Dr. Hall
I was reading on your site about removing a metal post in a tooth, which made me think of my experience. In May of this year I saw my dentist in The Netherlands for a checkup. I had a crown that was made by computer in 2017 and she said that this crown wasn’t fitting well and needed to be re-done. Also, the previous dentist had removed metal posts from my tooth before placing the crown. The new dentist said that the posts should have been vibrated out with ultrasonics and not by drilling.
My questions are:
1) Is the computerized-3D crown process as good as a ceramic old-fashioned crown?
2) Did drilling the posts out of the tooth damage my bone?
Thank you very much
Tessa from the Netherlands
(See Dr. Hall’s answer below.)
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Tessa,
Yes, it’s nice if you can vibrate out the post with an ultrasonic device. Most dental offices have ultrasonic scalers. But I can tell you from experience that this may not work. So, if you want the metal posts out, there may be no option but to drill them out. No, this won’t damage the bone. How can drilling on a tooth damage the bone? Dentists are always drilling on teeth. The risk in drilling out the post is that the drill could slip and perforate the side of the root, which would damage the tooth to the point where it would have to be extracted. For any people who have experience drilling into metal, you know that it is very easy for the drill to skate along the surface of the metal, so this is a real risk. But it sounds like your dentist got through that without any unfortunate accidents.
And then telling you that this crown “isn’t fitting well” makes me wonder. I’m not sure what that means. Are there gaps at the margins of the crown? If so, why doesn’t she say that clearly? That’s what we look for when we’re checking a crown—we use an explorer and run it around the margin to see if there are gaps. If there aren’t any, then the crown is fine. Also, her statement that drilling out the posts would damage the bone, that makes me suspicious. Some dentists try to accuse a previous dentist of doing something wrong as a way to get you to believe that they are better and to justify their plans to re-do the dental work of the previous dentist. I don’t know if that is happening in your case, but I have enough suspicion to make it prudent, in my opinion, to seek a second opinion about this crown that supposedly “isn’t fitting well.”
About crowns made with a computer. This process was developed about 35 years ago by Dentsply Sirona, which is when CEREC crowns were introduced. In the early days there were issues with the accuracy of fit, but that is no longer an issue. When I needed a crown 15 years ago, I decided I wanted to experience this technology and so went to a colleague who had a CEREC machine. I have had no trouble with that crown. It fits just fine. The whole process, which includes optically scanned impressions of your teeth instead of impression paste is a highly precise process that creates a high quality crown.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
