Case presentations in dentistry, dental diagnosis, treatment planning

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The thousands of pictures on NYCdentist.com have been created for educational purposes
by Dr. Jeffrey Dorfman, Director of The Center for Special Dentistry.

Case presentations in dentistry, dental diagnosis, treatment planning
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Image	Photo Description
	When not to treat a patient. This woman was a very lovely, 30-something year-old who presented for what she believed would be a quick recementation of a single, upper lateral dental crown. Many crowns and root canals were recently completed by her local dentist near her home. She indicated that she had a good relationship with him. There were many reasons why I chose not to treat this patient and instead recommended that she go back to her current dentist for care. 1) It appeared that the crown is completely seated on the post and core instead of being seated on a minimum of two millimeters of sound tooth structure. 2) The post preparation was short and should have been nearly double its length for strength and retention. 3) The post was prefabricated and not cast; this will also decrease its strength and retention. I did not want to take out the loose crown and then find that I also had a loose post and core in my hand. Proper care might indicate a new, longer cast post and core, possible crown lengthening, and a new crown. Crown lengthening surgery could likely affect the crown margins on all the other new anterior crowns. Once you touch it, you own the problem. Both the dentist and patient need to agree in advance what could happen, and what might need to be done, if an "easy" repair turns out to be quite a big problem. This philosophy is both fair and appropriate for the patient and will save a lot of young dentists from having a major, unexpected problem. All things considered it was not worth getting started. The patient was appreciative of my assessment and was happy to return to her dentist for the repair.
Information about these dental photos In medicine and dentistry "left" and "right" are based upon the orientation of the patient's body and not how they appear in a photograph of a smile. For example, a reference to the upper left teeth will actually appear to be on the right side when viewing a picture of the face and similarly an upper right tooth will appear to be on the left side. Many words in dentistry like oral and mouth have a similar meaning and are frequently used together to help our readers find specific words they best understand. This is particularly important because a majority of our visitors are from countries where English is not their primary language. Maxilla or maxillary refer to the upper jaw. Mandible or mandibular refer to the lower jaw. There are many other similar word combinations used throughout this website because our pages are read by patients and dentists. A few of the most common are discussed here. Tooth decay, tooth cavity and dental caries all mean the same thing. Tooth, teeth and dental are also frequently interchanged as in teeth veneers or dental veneer laminate. Oral rehabilitation and dental reconstruction mean smile makeover. The word for x-ray may be used with or without a hyphen (this is true for other words too) and can also be called a radiograph.

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