Hello, I am Dr. Richard Gangwisch. Previously, we had posted a video on crown preparation. Well today we’re going to take that crown and place it on the tooth. I’ve got the video in front of me, so we’re going to go ahead and turn it on so we can follow along together. So we start with the lab procedure and this is a model that we have, that the actual crown has been constructed on. You’ll notice that we have a porcelain-fused-to-metal crown. The beauty of the porcelain and the strength of the metal is a great combination. Keep the metal real thin which helps quite a bit. Now you notice here we have a temporary crown, one that was done previously. Now what the temporary crown does is to cover and protect the tooth and cuts down on sensitivity that the patient may have. It also keeps the tooth in alignment, so the teeth don’t drift. And if you don’t keep them in alignment, you get the crown back from the lab and it won’t fit. You notice the temporary cement, this is very important that we are able to clean that all off because these crowns are made very precisely and that they fit the tooth so well to the point that if we have anything in the way, then the crown won’t go into place. So we go ahead and put the crown into place. First thing we do is we check to see is how the contact is in between the teeth. Notice how that floss snaps well. We don’t want to leave anything open there because food can get trapped in between the teeth. Then we check the margins. We want to make sure that everything in between is nice and even with the tooth. We want to make sure that there is nothing overhanging into the gum. We also want to make sure that it’s not short. Now we check the bite. It’s very important because otherwise the patient will be just be chewing on the crown itself. We want to have all the teeth in harmony. So we go ahead and check with what we call articulating paper. It’s kind of like typewriter ribbon. You’ll notice the little blue dots on the area where it’s hitting heavy. So we’re able to use those as a guide and we go ahead and adjust wherever needed. Take whatever time is needed to just get that right. At that point we go ahead and are ready to seat, so we go ahead and polish where we had to adjust. Now these are rubber wheels that we have to use and they are impregnated with industrial grade diamonds and they get finer and finer grit to the point where we can actually get a virtually glazed surface. So it works out super. And that’s what a crown looks like. So we’re going to go ahead and cement that in now. We’re going to hold that in with a cement. Now we’re going to go ahead and take a little bit of de-oiling agent and the reason for that is sometimes the temporary cement has a little bit of oil to that. So we are going to go ahead and clean any remnants of that off. Then we have a desensitizer. Now anytime we work on a tooth at all, we are going to have that possibility that they could be some sensitivity to the tooth. We want to bend over backwards to make sure that there is no discomfort when we put this crown on so we go ahead and bathe the tooth in desensitizer. We want to make sure we’ve done everything possible to make this nice and easy for the patient. Now we’ll go ahead and dry that off and now we’re ready to cement the crown. Now the crown is going to go ahead in place with a material called a glass ionomer and that’s going to set. It will take a few minutes and we’re going to go ahead and let that patient bite that crown into place and give that a few minutes to let that set. And we’ll do a time lapse so you don’t have to watch that for 5 minutes while it’s setting. Now it’s important that we clean that all away. We’ll try to do this real gently to make sure the patient is comfortable and make sure we get every little piece out of there. We don’t want any remnants of cement sticking in the patient’s gum causing an irritation. Now I’ll check in between the teeth, a very common place to have extra cement. Starting to look pretty good at this point. So inspect to make sure there are no little specks of cement left. Now we are going to floss to make sure that that’s clean. Looks great! And the patient is happy and that patient will have that tooth for not only years but decades and should give her a wonderful service.
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