Fx'd Emax #8 - Pin Buildup- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

From this week, #8 Emax done in 2009 with 6,7,9,10 and 11 with angular fx just above tissue on the labial and 3 + mm's above tissue on lingual. On the day it fx'd we recemented with 3M Ultimate and it actually held up for a week. So this is prep day

Thomas W. Mitchell, DDS, FAGD
I just love seeing getting handed stuff like this...
Thomas W. Mitchell, DDS, FAGD
From the day he broke 8 we can see there's plenty of length below the margin on the lingual as I had left at least some of the cingulum intact.
Thomas W. Mitchell, DDS, FAGD
We recemented that day with 3M Ultimate
Thomas W. Mitchell, DDS, FAGD
From the facial the fracture's at tissue level
Thomas W. Mitchell, DDS, FAGD
Form the lingual we can still gain some prep length.
Thomas W. Mitchell, DDS, FAGD
We isolated it and got the dentin clean.
Thomas W. Mitchell, DDS, FAGD
Then placed 3 manikin pins
Thomas W. Mitchell, DDS, FAGD
And co-cured Surpass 1,2,3 and Titan A2 Flowable
Thomas W. Mitchell, DDS, FAGD
We blobbed on A2 Anchor and did the initial prep
Thomas W. Mitchell, DDS, FAGD
Then packed the tissue with 00 cord and did the final prep.
Thomas W. Mitchell, DDS, FAGD
From the lingual you can see how much prep length we gained. So even with the fracture we've got a good ferrule.
Thomas W. Mitchell, DDS, FAGD
From the occlusal it even draws.
Thomas W. Mitchell, DDS, FAGD
And a complete impression with 3M Imprint Quick Step regular and heavy body. This is actually in a full arch check bite tray.

Conclusion: 

We sent him to the lab for shade matching and have him scheduled to finish in a couple of weeks. I like using these small pins in these situations as they give us a little more vertical length for supporting the buildup and eventually the crown. They're small enough to limit the damage that we all know self threading pins do as they're placed. That's a "trade off" but I believe I'm gaining overall strength of the restoration. Hope this helps you with some of these difficult situations.

Case by: 

Thomas W. Mitchell, DDS, FAGD