On Thu, 08 Nov 2007 07:48:06 -0800, willydog <> wrote:

>Question: Is it better/worse or indifferent to leave the temporary
>filling in after the RCT? Should I look to do this right away, or wait
>a while.

I never put temporary fills in teeth with completed RCT.
Am currently placing fuji 9 as a core build up with the
rubber dam still in place.

Crowns should be fabricated for RCT teeth within 4 - 6 wks.

The endodontic seal must be from root tip to cusp tip.
Monobloc.

Newbie - are you saying that you are in the traditionalist "always
crown" camp for rear molars, or are there sometimes conditions where
you feel crowns are not necessary? I do not clench (that I know of
anyway). Recall Amatus's previous comments, which agrees with that of
my father in law:

=========
John, I personally think cracks in endo teeth are related to
isometric
bruxism during clenching, not RCT.

I could look to see if I still have the articles describing the amount
of
forces generated between occlusal surfaces during chewing. Very
light.
=========


A crown wouldn't be the worst thing, but it's another contraption in
my mouth that I don't want. You all know the pro's and con's of this
better than I.

On Thu, 08 Nov 2007 12:24:16 -0800, willydog <> wrote:

>Newbie - are you saying that you are in the traditionalist "always
>crown" camp for rear molars, or are there sometimes conditions where
>you feel crowns are not necessary?

>I do not clench (that I know of anyway).

How could you possibly know if you clenched in your sleep ?

>Recall Amatus's previous comments, which agrees with that of
>my father in law:
>

For all molars and *most* bicuspids there must be cuspal coverage or replacement
Standard C&B or Cerec.
The masticatory system functions like a class 3 lever,
there is much more force exerted in the posterior than
the anterior.

>=========
>John, I personally think cracks in endo teeth are related to
>isometric
>bruxism during clenching, not RCT.
>

Strongly disagree.
It's about the loss of dentin that must be removed just to gain access to the canal system.
The roof of the pulp chamber is gone, that leaves the cusps without a significant portion
of their support.
Add a little parafunction and you are asking for a failure.

>I could look to see if I still have the articles describing the amount
>of
>forces generated between occlusal surfaces during chewing. Very
>light.
>=========

But not in parafunction or when conciously clenching with maximum force.

>
>
>A crown wouldn't be the worst thing, but it's another contraption in
>my mouth that I don't want. You all know the pro's and con's of this
>better than I.

Let's cut to the chase shall we ?
I rarely have to extract endodontically treated teeth that have
been restored with crowns.
Those that have not however, are an entirely different kettle of fish.

Agreed.

Steve

Newbie wrote:

> On Thu, 08 Nov 2007 12:24:16 -0800, willydog <> wrote:
>
>

>
>

>
>
> How could you possibly know if you clenched in your sleep ?
>
>

>
> For all molars and *most* bicuspids there must be cuspal coverage or replacement
> Standard C&B or Cerec.
> The masticatory system functions like a class 3 lever,
> there is much more force exerted in the posterior than
> the anterior.
>
>

>
>
> Strongly disagree.
> It's about the loss of dentin that must be removed just to gain access to the canal system.
> The roof of the pulp chamber is gone, that leaves the cusps without a significant portion
> of their support.
> Add a little parafunction and you are asking for a failure.
>
>
>

>
>
> But not in parafunction or when conciously clenching with maximum force.
>

>
>
> Let's cut to the chase shall we ?
> I rarely have to extract endodontically treated teeth that have
> been restored with crowns.
> Those that have not however, are an entirely different kettle of fish.

> How could you possibly know if you clenched in your sleep ?

>

Sleep? What's that? I'm a software developer. We *NEVER* sleep. Just
slide some pizza under the door and we're all set. LOL. Seriously, I
am relatively sure I do not clench.

> Let's cut to the chase shall we ?
> I rarely have to extract endodontically treated teeth that have
> been restored with crowns.
> Those that have not however, are an entirely different kettle of fish.

I'll speak to my dentist and we'll go over the options. He does CEREC
and bonding too, but he's already echoed your sentiments. I'm leaving
the ranks of single guy shortly, I don't care about aesthetics that
much... better get a 24K crown though so I can look good in case I get
divorced . ... LOL

Anyway, I will talk to the father in law, my dentist, and maybe get a
second opinion to make my decision an educated one. Hopefully this
will be my one and only RCT I ever have to deal with. I do want to
get this temporary out of there after reading your post, whatever the
restoration ends up being.

Cheers to all,
Bill

On Thu, 08 Nov 2007 17:36:57 -0800, willydog <>
wrote:

>Sleep? What's that? I'm a software developer. We *NEVER* sleep. Just
>slide some pizza under the door and we're all set. LOL. Seriously, I
>am relatively sure I do not clench.
>

Hmmm. Let's examine your above statements, doesn't sleep because
of your profession. Er, well, software developers are renown for
major caffiene and sugar consumption. When you do sleep, do
you dream of code ? Prolly gnashing the crap outta yer teeth.
You *cannot* assume that you don't clench during sleep just
because you are aware enough to not clench while awake.

As for pizza, do you like anchovies ? <hehe>

If you want to be SURE that you do not clench during sleep,
an NTI is recommended.

>
>I'll speak to my dentist and we'll go over the options. He does CEREC
>and bonding too, but he's already echoed your sentiments. I'm leaving
>the ranks of single guy shortly, I don't care about aesthetics that
>much... better get a 24K crown though so I can look good in case I get
>divorced . ... LOL

24K gold is too soft to function as a cast crown.
Your best bet is to choose either full cast high noble, or Cerec,
or if you want a Porcelain Fused to Metal <PFM> .

>
>Anyway, I will talk to the father in law, my dentist, and maybe get a
>second opinion to make my decision an educated one. Hopefully this
>will be my one and only RCT I ever have to deal with. I do want to
>get this temporary out of there after reading your post, whatever the
>restoration ends up being.

Be sure to know what material was used as a 'temporary' .
Cavit or IRM are not suitable for teeth with completed RCT.
Have an endo buddy that places Fuji 9 as a temp.

At the very least while you are contemplating the definitive
restoration, at least get a solid "Build-Up" in your tooth ASAP.
Discuss the materials with your dentist. Composite can be an
acceptable interim restoration but there needs to be a definitive
cuspal coverage restoration.

>
>Cheers to all,
>Bill

Same to ya !

It's always nice to have agreement from a highly esteemed colleague.

Thanks dude, you made my day.

On Thu, 08 Nov 2007 18:46:31 -0600, Steven Fawks
<> wrote:

>
>Agreed.
>
>Steve

I think I am the one who should be flattered.
:-)
Steve

wrote:

>
> It's always nice to have agreement from a highly esteemed colleague.
>
> Thanks dude, you made my day.
>