Case studies

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Case studies

• Gary Wilson

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Ceramic crown for a fractured canine in a show dog
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History

• 6 year old female show dog got into fight with
  kennel mate
• fractured both upper canine teeth
• owner opted no treatment
• 6 months later owner decided to seek restorations
  crowns

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Clinical exam

• healthy but aggressive bitch
• upper right canine fractured in distal 3rd of
  crown
• upper left canine fractured 5mm coronal to
  gingival margin
• both had necrotic pulps

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Treatment

• both canines were treated endodontically to be
  re-assessed in 3 months upper right was
  recontoured to approach a normal shape
• 3 month recheck both good periapically owner
  opted for ceramic crown restoration of upper left
  canine

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Crown prep

• under general anaesthesia the left canine was
  reduced with a round-end taper diamond bur in a
  high speed handpiece

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Crown prep

• an attempt was made to produce an axial wall
  taper as close to parallel as possible
• the apical margin was made approximately 0.5 1
  mm above the gingival margin
• an external bevel shoulder was produced at the
  margin

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Crown prep

• mouth dental impressions were made with
  alginate for production of stone models
• vinyl polysiloxane impressions of the crown prep
  were made for accurate crown production

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Crown manufacture

• instructions were given to the technician for a
  colour matched ceramic crown to be produced that
  matched the size shape of the upper right canine

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Crown placement

• 2 weeks later the dog was re-anaesthetised and
  the crown trial fitted
• the tooth surface inside of the crown were acid
  etched, rinsed, dried 3M single bond applied,
  dried cured
• dual cure resin cement 3M RelyX was mixed
  crown cemented in place the margin light cured
• excess cement was trimmed off

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• the bitch has resumed its show career

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Apparently missing permanent upper right canine
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History

• 8 month old Staffordshire bull terrier bitch
  presented with an apparently missing permanent
  upper right canine
• all other permanent teeth had fully erupted
• a fractured upper right deciduous canine was
  present

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Treatment

• the dog was anaesthetised the deciduous tooth
  remnants extracted
• an intraoral radiograph was taken

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Treatment

• a probe was passed through the alveolus of the
  extracted deciduous tooth to attempt to pinpoint
  the structure re-x-rayed

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Treatment

• a buccal approach was made over the tooth it
  was located removed

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Treatment

• the site was closed in a single layer with 4/0
  monosyn the dog made an uneventful recovery