Embracing challenges help us to grow.  Today, it was 90 degrees and the sun was brutal at 1:00 pm. I was scheduled to run.  It was not going to be fun or pleasant unless I turned it into a game or challenge.  I told myself that not only would I train, but it would be easy and I would far exceed my goal for the day.  And because of that mindset, I did.

Challenging treatment is similar and gives us an opportunity to grow as a clinician and provide our patient with an opportunity for better options.

Below is a case that shows the benefit of a core buildup during routine restorative dentistry.  Many would have discarded this tooth in favor of an implant or no tooth replacement.  However, by placing a core buildup and provisional restoration, this tooth was given the opportunity to have perio/restorative treatment and save the tooth.  In fact, saving this tooth help avoid a sinus graft and implants.  Not that those options are undesirable,  just that this elder gentleman was not of the mindset to go through implants. 12 years later, he still has the tooth.

Placing a core buildup and temporizing allows the final definitive restorative margin to be established prior to biologic width correction and therefore serves as the biological guide for the periodontist to create the architecture to have a healthy biologic width without removing excessive bone.

Fig 1.

This is initial caries removal.  The resulting prep sits near the bone. 

Fig 2.

The core buildup was placed to give the apical extent of the caries and future restorative margin. 

Fig 3.

During surgery, the benefit of the core as the biologic template.  The core sets the tone for the extent of osseous involvement. 

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