work in Trinidad, where he learnt a wide range of surgical skills and developed an interest in the treatment of tempero-mandibular joint dysfunction (TMD). On returning to the UK in 1994 Dr Kerr worked in a prestigious private practice in Bromley in Kent. During his time there he completed extensive post graduate training in advanced restorative techniques and further advanced his interest in TMD.

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About StoneRock Dental Care

StoneRock Dental Care is a stunning dental practice in Hawkhurst, Nr Cranbrook on the Kent and East Sussex border. We provide every level of care, from routine family dental visits to complete cosmetic dental makeovers, including dental implants, teeth whitening, veneers, bridges and other cosmetic dental and facial aesthetic techniques.

We know how hard it can be to choose a dentist and we know how tough it can be to decide what treatment is right for you, therefore we put your comfort and your well being at the heart of every treatment that we provide.

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