Page 59 - CEREC Q4 | 2014

QUARTER 4 | 2014 | CERECDOCTORS.COM | 57
Thomas Kauffman
The first molar looked like the endo fills were
quite a bit short, and it seemed it might have been
an option to retreat rather than remove. Just wondered if
there were other issues not apparent on the film that led to
the decision to remove.
Baron Grutter
The first case I posted (the first post), I think
you can see the decay into the furcation on
the film and the endo doesn’t appear as inadequate as
the second case (farther down the thread). If I’m correct
in which case you’re referring to, here are the intra-oral
photos: first after crown removal and second/third after
decay removal. There was essentially 20 percent coronal
tooth structure remaining above 1.5 mm sub-g. Perhaps a
cast post and core in addition to a retreat, BCL, and new
crown could have been done. But, in my mouth, Titanium.
#19 (below)
If, in fact, you were talking about my first post, there is
the picture of that tooth. Similar situation except that the
decay went so far sub-g, the only option would be BCL.
Again, in my mouth, Titanium.
#30 (right)
Baron Grutter
Today’s case. My associate was planning to
retreat and replace the crown. After removing
the crown, restorability came into question. Still, he thought
it worth a shot. Then, during the retreat, he encountered
sclerosed canals and decided that he would have to punt to
the endo. After explaining the costs and additional expense
of post & core and likely BCL, she decided on Titanium.
volume to allow placement of a smaller implant. The plan
was to place a Zimmer 6.0X 11.5. We were able to complete
without a problem, but I was pretty close to going to a 7.0
x 9.0 Trimax.
I have not experienced the problems apparently feared
by others, especially labial plate dehiscence or frank frac-
ture. Quite the contrary, we are currently 100 percent
success of all the cases I have personally placed and
restored. Another case shown is a root form implant placed
by a surgeon more than 10 years ago that fractured under
function. There is some benefit to having a bit more bulk
for subcortical support. Failures are not a common occur-
rence in my practice, especially in the arena of implant
restorations. The large body TriMax system is worthy
of consideration for use in the molar site. With appro-
priate attention to surgical protocols, it offers predictable
success, with a more natural emergence profile closer to
the normal dimension of most molars.
I also wanted to ask Baron why he chose to remove #30
crown rather thanattempt to salvage. Sometimes I observe the
removal of teeth that inhindsight couldhave been salvaged. In
this particular case, perhaps that shouldhave been considered.
Baron Grutter
I’m sorry. I posted two cases that were tooth
replacements. To which are you referring? I’m
sure you didn’t mean it, but your last statement brings with
it an implication of negligence. LOL.