State My Case

This State Your Case is truly me, stating my case. Recently, I fell victim to fracturing a tooth. Tooth No. 14 had a large amalgam filling (more than 25 years old), which should have been crowned some time ago. Like our patients, I kept putting it off, hoping for the best, but my luck ran out a few months ago.

While eating, the tooth fractured mesial-distally and was nonrestorable. I referred myself to my oral surgeon. He removed the tooth, and we discussed plans for the future implant/crown replacement.

With the extraction site ready for the implant, I'm also ready for the temporary replacement of the tooth. What are my options? Have a flipper made to replace tooth No. 14, while the implant integrates and the abutment/crown is fabricated or, have a Delineator (Keating Dental Arts) made and having a strong, stable, esthetically pleasing temporary replacement.

I chose to go with the Delineator, which is exclusive to Keating Dental Arts. The Delineator acts as an radiographic guide, surgical stent, esthetic immediate provisional, and an implant locator, saving additional laboratory time and expense.

Recording the patient's bite is the first step in getting a removable appliance back from the lab that will not need any adjustments at insertion. The bite registration was made with Correct Plus Bite Superfast (Pentron). The tray materials I used to make the final impression were Correct Plus Putty (Pentron) and Correct Plus Thick-n-Thin Light-Body Impression Material (Pentron). The putty material was mixed and placed into the upper impression tray. At the same time, the Correct Plus Thick-n-Thin Light-Body impression material was applied to the area of the missing tooth and the adjacent teeth. The loaded upper impression tray was placed into the mouth, then removed after the recommended setting times.

I did not know what to expect from the Delineator, as I often have recommended this product to my patients without having a clue on how it really functions in the mouth. The fit, the look, and the functionality were all excellent.

It took me losing a tooth to rediscover how good these products are and how they can truly help my patients. Now, my patients can feel at ease, by giving them a "take it from me" stance about their treatment options. Taking one for the team isn't fun, but so far, I'm happy with the outcome of my case.