88-year-old woman had recent endodontic treatment on tooth #20 by endodontist. Tooth #20 needs a crown lengthening in order to be restored, as seen radiographically and in the pre-op photo. Due to the patient's age and medical history, a flapless (closed) crown lengthening was performed. The clinical objective was to restore the tooth, necessitating crown lengthening to expose adequate tooth structure. This procedure took approximately 40 minutes.
The patient was anesthetized with 1/2 carpule of 4% articaine with epi 1:100,000. The previous crown was sectioned off and the composite restoration and decay were removed. The entire procedure was performed using the hard and soft tissue selection. Excess gingiva was ablated using the 1.00 mm and 0.25 mm spot size with 1% mist with cutting speed between 20% – 40%. The bone adjacent to the tooth was removed until 3 mm of tooth structure was coronal to the alveolus, using the 1.00 mm and 0.25 mm spot size, 100% mist and cutting speed between 40% – 60%. A Piezo scaler was used to smooth root surface and remove any spicules of bone on cementum. A temporary restoration was placed Tempit, (Centrix) and flowable composite Esthet-xflow, (Dentsply) were used. Retraction cord was placed to protect surgical site during fabrication and cementation of temporary crown. This cord was useful for stopping temporary cement from lodging subgingivally. The total procedure time was approximately 40 minutes.
With Solea, this was a minimally invasive procedure. Solea’s precision and ability to maintain a clean surgical site allowed this procedure to be completed successfully. Patient reported no post-operative discomfort and rapid healing was observed. As the radiograph and photos show, excellent conditions for restoration were established.