[Allen Ali Nasseh]

A tooth #10 with a history of trauma followed by a crown that broke off at the gingival level was sent for endodontic therapy prior to post space preparation.
[See the full post at: Dystrophic Calcification]

[Francesco Piccione]

Hello Dr. Nasseh,

Great video! Some questions for you:

1. How did you cement temporaries in situations like these where there is no tooth structure remaining above the gingiva?

2. Also how do you cement the temporary in situations like these while maintaining proper isolation? In order to cement the temporary you would have to remove the opal dam to expose the margin of the tooth, which is where the gingiva and the tooth meet, thus potentially contaminating the canal with seepage of fluid from the gingiva, saliva, etc. Is there a better way to maintain isolation, or in situations like these where there is extensive loss of tooth structure is it just a risk that we have to take?

Thank you.

[Allen Ali Nasseh]

Hi there! Teeth like this can be temporized with using the fiber post as an extension of the temporary in order to get some in track Ronald retention. It will also help you understand is the final crown can be maintained that way since there’s no ferule. Yes, it’s a compromise and involves a lot of trade offs; but as long as the patient understands it’s an attempt at saving the tooth and understands the limitations it’s worth a try. Regarding contamination, it’s easier in this area due to not having salivary flow and staying dry is not an issue. In the mandibilar molar area with the tongue and higher saliva content sometimes it’s better to do a quick build up on the tooth prior to the access. Hope this helps. 🙂

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