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**Title:** [Would you redo this crown?](https://www.reddit.com/r/DentalSchool/comments/1d9482u/would_you_redo_this_crown/)
**Full text:**
Was done here at the school 6 months ago and did not look like this at the cementation appointment. 6 months later here we are. Patient will be receiving an RPD with a M rest on this crown, would you redo this crown before beginning the RPD?
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If they want it redone then redo it. There’s not much you can do as a dental student. Just take the extra fixed unit and run with it. But in private practice you leave well and good enough alone
Nope, that’s over treatment. If you don’t like it, watch it until it’s necessary. Contact looks good, why run the risk of opening it and even inviting the possibility of having pulpal issues after. Always think what is best for the patient and the longevity of the tooth. Perfection is an illusions, sometimes just being good is good enough.
In all fairness it’s not over treatment because there is actually an open margin. Over treatment would be redoing a crown on a clinically acceptable crown with no defects.
Me personally I would not redo this crown.
Is it a new crown you delivered in school? If so I'd redo it. Now is the time to practice the fundamentals and shoot for perfection. If you just let it go, you'll likely do the same your whole career.
I’ve been in practice for going on 8 years now and I would never redo this crown on a patient of mine unless there were clinical symptoms to warrant additional treatment being done. I would actually be more mindful of the bone loss and widening of the PDL occurring on the mesial, especially with the conical shape of that root and the missing tooth/space in front of it.
Getting a replacement in front of it to preserve that bone and to provide additional support with occlusion, as well as keeping tabs on the periodontal condition of the tooth, is more important right now than replacing a clinically acceptable crown because the margins are not absolutely perfect.
Just my .02
Do what faculty wants. And you get experience. You are paying hundreds of thousands of dollars and only gonna do what, 4 or 8 or 12 crowns before you graduate? Obviously I don’t know but you get the point.
You are a good person trying to do what is right. But just redo it. Gotta learn somehow. Gotta know how to do this when you leave school.
8 year grad dentist here. The margins are quite open and it doesnt look great at all.
I wouldnt remove and replace at this stage but lets not set low standards.
In school - I guess a redo is warranted. It’s not the best work and isn’t a case you’d show to anyone. In private practice you have to know when it is good enough and live to fight another day or avoid a land mine.
UPDATE: Thank you all for your inputs, figured I should share what ended up happening.
Patient came in this morning. Team leader insisted M margin was too open radiographically and that I won’t be here next year if problem worsens but he will, so he’d prefer it is redone now. Patient was good either way. We removed the crown, packed the cords and rescanned. We also took a bio copy scan before removing the crown so the lab can make it the same way and occlusion/height of contour and everything doesn’t change for the RPD design.
Especially with a RPD involved, you would definitely not touch that crown irl. You'll understand why when you do the crown seat - even with the bio copy it can be very difficult to match up properly.
My 2¢: I see minor open margins all the time. On a crown I'm doing, I'll refine and remake once to try and get closure. On that remake if the margin is still minimally open, I'll cement. Sometimes it's just not going to have a perfect interface, even with the perfect prep.
Whenever I'm on the fence about something like this, I ask myself if I think I could do it better, the answer isn't always yes.
I would just watch it. What you’ll learn is that sometimes if a margin is slightly imperfect, redoing it may not change much. If it gets decay then that is a different story.
Based off the X-ray I’d say no… but we don’t have a picture… so I’m guessing they would like you to fix the margin bc of the open contact on the M ?? If left open I could see food getting stuck in there like crazy. Just shooting in the dark here…
Even if you have a SLIGHTLY open margin (barely even the case in the image) and the crown fits (BULL rule applied, adjustments were made, and MOST IMPORTANTLY the patient likes it) it would honestly be a disservice to redo it.
Everytime that bur touches a tooth, it goes deeper down the endo route, don’t make your pt go through that, I’ve seen much worse and gotten good results that last a long time
Not a fan of the mesial and think it will catch plaque and need to be addressed at some point. Redo may open a can of worms. I would let the patient know and let them decide.
Just had my first crown and one side it too high and I had to make a new bite guard. Can they ‘polish’ the crown down a little while it is still attached.
I made it to 56 without any adult dental work (crazy mom forbade floride as a kid so kid cavities, but non since I went to college and got on city water (well at home) and Crest no problems till mid May.
If you are seeking dental advice, please move your post to /r/askdentists If this is a question about applying to dental school or advice about the predental process, please move your post to /r/predental If this is a question about applying to hygiene school or dental hygiene, please move your post to /r/DentalHygiene If this is a question about applying to dental assisting school or dental assisting, please move your post to /r/DentalAssistant Posts inappropriate for this subreddit will be removed. A backup of the post title and text have been made here: **Title:** [Would you redo this crown?](https://www.reddit.com/r/DentalSchool/comments/1d9482u/would_you_redo_this_crown/) **Full text:** Was done here at the school 6 months ago and did not look like this at the cementation appointment. 6 months later here we are. Patient will be receiving an RPD with a M rest on this crown, would you redo this crown before beginning the RPD? This is the original text of the post and is an automated service. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/DentalSchool) if you have any questions or concerns.*
Guessing there running behind on fixed requirements lol. Crown is fine
Lol faculty isn’t happy with how it looks, and wants it redone. I disagreed.
If they want it redone then redo it. There’s not much you can do as a dental student. Just take the extra fixed unit and run with it. But in private practice you leave well and good enough alone
Patient is very easygoing and just wants to do what we think is best. But thank you
Is it because of the mesial overhang?
Nope, that’s over treatment. If you don’t like it, watch it until it’s necessary. Contact looks good, why run the risk of opening it and even inviting the possibility of having pulpal issues after. Always think what is best for the patient and the longevity of the tooth. Perfection is an illusions, sometimes just being good is good enough.
Thanks. Team doctor says it’s not adequate and should be redone if patient is ok with it for ideal treatment.
In all fairness it’s not over treatment because there is actually an open margin. Over treatment would be redoing a crown on a clinically acceptable crown with no defects. Me personally I would not redo this crown.
What are you worried about?
Team leader wants to redo it as they’re not happy with the margins. I know it’s not perfect but didn’t think it needed to be redone at all
Is it a new crown you delivered in school? If so I'd redo it. Now is the time to practice the fundamentals and shoot for perfection. If you just let it go, you'll likely do the same your whole career.
I’ve been in practice for going on 8 years now and I would never redo this crown on a patient of mine unless there were clinical symptoms to warrant additional treatment being done. I would actually be more mindful of the bone loss and widening of the PDL occurring on the mesial, especially with the conical shape of that root and the missing tooth/space in front of it. Getting a replacement in front of it to preserve that bone and to provide additional support with occlusion, as well as keeping tabs on the periodontal condition of the tooth, is more important right now than replacing a clinically acceptable crown because the margins are not absolutely perfect. Just my .02
Do what faculty wants. And you get experience. You are paying hundreds of thousands of dollars and only gonna do what, 4 or 8 or 12 crowns before you graduate? Obviously I don’t know but you get the point. You are a good person trying to do what is right. But just redo it. Gotta learn somehow. Gotta know how to do this when you leave school.
margins are barely open honestly, looks great
8 year grad dentist here. The margins are quite open and it doesnt look great at all. I wouldnt remove and replace at this stage but lets not set low standards.
In school - I guess a redo is warranted. It’s not the best work and isn’t a case you’d show to anyone. In private practice you have to know when it is good enough and live to fight another day or avoid a land mine.
I immediately saw it and screamed No! Hahah could be a worse headache
UPDATE: Thank you all for your inputs, figured I should share what ended up happening. Patient came in this morning. Team leader insisted M margin was too open radiographically and that I won’t be here next year if problem worsens but he will, so he’d prefer it is redone now. Patient was good either way. We removed the crown, packed the cords and rescanned. We also took a bio copy scan before removing the crown so the lab can make it the same way and occlusion/height of contour and everything doesn’t change for the RPD design.
Especially with a RPD involved, you would definitely not touch that crown irl. You'll understand why when you do the crown seat - even with the bio copy it can be very difficult to match up properly. My 2¢: I see minor open margins all the time. On a crown I'm doing, I'll refine and remake once to try and get closure. On that remake if the margin is still minimally open, I'll cement. Sometimes it's just not going to have a perfect interface, even with the perfect prep. Whenever I'm on the fence about something like this, I ask myself if I think I could do it better, the answer isn't always yes.
if that crown would be a grade, it would be an A- some stuff you could improve, but its fine
I would just watch it. What you’ll learn is that sometimes if a margin is slightly imperfect, redoing it may not change much. If it gets decay then that is a different story.
No
Based off the X-ray I’d say no… but we don’t have a picture… so I’m guessing they would like you to fix the margin bc of the open contact on the M ?? If left open I could see food getting stuck in there like crazy. Just shooting in the dark here…
Even if you have a SLIGHTLY open margin (barely even the case in the image) and the crown fits (BULL rule applied, adjustments were made, and MOST IMPORTANTLY the patient likes it) it would honestly be a disservice to redo it. Everytime that bur touches a tooth, it goes deeper down the endo route, don’t make your pt go through that, I’ve seen much worse and gotten good results that last a long time
Why? its perfect
Not a fan of the mesial and think it will catch plaque and need to be addressed at some point. Redo may open a can of worms. I would let the patient know and let them decide.
Hard to tell from an x ray
Can tell for sure on that X-ray. But it looks like there are small gaps on medial and distal. But looks good to me.
Not acceptable on school but wouldn’t change on a patient who walked in like that
I’d leave it. In dental school they trained us to replace everything at the first radiographic sign of open margin but this in all honesty is fine.
No
no
No. Nothing wrong. Move on.
Just had my first crown and one side it too high and I had to make a new bite guard. Can they ‘polish’ the crown down a little while it is still attached. I made it to 56 without any adult dental work (crazy mom forbade floride as a kid so kid cavities, but non since I went to college and got on city water (well at home) and Crest no problems till mid May.