|Dr. Alan Wishneff D.D.S.
Restorative Dentistry / Oral Health
February 17, 2017
There have been many devices that are designed to remove crowns and bridges from abutment teeth. These crowns and bridges can be fabricated from dental acrylics cemented to the abutment teeth with non-rigid temporary cements, or they may be definitive restorations fabricated from cast metal, porcelain-metal, ceramic, or composite resin cemented with more rigid cements. While the removal of temporary crowns and bridges is usually very straightforward, the removal of a definitive cast crown with unknown cement is more challenging.
For a temporary crown or bridge, the restoration can be removed using a hand instrument by exerting a force parallel to the long axis of the tooth. This hand tool can be a scalar or large spoon excavator, crown-removing pliers or a hemostat. The crown or bridge is then gently moved until the cement seal is broken. The restoration is then easily removed by breaking the weak cement seal between the tooth and restoration.
While removing a temporary crown or bridge is relatively easy, it is not the same when a permanent one needs to be replaced with a new restoration. If the same technique that was used to remove a temporary crown was used on a permanent one, the results would be disastrous. There are many designs of crown removers that use a bumping force created by a weight sliding on a bar or an air-driven motor to knock the crown or bridge off the tooth; however these devices are radical and can cause considerable damage. A crown bumper, even when well controlled, can cause fractures in the crown of the tooth, root fractures, pulpal injury or injury to the periodontal ligament.
Because of this, the rationale and technique for a safe and non-traumatic removal of defective crowns and bridges using a dentated bur and a professional crown remover.
When cutting through the existing crown, it is important that:
- The initial cut is made to visualize the metal of the crown, the cement line, and dentin of the crown preparations when cutting through the metal
- When sectioning the crown, the tooth not be cut into creating a notch; this can create a hazard to the tooth when the flat end of the crown splitter is placed into the notch as a purchase point to pry the crown apart.
- The crown should be sectioned completely through the most gingival portion of the crown margin, so that when the crown is pried apart, there is no intact metal holding it together.
Once the decision is made to remove rather than repair a defective crown or bridge, it is removed from the abutment tooth or teeth in a non-traumatic manner. Using the methodology presented in this article, the task was found to be safely and easily accomplished. It is always recommended however to consult with your local dental office and set up an individual plan for your specific needs.
For more information about this topic or any other dental topic, contact Dr.Wishneff at [email protected] or call (561) 488-3111. Dr. Alan Wishneff is a Boca Raton Dentist dedicated to bringing patients state-of-the-art dental care. As a cosmetic, family and restorative dentist, he helps patients enjoy a natural and healthy smile. He is trained in cosmetic dentistry, including porcelain veneers; advanced cosmetic bonding techniques; oral surgery; medical emergency procedures; advanced crown and bridge; advanced TMJ; implant dentistry; endodontics-root canals: utilization of most advanced dental materials. Dr, Wishneff and staff are dedicated to providing great smiles in Boca Raton for more than 30 years. After more than two decades of practicing dentistry in Boca Raton, Dr. Wishneff is more committed than ever to this community.