Seating a crown is not always the simplest process. When issues occur, you have to take the time to figure out what went wrong.
Seating a Crown: Using Processes to Understand the Problem
All of us have had the experience of seating a crown and having the contacts be too tight or too loose. Normally, we go right to problem solving and move on to our process of correcting the issue so we can complete the patient’s care. But equally valuable is to try and figure out what happened. We must put some processes in place to prevent it from happening as often.
The Most Important, Often Overlooked Step
One of the most important steps in problem solving with lab cases is looking at the fit of the provisional on the solid model. The position of the prepped tooth is maintained by the fit of the provisional. Most of these temporary restorations are made by dental assistants. They may or may not understand the importance of this job.
When the contacts of the crown aren’t optimal in the mouth, it is time to check the provisional. If the contacts of the provisional on the model are open or loose, then I expect that the contacts in the mouth may be too tight and I will have to make adjustments. The opposite is also true. If the provisional is tight and difficult to seat as it is binding on the contacts on the solid model, then they may be open in the mouth.
Checking the fit of the provisional on the model is a great way to work with your assistants and ensure they understand the criteria for success. Make sure when you check the contacts you use the solid model, as the die model will give you inaccurate information.
What is your process when seating a crown doesn’t go as planned? We’d love to hear from you in the comments!