Technique tips: things are not always what patients think!

Most practising clinicians have had patients phone the practice saying, ‘My crown has come off’, only to find that, when they attend, it's not just the crown but the entire crown, core and sometimes tooth substance too. Therefore, what for the patient seems like a simple matter of ‘Can you stick it back in?’, turns into, ‘I am afraid it's not quite so simple’. Once patients have viewed an intra-oral photograph or radiograph of the affected tooth, it may be hoped that most will become more aware of this (difficult) clinical situation.

Conventionally, a new core and, more often than not, a new crown could be considered, given that it is common in situations like this that there are marginal issues which would preclude from recementing the same crown.

This is such a situation. The patient was a fit and well middle-aged professional man who had lost a crown and core from his LL6. In this case, there was little caries but the original crown was ill-fitting and it was deemed that a new restoration was warranted (Figure 1).