Monthly Archives: January 2009

***Update (Feb 28, 2009): Porcelain Fused to Metal Crown Part II

Today I had the goal of fast tracking someone through the fixed clinic.  The graduate periodontology clinic picked this patient up right when we were done with his comprehensive cleaning and stalled my treatment by TWO MONTHS!  The service they were trying to treatment plan him for was needed but he is on government aid and they would never approve the treatment grad perio wanted to do.  Anyway, to avoid becoming too bitter in this post, lets just say that I was motivated to get this patients treatment done as quickly as possible so no more delays can get in the way.  His treatment plan is as follows:

1) Extract all remaining maxillary molars
2) Prophy, Flouride, OHI
3) PFM noble metal #22, 23
4) Mandibular RPD, Maxillary FPD
Here is the FMX series:

The extractions were completed, the prophy and scaling was completed and today we started on both of his crowns. I picked a good row instructor in the fixed department so I could get as much as possible done today.  One thing I like about Temple – and I am not sure if it is like this at other schools – if you can get the treatment done in the allotted time then you are given the green flag to do it.  So here are the crown preps I was able to do today.  Remember that everything went smoothly during this appointment and so far this is not common for me. I had some luck on my side today and was happy with the results.  Here is a before shot:

I took a pre-impression with impergum (hence the purple on the lips).

Here are my preps, a few from the facial, occlusal and a shot with packed cord:

After the preps were done I made the temporaries using Integrity. I had never used Integrity before and I really liked it. I got it from a vendor who got my name from a Temple Dental graduate. Thanks Dr. Beth! The integrity was fairly easy to work with, set quickly, didn’t shrink, and the color (A2) was a great match. The margins were easy to read and easy to trim. Check out the final product:

I was able to do all this and get my final impression in one clinic session. I was pretty amazed with how smoothly everything went. Two preps, two provisionals, an impression of the final preps and some photographs all in 3 hours. I know that is nowhere near private practice status – but remember this is dental school and these were my 3rd and 4th crowns (if you remember I finished a bridge not too long ago).