How to intraorally repair porcelain-fused-to-metal or zirconia/alumina restorations
Intraoral repair with BISCO's Intraoral Repair Kit can be a treatment option that can save the dentist, technician and patient valuable time and money.
Sometimes a patient presents with damage to a restoration, such as a fracture or chip. In some cases, the damage may not result in reducing the integrity or function of the restoration; it simply compromises the esthetics.
Unexpected failures can even occur with restorations in just a few weeks after placement. Although this can be frustrating, there are many reasons this may occur:
- A high bite or patient’s occlusal dysfunctions, including refusal to wear a nightguard
- Repairs made during manufacturing in the laboratory that causes some alterations in its strength and structure
- Bubbles or cracks in the internal structure that were not evident to the technician
Regardless of the root cause for premature failures, intraoral repair can be a treatment option that can save the dentist, technician and patient valuable time and money.
There are a number of situations when intraoral repair can be a useful procedure in your daily practice. At other times, the treatment plan requires replacing the fractured restoration. An intraoral repair can also be considered a temporary solution when the replacement cannot be made immediately. The decision between repairing the damaged material or fully replacing the restoration will depend on the clinical situation.
Clinical situations for choosing intraoral repair
The most common reason for intraoral repair is that the patient may prefer not to invest the time or money to fully replace the restoration. The patient simply may not have the time for multiple visits, including the preparation and seating appointments as well as the temporization time. In addition, depending upon the
circumstances, the patient may not want to incur the expenses of a full replacement.
There are several scenarios where the clinician and patient may determine that repairing the restoration would better serve the clinical purpose than replacing the restoration. Some examples include:
- If the fractured material is part of a well adapted restoration or a sealed three or four unit bridge.
- If the restoration is seated on a highly sensitive tooth that is under control after the original restorative cementation, and there is no clinical or radiographic evidence that the pulp has been compromised.
- If this is already a replacement for other failures such as incorrect shade or gingival recession after impression.
Clinical situations for choosing replacement
There are also clinical situations where the fractured restoration should be replaced. If upon inspection, it is determined that there are problems with marginal adaptation, root canal condition, contact points to adjacent teeth or periodontal disease, the restoration should be replaced. The age of the restoration should also be considered.
Finally, the accessibility to the area to be repaired should be considered since the key to a successful repair is to follow a proper protocol.
Continue on to read a clinical case...