Dr. P. asks:
I have had some problems with porcelain fracture on my implant crowns and bridges. I try to tap off the crown or bridge with a Morrel Crown Remover with gentle tapping. I have heard about using an ultrasonic unit like a Cavitron [Denstlpy] to vibrate the crown or bridge and break the cement seal. I have been using ImProv [Salvin] for cementation and this has worked well. Very retentive and easy to clean up. Most of the time I end up cutting off the crown or bridge and remaking it. What is everybody else doing out there?
Problems with Procelain Fractures on Implant Crowns and Bridges: Use Ultrasonic Unit?
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I rarely, if ever, cement implant crowns with a hard cement. I prefer a temporary cement like TempBond NE or a medium cement like Temrex so that if I have a problem, I can easily remove the crowns. If you have a good lab, the retention on custom and stock abutments should be good to begin with so a temporary cement is not a problem.
Although I am not familiar with ImProv cement, if I have to get a crown off, a trick I like is to have the patient rinse for 20-25 minutes with very hot water. It causes the crown to expand slightly and the cement seal breaks. It is then easier to tap off the crown or bridge. Hope that helps.
Hi Dr. Stall, l found your hot water trick quite interesting. Does it work for temporary cement only or can it be used for permanent cements like Harvard?
I believe the Morell remover is the sliding hammer style of remover.
I have had success with the Richwill crown remover which is a thermoplastic “jujube” and the pneumatic crown and bridge remover.
The Richwill remover needs the right opposing dentition.
You may want to give these a try.
You can also place “hot” moist impression compound around the crown itself. I usually place it remove and rewarm several times to allow for expansion prior to “tapping the crown off.
This hot water trick cannot be true
If crowns were expanding to the degree sufficient to alter cement fixation: 1.cements wouldn’t hold long 2.porcelain would crack in 100% of cases.