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Thursday Troubleshooter: Dentist having PFM crown troubles

Feb. 2, 2017
What is this dentist doing wrong that he can't remove the PFM crown?

Do you have a tough issue in your dental office that you would like addressed? Each week the experts on Team Troubleshooter will tackle those issues and provide you with answers. Send questions to [email protected].

QUESTION: The other day I tried in a PFM crown but was unable to remove it! Everything looked good and it clearly fits well, but I'm worried because there's no cement layer. What should I do?

ANSWER FROM CHRIS SALIERNO, DDS, editor of Dental Economics:
I think every dentist has at least one case like that! I'm not aware of any research that follows this type of situation so I can't say that there are any definitive negative outcomes to expect.

Here's what I would do. First, try removing the crown without damaging it. GC America makes GC Pliers that work great! Next, if the crown still doesn't come off, it's important to inform the patient and note the dilemma in the chart. Let the patient know that there is a chance the crown may exfoliate some day and that he or she should be careful, especially in the first few weeks after insertion. If the crown continues to stay in, then I would monitor it a little more closely on recall visits. You may want to take a bitewing radiograph there more frequently to ensure that the interproximal margins are still looking good.

Hope this helps!

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