Apex Information Exchange Forum Index Apex Information Exchange
Hosted by Dr. John Kanca III DMD
 
 FAQFAQ   SearchSearch   UsergroupsUsergroups   REGISTER 
 ProfileProfile   Log in to check your private messagesLog in to check your private messages   Log inLog in 

Visit Apex Dental Materials     Upload Photos To Your Post


Debond of Resin Crowns

 
Post new topic   Reply to topic    Apex Information Exchange Forum Index -> About Simplicity®
View previous topic :: View next topic  
Author Message
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Wed Jul 25, 2007 1:42 pm    Post subject: Debond of Resin Crowns Reply with quote

I did two resin crowns for an 90 year old gentleman two weeks ago, and they popped off today. Here is the technique used, and I'm wondering if the problem wasn't placing Interface on the internal surface of the crowns, but I'll see what the experts think.

Used Paradigm z100 composite blocks with CEREC:

Resin Crowns: try in, adjust, polish; Microetch internal with 50 micron Al2(O)3 in lab; steam clean internal; dry; interface for 10 secs; dry; Sim 2 applied; air dry; cure 10 secs; set aside

Tooth: alcohol on microbrush and scrub residual Vita Powder from preps; rinse & dry; Sim 1 for 10-20 secs on preps; leave wet; apply Sim 2 with brush tips in 3 coats; dry thoroughly; Sim 2 in two coats; dry thoroughly; cure 10 secs each tooth;

Seat: Sim 2 placed within crown, dry to evap solvent; Sim 2 on preps, wiht light wipe; load crowns with Anchor; seat fully; let sit to gel for 1.5 minutes; clean excess from margins; floss;

I seated these at the same time, and remember flossing aggressively to remove IP cement, and there was decent bleeding, but this was when it had gelled significantly. ALSO, as these were the distal-most teeth and stand-alones at that, with nearest neighbor being #7, I didn't use the RD. Isolated with high vac suction and cotton rolls, but had very dry field. My only concern was ambient humidity, but pt is not a mouth breather. I know we can't measure that effect, but I still doubt that this would have caused the de-bond.

Thoughts? I'm thinking when I re-bond them today, I'll just Microabrade internals, microabrade the preps, and leave out the Interface, and place Sim 2 on internal of crowns, dry, cure, and same steps as above for crowns and seating.
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Jul 25, 2007 1:50 pm    Post subject: Reply with quote

Interface isn't necessary on resin crowns, FWIW. Sandblast and Sim 2 only is what you need.

Where was the cement- on the tooth or on the crowns?

When you put the extra Sim 2 on the crowns and teeth- did you dry both?

Also- a suggestion- light-activate each surface for at least ten seconds after gelation.
_________________
"You need me on that wall."


"You don't have a town named after you"
Back to top
View user's profile Send private message
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Wed Jul 25, 2007 2:02 pm    Post subject: Reply with quote

Place Anchor in crowns; also, after gel state acheived, flossed, removed excess, then cured 10 secs each surface as you mentioned. Sorry, I forgot to mention the curing step.

Thanks.
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Wed Jul 25, 2007 2:05 pm    Post subject: Reply with quote

also, did not air dry the wiped layer on the prep. I simply put what was left on the brush on the prep. Is that step still necessary? It seems like the Sim2 on prep and inside the crown has been said to be an un-needed step.
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Jul 25, 2007 2:16 pm    Post subject: Reply with quote

Renzo wrote:
also, did not air dry the wiped layer on the prep. I simply put what was left on the brush on the prep. Is that step still necessary? It seems like the Sim2 on prep and inside the crown has been said to be an un-needed step.


The extra Sim 2 in the crown is not critical.

Place a good amount of Sim 2 on the prep and then dry it well. That's what I do.
_________________
"You need me on that wall."


"You don't have a town named after you"
Back to top
View user's profile Send private message
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Wed Jul 25, 2007 2:47 pm    Post subject: Reply with quote

Will do. Now, to explain the debond . . . do you think it was the Interface, the lack of the RD, or fact that maybe too much solvent was remaining on prep from lack of air drying?

FYI, I have had three other resin crowns debond, and they were all with Maxcem or Multilink, so I'm wondering about the interface of the resin to the crowns themselves, and if this is going to be an issue with all of my resin crowns.

Fortunately I don't do a ton of resin crowns, but they are often an affordable solution for older patients.
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
Ekrause



Joined: 11 May 2005
Posts: 782
Location: I'm here now.

PostPosted: Wed Jul 25, 2007 3:02 pm    Post subject: Reply with quote

When you're using the Cerec, why a difference in price between a resin crown and a ceramic one?? The blocks cost the same, if not more for the resin. The procedure is the same too. If you want to give the patient a break, just lower your price a bit and give them the ceramic crown anyway.
_________________
No, Donny, these men are nihilists, there's nothing to be afraid of....
Back to top
View user's profile Send private message
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Wed Jul 25, 2007 5:41 pm    Post subject: Reply with quote

Ekrause, not to get off on a big tangent with the CEREC, but the resin crowns I'm doing are typically in pts that need a gentler surface to wear against. Really the only reason. I like the idea of just doing the Porc at reduced rate though, so I appreciate the tip.

Also, John, I'm back with my tail b/w my legs a bit here, as I saw that pt that had his crowns in hand. Guess what! They were lower canines that had been put in with Multilink. The uppers on 3 & 4 done two weeks ago with Anchor and Simplicity were still rock solid. Maybe this thread will have some good information nonetheless.

Thanks for the quick replies.
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
Howardmg



Joined: 11 May 2005
Posts: 455
Location: Bethlehem, PA.

PostPosted: Wed Jul 25, 2007 9:18 pm    Post subject: Reply with quote

Renzo- Your last post just helped John in his recovery just a little bit more!
Good job!! Very Happy
_________________
Take Care...Howard

Howard M. Goldstein DMD.
Bethlehem. PA.
www.exceldentalcare.com
Back to top
View user's profile Send private message Visit poster's website
Renzo



Joined: 12 Jun 2007
Posts: 36
Location: Redmond, OR

PostPosted: Thu Jul 26, 2007 9:37 am    Post subject: Reply with quote

every little bit helps, especially in times like this Smile
_________________
"It is not enough to do your best; you must know what to do, and THEN do your best" - W. Edwards Deming
Back to top
View user's profile Send private message Visit poster's website
john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Thu Jul 26, 2007 11:13 am    Post subject: Reply with quote

Howard's quite right. That does help! Cool
_________________
"You need me on that wall."


"You don't have a town named after you"
Back to top
View user's profile Send private message
Display posts from previous:   
Post new topic   Reply to topic    Apex Information Exchange Forum Index -> About Simplicity® All times are GMT - 5 Hours
Page 1 of 1

 
Jump to:  
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot vote in polls in this forum


Powered by phpBB © 2001, 2005 phpBB Group