It is often best to remove large amalgam, composite and cast restorations from teeth that are planned for endodontics. Dentistry leaks and cement lutes fail. There is often hidden dental caries beneath repairs. It is necessary to visually assess the amount and quality of remaining tooth tissue in order to determine if teeth are beyond reasonable restoration before endodontics commences.

 Komet crown-cutter

Removing crowns

Use a round diamond to remove the porcelain veneer from PBC’s. Use a transmetal bur to brush cut through the metal casting, use the largest bur for maximum strength. They can fracture in use although this has only ever happened twice in 6 years. Make sure you, the patient, your assistant all wear safety glasses.

A WAMKey  or equivalent can be used to lift off crowns safely as illustrated below.

WAMKey

Removing restorations does place an additional burden on patients but very often teeth are borderline restorable and beyond and it is in the patients best interest to determine this before root canal commences.

Removing plastic and cast restorations frequently reveals dental caries, the dentist can assess for fractures and provide for an effective seal between visits when the root canals have been prepared and dressed with non-setting calcium hydroxide.

 The WAMKey is inserted and rotated, the oval profile is used to lift off the crown

 The crown is lifted away

 Evidence of leakage

 Extensive caries, the tooth is unfortunately beyond  reasonable restoration