CORONAL DISASSEMBLY
Q. I understand that endodontic procedures are often performed through an existing restoration, while in other instances, a restoration may be sacrificed. Is it possible to safely remove an existing restoration to facilitate treatment?
A. There are a variety of devices and techniques that can successfully remove provisionalized or definitively cemented restoratives. The safe dislodgment of a restoration is dependent on the type of preparation, the restorative design and strength, the restorative material, and the cementing agent. There are many important removal devices and they may be generally divided into three categories: (1) Grasping instruments, such as K.Y. Pliers (GC America, Alsip, IL), (2) Percussive instruments like the Peerless Crown-a-Matic (Henry Schein, Port Washington, New York) and the Coronaflex (KaVo America, Lake Zurich, IL), and (3) Passive-active instruments such as the Metalift (Classic Practice Resources, Baton Rouge, LA). My Ruddle on Retreatment video "Disassembly & Missed Canals" clearly shows these instruments in clinical use.
A. There are a variety of devices and techniques that can successfully remove provisionalized or definitively cemented restoratives. The safe dislodgment of a restoration is dependent on the type of preparation, the restorative design and strength, the restorative material, and the cementing agent. There are many important removal devices and they may be generally divided into three categories: (1) Grasping instruments, such as K.Y. Pliers (GC America, Alsip, IL), (2) Percussive instruments like the Peerless Crown-a-Matic (Henry Schein, Port Washington, New York) and the Coronaflex (KaVo America, Lake Zurich, IL), and (3) Passive-active instruments such as the Metalift (Classic Practice Resources, Baton Rouge, LA). My Ruddle on Retreatment video "Disassembly & Missed Canals" clearly shows these instruments in clinical use.
Q. I have recently purchased your ultrasonic tips and was told one of them could be used for crown removal. Do you have a prepared instruction sheet?
A. Dentply Tulsa Dental, the ultrasonic source for my ProUltra instruments, has a technique card detailing all the pertinent information regarding directions for use. Additionally, information concerning the various tips and their applications is posted to the Inventions page of this site. Separately, our Ruddle on Retreatment video series includes the following titles:
1) "Nonsurgical Retreatment: Disassembly & Missed Canals, Quality & Profitability"
(has a lot of information on crown and bridge removal utilizing ultrasonics)
2) "Nonsurgical Removal of: Gutta Percha, Silver Points, Carriers & Paste Fillers"
3) "Nonsurgical Removal of: Posts & Broken Instruments"
4) "Management of: Blocks, Ledges, Transportations & Perforations"
The videos can be purchased individually or as a complete set (includes all four titles).