Today’s patient came in to have new zirconium crowns placed on #8 and #9. Here is a summary of the patient’s previous relevant visits:
First visit – #6,7,8,9,10,11 prepped based upon lab models
Second visit – zirconium crowns placed for #6-11 with Nexus base clear. Patient requested darker shade – changed to A2.5 and canines to A3.0 with lab on same day
Third visit – patient feels #8,9 are too thick palatally. Pt informed that space at mesio-gingival margin can be closed
Fourth visit – crowns on #8,9 removed, slightly reprepped and new temp placed
The patient had signed a consent form before cementation, stating that the patient is happy with the try in and understands the consequences of changing their mind once the crowns have been cemented. However Dr. Dorfman was went out of his way to accommodate her and agreed to place new crowns on #8,9.
Today the new zirconium crowns for #8,9 were placed so the patient could see the new look. However she was still unhappy after the try in. She felt that it was still a bit thick palatally and also didn’t like the convergence of the teeth mesio gingivally. At another office, the crowns would have to be sent back to the lab and the patient recalled. However Dr. Dorfman called up his lab tech who showed up in minutes. He noted the changes the patient wanted and advised it would take a few hours.
The impression was taken with Impregum polyether impression material, using both light and heavy body. An anterior tray was filled with the polyether regular body and the light body was placed around crown preps. The lab technician said it was a good idea to blow air over the light body to prevent bubbles from forming. Once air had been blown all over the light body, another layer of light body was injected. Then the anterior tray was placed. The lab tech took his impression back to the lab to make the necessary adjustments.
The adjusted crowns had outstanding contours in the mesio-gingival area. The patient did still feel a slight thickness palatally so this was adjusted down. The crowns were then cemented on with Nexus Base Clear.
This experience really showed me the importance of always giving the highest standard of care, regardless of the circumstances. The patient clearly signed the waiver and knew once the crowns were cemented in, it would be difficult to make any changes. However, it’s clear from all my visits so far that Dr. Dorfman takes tremendous pride in the work he delivers to his patients. It is this reputation that he has build, which draws patients from all over the world to his office.
R.A., Columbia University School of Dental Medicine
Categorised in: Dental Student Experiences
This post was written by Interns