Fistula Beside Crown: Case Resolution with Dr. Effie Habsha
February 15, 2016
In this video, Dr. Effie Habsha, from Prosthodontic Associates, comes back to demonstrate the management of the fistula beside crown case previously posted on Oasis Discussions.
Watch the initial Case Presentation
We would like to sincerely thank the numerous dentists who responded to the case conference questions: Thank you!
Case Resolution
Would you have considered a tracer to locate orgin of fistula/li flap to remove cement?
I would have used a tracer to confirm the diagnosis. I would not have flapped the tissue to remove the cement because of the risk of attachment loss and because of the odds of success by removing the crown. I would add that even the most tenacious adhesion of a crown to an abutment can be overcome by thermocycling in the lab and it is my opinion that the original crown could have been retrieved after accessing the abutment screw, removing the crown and abutment intact, and retrieving the crown from the abutment in the lab. This is all assuming that the method of retention was not selected because a screw retained access would have been through the labial or the inciisal.
I have had a similar case to this. It was on a molar, and I was able to prepare through the crown and locate the abutment screw. The crown/abutment was removed as one unit, the cement was removed, and then we re-inserted the crown/abutment as a “screw-retained” unit. I assume in this case that the access to the screw may not have been through the lingual, rather the incisal or facial, and compromised the esthetics afterwards.