CDOCS a SPEAR Company

Why I prefer to replace most complex Amalgams with CeraSmart inlays and onlays

This patient presented from another dental office in town needing 2 crowns.  He was in attendance at a CEREC technology  presentation I gave several years ago to our local Kiwanis Club and he decided that he wanted his crowns done in a single visit the CEREC way.  I can post photographs later after the gingiva heals.  It is obvious why I wouldn't consider allowing this dentist to provide any dental services for me.  He was obviously absent for the lecture in dental school in which were presented the techniques for burnishing matrix bands to produce a proper convex inter-proximal contour for complex amalgam restorations.  Or, he just doesn't give a damn, or it's the best he can do.  That flat inter-proximal contour and marginal ridge only contact would have landed this guy on the bolo squad when I was in school at the University of Illinois.  But he is an Iowa grad. big grin  At least he didn't leave a huge gross overhang.  smug  #19 had a fractured DL cusp and he was packing food, so that was his chief complaint.  I insisted on replacing the poorly contoured MO amalgam on 18 because recontouring that restoration would have resulted  in an over contoured distal on the crown and leaving it would not have totaly solved the food packing issue. 

Post op bitewing, shows a little bonding resin on some soft tissue tags left over from the laser troughing.  I removed most of them with a Soft-pick and the rest of them will slough.  This bitewing also shows the next project, removing and replacing the PFM on #14--hopefully that decay hasn't progressed to the point where the tooth structure under the crown is totally mush.  What is also obvious from the post op bitewing is that, super-tech that this other dentist is, he butchered the distal of the PFM on #14.  Therefore, the mesial proximal of that amalgam is over-contoured and can be satisfactorily reshaped to provide a nice contact and eliminate the food packing in that area.  Unfortunately, this patient has some pretty average, for my area, dental work.  The dentist who produced this dental work needs to care less about his bottom line, and care more about the quality of the services he provides. 

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