Chairside - Glidewell Dental Labs

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BIOLOGIC SHAPING An Alternative to Extracting a Tooth with a Severe Fracture – ARTICLE and CLINICAL PHOTOS by Daniel J. Melker, DDS When a cusp of a tooth is fractured subgingivally approximating the bone, extraction is a commonly considered treatment, due to concern about the significant bone removal required by other procedures to create space for the biologic width. That being said, addressing this primary concern of removing bone to create space for the biologic width presents the alternative procedure of biologic shaping. The premise for traditional crown lengthening to preserve a fractured tooth is that the surgeon must remove enough bone, starting from the most apical portion of the fracture, to create space for the biologic width. This method can result in a significant loss of bone, tooth mobility and, if the fracture is located near the furcation, a compromised furcation area. Biologic shaping offers an alternative to conventional crown lengthening through removal of the fractured portion of the tooth, allowing for a new biologic width to reform without significant removal of bone. The case presented here illustrates this technique. 62 www.chairsidemagazine.com
CASE EXAMPLE Figure 1: Provisional crown placed after the buccal cusps of tooth #30 fractured approximating the bone Figure 2: Removal of provisional crown to access the fractured tooth surface Figure 3: Reflected tissue verifying location of fracture into the furcation and approximating the bone Figure 4: Removal of fractured tooth surface using a coarse diamond bur Biologic Shaping: An Alternative to Extracting a Tooth with a Severe Fracture63
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Chairside® A Publication of Glidew
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Contents 35 Faster Is Not Always Be
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Letters to the Editor Dear Dr. DiTo
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Contributors Michael C. DiTolla, DD
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Numbers by the 52% Percentage of de
Page 12 and 13: Dr. DiTolla’s CLINICAL TIPS PRODU
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Page 19: 12 Figure 12: Veneers returned from
Page 22 and 23: Figure 1: A smile in need of a rema
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Page 30 and 31: Figure 1: A preoperative view of to
Page 32 and 33: Figure 10: A provisional restoratio
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Page 38 and 39: quality of the impression.” Howev
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Page 44 and 45: 42 www.chairsidemagazine.com
Page 46 and 47: Dr. Michael DiTolla: The thing I lo
Page 48 and 49: you go over and the caller ID says
Page 50 and 51: low. If I’m about to prep away th
Page 52 and 53: that is we have to give the technic
Page 54 and 55: is one little spot where there’s
Page 56 and 57: worrying that self-etchers don’t
Page 59 and 60: - ARTICLE and CLINICAL PHOTOS by Ca
Page 61 and 62: Patient Positioning You can take th
Page 66 and 67: Figure 5: Smoothing the tooth’s s
Page 68 and 69: Doc moved to Dallas, Texas, and qui
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Chairside - Glidewell Dental Labs

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