Tag Archives: open margins

CEREC crowns

Open Margins on CEREC Crowns

I had three CEREC crowns made. I don’t feel like they are fitting well and I’m think there are open margins. There are radiolucent images that seem to support this but my dentist is telling me that those are radiographic burnout. Can you verify that?

James

Dear James,

block of porcelain for a cerec crown.

I can verify it with any definitive answer without examining you. CEREC crowns are usually more accurately fit than traditional ones because they are milled by a machine that designs the crown based on sophisticated software. Even so, it is still possible for a dentist to place them with open margins.

I can tell you that radiographic burnout is possible. A cleaner x-ray and running an explorer around the margins should tell you with certainty.

It doesn’t sound like you have much faith in your dentist to tell you the truth. This is a problem. You really do need a dentist that you can trust and feel is ethical. I would get a second opinion from another dentist. Make it a blind second opinion. By that I mean do not tell them who your dentist is or tell them anything about the radiolucent image.

The dental field is a small universe and it is very likely your dentists know each other. He or she may feel torn about saying your dentist messed up if they know who they are. If they ask, just tell them you want an unbiased opinion so just to look at the crowns and ask if there are open margins.

If it turns out that you do have open margins, then I would start looking for an ethical dentist who does quality work. Check out their reviews online. That can often be a way to weed out those whose patients have had bad experiences with them.

This blog is brought to you by a friendly dentist at Libertyville, IL Dr. Matt Roper.
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CEREC crowns

CEREC Crown Disaster

Everything I’ve read about CEREC crowns and their procedure leads me to think my dentist was way off on how she handled my particular case. What’s done is done, but I just need to make sure the sensitivity I’m feeling is normal and will go away after some healing or if I have a problem. When the dentist did my crown, she said my tooth was in too bad a shape to get a good image so she was just going to pull one from a CEREC database. I wasn’t too worried because the advertisements all talk about how perfectly these crowns fit. Well, it didn’t. It was too big all around. She spent well over an hour grinding down all the sides of it. Not only was that remarkably uncomfortable, but it doesn’t even look like a real tooth anymore. It looks more like a box. Plus, every time I eat or drink something cold it zings me. Will that end after a period of time or do I have a problem on my hands?

Dirk B.

Dear Dirk,

Gilbert CEREC Crowns
A CEREC Machine

You have a problem. You’re also right that this seems to be a disaster. CEREC crowns should be able to be placed in minutes. I have no idea what your dentist meant by your tooth was in too bad a shape to get a good image. It’s only teeth which are in bad shape that need a dental crown to begin with. I have no idea why she couldn’t get a clear image.

The only thing I can think of with an image database is when she input into the CEREC machine which tooth she was going to crown. It will give her a basic image to work from, then she’ll put images of the surrounding and opposing teeth so the computer can design a crown with a perfect fit. It sounds like your dentist had absolutely no idea what she was doing.

Get a New CEREC Crown

The sensitivity to cold concerns me. It sounds like your dentist left an open margin. That not only causes some pain when you drink something cold, but it also allows food and drinks to get trapped in there. You don’t want to leave any opening for decay. A mistake like this can cost you your tooth. Then, you won’t be trying to get a crown, but a complete tooth replacement.

You need to get a new CEREC crown made. But, you’ll want to go about this in a way that won’t cost you any more money. You’ll first need to get a second opinion from a dentist verifying everything I’ve said so you have ammunition. Do NOT tell the second opinion dentist the story you told me. Just tell them you want them to look at your crown. Also, do NOT tell them who your dentist is. You don’t want any friendship or misplaced sense of loyalty to cause them to waver in their true opinion. If they pressure you to know, tell them you’ll let them know AFTER they give their opinion. Tell them you just want their pure, untainted thoughts.

Once what I suspect is confirmed, don’t just ask for a refund. Your dentist should also pay for any expenses you incur to fix her botched job.

I hope this helps.
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