Indian Journal of Dental Research

SHORT COMMUNICATION
Year
: 2012  |  Volume : 23  |  Issue : 5  |  Page : 689--690

New atraumatic easy removal technique for permanently cemented crown


Pravinkumar G Patil 
 Department of Prosthodontics, Government Dental College and Hospital, Nagpur, Maharashtra - 440 003, India

Correspondence Address:
Pravinkumar G Patil
Department of Prosthodontics, Government Dental College and Hospital, Nagpur, Maharashtra - 440 003
India

Abstract

Removal of a permanently cemented crown or fixed partial denture is a cumbersome procedure for a prosthodontist, especially when there is no purchase point available to remove it. The technique described in this article consists of sectioning of a crown on facial surface followed by removal of the crown with orthodontic plier. This technique does not damage the gingival/periodontal tissues or underlying tooth structure as the crown need not to be removed with jerky back-action force.



How to cite this article:
Patil PG. New atraumatic easy removal technique for permanently cemented crown.Indian J Dent Res 2012;23:689-690


How to cite this URL:
Patil PG. New atraumatic easy removal technique for permanently cemented crown. Indian J Dent Res [serial online] 2012 [cited 2019 Oct 23 ];23:689-690
Available from: http://www.ijdr.in/text.asp?2012/23/5/689/107412


Full Text

Removal of a permanently cemented crown or fixed partial denture is a cumbersome procedure for a prosthodontist, especially when there is no purchase point available to remove it. Many crown removal instruments (air driven, pneumatic, back action or spring activated) and techniques (ultrasonic vibrations, adhesive resin tablets or sectioning) have been described in the literature. [1],[2],[3],[4],[5] The techniques which use vibratory instruments or adhesive resin tablets may take longer time for removal and are not much effective. Methods which use instruments with jerky removal force may damage the gingival/periodontal tissues or underlying tooth structure. In these situations, sectioning the crown rather than attempting to remove it intact is often the best policy. [1] Most of the time, sectioning of the crown requires involvement of labial, lingual as well as incisal/occlusal surfaces. The sectioning technique described in this article involves only facial surface. This technique does not damage the gingival/periodontal tissues or underlying tooth structure as the crown need not to be removed with jerky back-action force. There are two major and definite indications to use this crown removal technique: 1) the crown in patient presenting with tender or mobile abutment tooth and 2) the cement-retained implant supported crown after abutment-screw loosening or other prosthetic failures. Implant supported crowns should not be removed with jerky back-action force or ultrasonic vibration techniques. We are using this technique routinely in our hospital, which seems to be highly efficient and less cumbersome for the operator.

 Procedure



Examine the crown to be removed carefully.Section facial surface of the crown along the long axis with a round-end-taper diamond bur (Super coarse diamond; Brasseler USA, Savannah, GA USA) in a high-speed handpiece with water spray to cut through ceramic and/or metal (from crown margin to facio-incisal/facio-occlusal line angle), just to expose the underlying cement layer [Figure 1]. Do not cut the underlying tooth/core structure. Note that the sectioned groove should be lesser in width (mesio-distally) than the width of round tip of the universal orthodontic plier (Universal plier; Jaypee General Agencies, Calicut, India).{Figure 1}Pinch the crown by keeping round head of the universal orthodontic plier parallel in the sectioned groove on facial surface and rectangular head of the plier lingually (by keeping gauze pack under the rectangular head) [Figure 2]. Apply controlled force during pinching, just enough to open up the sectioned groove and to dislodge the crown from prepared tooth. Note that once the groove gets opened up, the crown automatically dislodges.{Figure 2}Remove the dislodged crown by holding it with plier or give slight removal force on dislodged crown with back-action crown remover (Crown Remover Morrell; Henry Schein Inc., Melville, NY USA) if required.

References

1Rosensteil SF, Land MF, Fujimoto J. Contemporary Fixed Prosthodontics. 4 th ed. St. Louis: Mosby; 2004. p. 928-69.
2Pruitt CO. A review of methods and instrumentation for removing crowns and bridges from prepared teeth. Gen Dent 1994;42:320-6.
3Parreira FR, O'Connor RP, Hutter JW. Cast prosthesis removal using ultrasonics and a thermoplastic resin adhesive. J Endodo 1994;20:141-3.
4Sutherland JK, Cheeseman SL. Multiple prosthodontic uses for permanent crown remover forceps. J Prosthet Dent 1997;77:99-101.
5Williamson RT, Breeding LC. Removing a cemented fixed prosthesis using a crown remover. J Prosthet Dent 1993;69:634-5.