No dental practice wants a crown-seat surprise

No dental practice staff wants their perfect day thrown into turmoil over a crown-seat appointment gone bad. Here's what can be done to prevent the disruption from occuring.

Jul 17th, 2018
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This article originally appeared in Dental Assisting Digest e-newsletter. Subscribe to this informative monthly ENL designed specifically for the dental assistant here.

Your morning huddle clearly illustrates that it’s going to be another busy day in the practice, but no worries. The mid-morning appointment is a simple crown-seat for a wonderful patient who doesn’t even require anesthesia.

You remember that the impression was bubble-free with perfect margins, and the lab work looks superb. It’s going to be a slam-dunk seat that won’t even require all of the scheduled time.

By mid-morning, however, the practice is running 15 minutes behind schedule and you’re thankful for the “easy” appointment. As the beautiful all-ceramic crown is tried in place, you note that it doesn’t fully seat. Your first thought is that this is someone else’s case, but a quick comparison of the prepared tooth to the model suggests otherwise. This easy appointment just went south, your schedule is now a wreck, and you’re not even sure what just happened or why.

Avoid this in your practice

This unfortunate scenario is all too common, but it can be easily avoided by evaluating the patient’s oral tissues and facial musculature in advance of the final impression. If the retromolar pad is large and fibrous, or if the patient’s masseters suggest he or she is a bruxer, a standard plastic triple-tray will often distort when the patient is asked to close on the impression tray. Once set, the final impression will imperceptibly change shape as the patient opens, the model will be inaccurate, and the crown-seat appointment will fail.

Using a disposable quadrant or full-arch tray will prevent this problem. Additionally, Clinician’s Choice makes an all-aluminum triple-tray called the Quad-Tray Xtreme. Not only is the posterior border thinner than most, but the tray itself is wider than usual, making it perfect for impressions that must work around large bony exostoses.

None of us enjoy surprises in our schedules, especially on busy, productive, well-planned days. If you’ve ever experienced a crown-seat surprise, consider modifying your final impression technique. It could make the difference between another great day in the office or a schedule that falls apart.


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Sharing 40 years of clinical and business experience with the dental profession, Wayne Kerr, DDS, earned Mastership in the AGD and was honored in 2011 with its presentation of the Life Long Learning and Service Recognition Award. He is a Fellow of the ACD and ICD, and has been recognized by state and local organizations as Dentist of the Year, Small Business Person of the Year, and Citizen and Professional of the Year.

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