Prepping Decayed Mandibular Cuspid and Bi-Cuspid for Crowns - with Steven T. Cutbirth, DDS

[@mhmdamin4238]

One of the most useful dental channel that I have ever seen , thank you so much doctor Steve

[@centerforard]

You are welcome. I hope you have subscribed to DentistryMasterClasses.com. That is the best material.

[@LUCIFER-bo3zw]

The most classy and intelligent doctor on the earth. I love your channel and you are one of my favourite doctors.Already subscribed to your dentistry master classes.

[@centerforard]

Terrific. Thank you.

[@sivawilson]

Great mentor love your in depth explanations

[@centerforard]

Terrific. I hope you are subscribed to DentistryMasterClasses.com. The really good stuff!

[@mladendenni9638]

you are one Gentleman first of all and a phenomenal doctor ty sir

[@centerforard]

Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@timter3181]

Thanks !! Dr, can you make videos with a larger plan ? So that we can see your working positions... Thank you ☺☺

[@centerforard]

Interesting request. I have never had anyone make that request. The problem is you would not be able to see a close up of the actual work. I will ask my videographer to take some pans of the entire working area, showing my assistant and me at work.

[@timter3181]

@@centerforard thank you very much, it would be very interesting. Ive just started practicing and my first problem was positioning !

[@sserunjogijesusssongs4644]

Thanks. Doc ,u have mentored me

[@centerforard]

Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@MyGabriella21]

Hello, Doctor, why You did not place a composite filling to restore a 33 tooth? It was not so bad to restore it with a crown. Thank you for answer

[@centerforard]

Large area of decay or class 2 decay, I place inlays or crowns. Smaller area of decay, composite restoration.

[@doctoredable]

What was the endodontic diagnosis for these teeth. I would be very surprised if either tooth had a lingering response to cold or heat application. I would also expect neither to be percussion positive. There are no changes to the periapical tissues for either tooth on the radiograph. The caries appears to be far away from the pulp. SMH.

[@centerforard]

Did you watch the video? Look at the major amount of decay in these teeth. If you have been in practice very long, you should know that you do not want to place a crown on a tooth that becomes hyperemic after the crown placement. Endo through a crown compromises the crown plus the patient is not happy about having to have and pay for the undiagnosed endo. There a multiple reasons for endodontics on these teeth.

[@johnmiller323]

@@centerforard Hey doctor, thanks for the videos. Are you saying that the tooth has a high likelihood of developing pulpitis so you do preemptive endo?

[@centerforard]

I am saying I do not want to perform endo through a recently placed crown. If the crown is prepared into the cementum on the root, or deeply into the dentin due to decay, there is a high probability the tooth will be sensitive post crown placement. Because the provisional crown is made of bisacrylic, it does not conduct hot and cold like the final crown, so you often cannot get a good read on post op hypersensitivity while the patient is in a provisional crown. Quick story: 30 years or so ago I performed a full mouth restoration, including many crowns on a gentleman from Dallas. One of the teeth had significant gingival recession onto the cementum (root). I carefully prepared the tooth for a crown, placed the bisacrylate provisional crown and waited 2 months. The patient reported no hot or cold sensitivity in the tooth. I placed the crown and finished the case. 2 weeks later he phoned the office and reported that hot or cold things "put him through the roof" when they contacted that tooth. I told him that, unfortunately, that tooth was going to need a root canal. He was not upset, but I will never forget what he said: "If you thought that tooth had a good chance of needing a root canal, why didn't you do it at the same time you did the crown?" I am like that gentleman when I am having dental work performed on my teeth or, for that matter, any medical procedure. I want to be finished with the treatment and not have to go back and have to have something else done. I'm not saying perform endo randomly, but don't do it through a recently placed crown. Really bad PR. The patients do not like it. Just be sure you know how to perform proper endo.

[@johnmiller323]

​@@centerforard Thank you for taking the time for that explanation doctor.

[@ntian3572]

Thank you for the great work, Dr. I want to ask what material you use to build up the cavities after removing caries? Thank you!

[@centerforard]

Either composite or IRM. If I am placing a crown, normally IRM. It is a simple material to use.

[@gobeyondtheuniverse]

Great case. I would go to you if I needed work. I haven't seen anyone use anything other than PVS. Nice to see some people using reversible hydrocolloid and polyether.

[@centerforard]

I like PE and reversible hydrocolloid be cause they are extremely accurate and are hydrophilic. PVS is hydrophobic.

[@centerforard]

Be sure to use a custom tray with PE or PVS. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.

[@rasleenkaur7636]

Hi Dr, Do you block the undercuts in every case with Luxabite before taking the impression?

[@centerforard]

Only when taking a polyether with custom tray impression. You do not need to block the undercuts with reversible hydeocolloid impressions.

[@carloslasarte2153]

congratulations , Doc.....

[@centerforard]

Thank you. Glad you like the videos.

[@asitmc]

just curious, why were RCT's performed? esp the canine

[@centerforard]

Preoperative hypersensitivity. If a tooth is hypersensitive preoperatively, a crown is not going to make it less sensitive. If the tooth is in the aesthetic zone, and you must prepare it onto the root to achieve a crown margin at or slightly apical to the gingival line, the tooth will be even more sensitive. I do not want to have to perform endo through a crown because the composite filling in the hole in the crown compromises the longevity of the crown. If the tooth is going to need endo, you want to do it prior to seating the crown. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@jakedent]

How long does the tooth preparation, impression and provisionalisation appointment take Dr?

[@centerforard]

I normally see one sedation case most mornings from 8-1 or 2, then smaller cases and consultations in the afternoons.

[@drhasbi1139]

Thank you doctor

[@centerforard]

You are welcome.

[@benandre9648]

Why did you do Endo on those teeth ?

[@centerforard]

Deep decay. I did not want the tea to be hypersensitive following crown placement. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@timter3181]

Doctor ,in this case did you do a wax-up for the provisional ?

[@centerforard]

I do a wax up for crown provisionals if the tooth is broken down. I always do a wax up for veneer provisionals. You can watch the videos on DentistryMasterClasses.com library.

[@timter3181]

@@centerforard so in this case you did a PVS key of the initial situatiok in mouth ?

[@centerforard]

Sorry, I do not understand your question.

[@timter3181]

@@centerforard i mean how did you do provisional in this case ?

[@osmanberathamurcu]

do you use retraction chords while taking impressions?

[@centerforard]

Yes, if the preps are sub gingival. There are many comprehensive case videos on veneers, crowns and bridges in the library of DentistryMasterClasses.com. I encourage you to watch them all several times. I rarely learned anything by observing a procedure just one time.

[@shotaereklishvili792]

Hey Doc, what's that stylish thing you wear in every single video on your kneck?

[@kilow4957]

That’s a bolo tie

[@centerforard]

Bolo.

[@hqbhfa3467]

Thanks

[@centerforard]

You are welcome.

[@shawndsouza8115]

Superb drcutbirth

[@centerforard]

Thank you. Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@emadebrahim1333]

شكرا جزيلا لك Thanks a lot for you Merci beaucoup Teşekkürler

[@centerforard]

You are welcome.

[@sajathebunny2687]

What do I do if I invade the gingival width ?

[@centerforard]

Do not prepare into the junctional epithelium (attached gingiva). If that depth preparation is necessary, you probably should perform a periodontal crown lengthening surgical procedure and allow that to heal 3 - 6months, then prepare the tooth for a crown.

[@sajathebunny2687]

@@centerforard thank you so much

[@DeeDandle]

hmhhhhh interesting... nice Chanelle doc

[@centerforard]

Glad you like the videos.

[@Mig-nr8hc]

I have TMJ .

[@centerforard]

Sorry. You might like to watch my videos on TMJ treatment.