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: 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!
Editor's note: This content was originallu published in 2017 and has been updated as of September 2025.
This column features questions from everyday people who work in dental practices, who have issues they would like addressed by the experts. It no longer runs regularly, but the questions sent in the past still apply to dental practices today. Search "Troubleshooter" on DentistryIQ to read more.
