Herodontics for tooth #27

Posted on November 05 2016

"Elderly patient - Tooth opposed by a denture. Patient desperately wants to maintain remaining lower teeth."

Extensive carries tooth #27

Step 1


Deep subgingival prep

Step 2

No pulp exposure. Pulp had recessed into the root.

Caries was flush to the bone level.

Step 3

I used a Karl Schumacher bone chisel to remove bone 1 mm below the prep margin.

Greater Curve Wide Band in place

Step 4

Prep very well isolated. I am holding the matrix with my fingernail to keep the matrix below the prep margin. There is a small gap at the mesial, but no bleeding. I will carve away the overhang with a #12 when I shape the composite.

Bonding Sequence:

Step 5

"Clean and Boost, Etch enamel, Consepsis, Prelude SE Placed a thin layer of A2 Activa along the margin and cured. I can now release my finger hold because the matrix is locked down.

Completing Restoration

Step 6

Layed Filtek Supreme Ultra A2 Body to complete the restoration

Completed Restoration

Step 7


I do not want to suggest this was easy, but I believe it would be impossible to do without the Greater Curve band. I violated the biologic width along the mesial border. However, I have observed that a biologic width violation is of no consequence when there is a well sealed highly polished composite in close proximity to bone.