Dr. U. asks:
I have taken many courses on all-ceramic restorations. Generally the preparations are done on nearly virgin teeth with minimal caries. All the finish lines are supragingival. Cementation of the all-ceramic restoration is accomplished easily because the course instructor does not have to deal with saliva or blood. But in the real world, my margins generally end up subgingivally and I have to contend with tissue retraction, saliva and blood. How do you achieve adequate isolation so you will not get contamination of the resin cement at the gingival margins? I have found this to be a very difficult problem. Any thoughts?
All Ceramic Restorations: Preventing Contamination of the Resin Cement at the Gingival Margins?
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1. Rubberdam or Isolite for saliva
2. Cord (doublr technique) for blad
3. Crown lengthening prior to crown placement
4. Switch to all-ceramic cementable crown(zirconia, Procera etc.)less sensitive to moisture contamination