Peter Gardell Many times we get in our own way. There can be a voice in our head that chattering away that causes us to second guess ourselves. For any dentist, including those who use CEREC, there is the issue of proper reduction of a preparation. Maybe it goes back to dental school and the ominous warning “ You perf and you fail!”. Many times dentists try to minimize the reduction, sometimes at the risk of reducing the chances for long term success. There are router reduction burs which are great aids to ensure proper reduction.
Now even when a dentist has a clear radiograph, or now in some cases a crystal clear Galileos scan, a dentist can still second guess them self. In this case we have a 20 y/o who had a large composite placed and she ended up getting irreversible pulpitis. Endodontic therapy was indicated to relieve her pain.
On accessing this tooth with a large pulp chamber I decided to do a test.
When I had prepped near the top of the pulp chamber I took out a periodontal probe to measure how far I had prepped. I had prepped down about 6 mm and I had yet reached the pulp chamber.
Now I know there are teeth with abnormally large pulp chambers. Most of these can be identified on radiographs and we can inform the patient prior to an operative procedure. But for most cases, have the confidence that you have plenty of room to prep the tooth adequately without compromising the tooth's pulp.
Set yourself up for success - prep enough for the CEREC software to give you a great proposal. Also, the restoration will have the proper thickness to function without risk of fracture.
