CEREC doctors.com - Q1 2017 - page 66

64 | CERECDOCTORS.COM | QUARTER 1 | 2017
| | | D I S C U S S I O N F O R U M
MIKE SKRAMSTAD (FACULTY)
Here are some references from Magne. He told
me tonight he is really doing a lot on this topic.
He gave me a lot more, but all say really the same thing.
Operative Dentistry, 2014 39-6, 000-000. Influence of
No-Ferrule and No-Post Buildup Design on the Fatigue
Resistance of Endodontically Treated Molars Restored with
Resin Nanoceramic CAD/CAM Crowns
Showed that they all survived with normal masticatory
forces, and the failuremode was more favorable with the 2mm
buildup or endocrown (composite milled, not ceramic).
Operative Dentistry, 2016 41-1, 64-75. Composite Resin Core
Buildups with and Without Post for the Restoration
of Endodontically Treated Molars Without Ferrule
All groups with posts were affected by an initial failure
phenomenon (wide gap at the margin between buildup/
crown assembly and the root). High performance polymers
with no posts have higher performance than with posts ...
and insertion of fiber-reinforced post had no effect on perfor-
mance or survival rate using all materials.
GRADY TWOHIG
I did that once by accident with an anterior
crown that snapped off with tooth inside. After I
did a root canal, I bonded a crownwith the prep broken inside
with Scotchbond/Rely-X Ultimate so I’d have something for
Biocopy. I thought it would easily come off but it didn’t, so I
cut off the crown and the prep was still bonded underneath.
I ended up not doing a post. I had some extra tooth to prep
though as the old crown margin was not at the gingiva.
MIKE SKRAMSTAD (FACULTY)
How long has it lasted? I have some in the
mouth for 10 years now that are perfect and I
cannot remember it not working. ... I never did what you said
though :) That’s pretty funny that you cut the crown off and
the prep still stayed.
SAM CARROLL
That’s awesome.
JAMES EIKE
Mike, that is great!
You stated that
you used VITA TriLuxe. Could you
show us how you positioned the
crown in the block to get the trans-
lucency effect you show in your
contrasted picture?
TOM MONAHAN
Very nice case Mike. Will keep this in mind for
future cases.
TYSON ROE
I think the most significant variables in a case
involving lateral incisors would be amount
of palatal tooth structure remaining (pretty good in this
case here) and the occlusion. Looks like the laterals can be
protected in protrusive by the centrals. A lateral that breaks
off in “table top” fashion at the gingival margin I would think
needs to be handled differently. What do you think, Mike?
MIKE SKRAMSTAD (FACULTY)
I would agree Tyson. In those cases, you have
to generally extrude to make it work, and you
don’t have great tooth structure to bond to. As you can see on
that second case I posted that has been solid for five years,
that was more or less table-top bonding, but there was a lot of
enamel. This first case had excellent ferrule.