Immediately As Comfortable As Your Own Tooth

It is my belief that new crowns should immediately be as comfortable as if they were the patient’s own teeth. Creating a method of consistently achieving this result has been my personal goal for years.

In a recent case, a lab-fabricated crown #15 was tried in the mouth, and it appeared to fit well after checking the margins and proximal contact intensity. Still, to confirm how well the crown felt to the patient, Mike, I asked him to let his jaws close without biting and tell me how he felt. “The crown feels high.” Mike answered.

Instead of adjusting the occlusion, I adjusted the mesial proximal contact with the ContacEZ Black Diamond Strip to allow the crown to sit more closely onto the abutment tooth (Fig. 1). After several passes with the Black Strip, Mike said he “felt much more comfortable” and did not feel any pressure on the crown. A bitewing x-ray confirmed the crown margin fit perfectly (Fig. 2).

After the patient had seen his new crown in place and approved of the shade, it was cemented. Excess cement was removed, and the White Serrated Strip was used to remove stubborn cement debris trapped in the interproximal space (Fig. 3).

When the occlusion was checked, I found that only minimal occlusal adjustment was necessary because the crown was seated completely. Also, performing occlusal adjustment after cementation prevented over-adjustment.

Finally, using the Gray Final Polishing Strip, the contact surface was polished to a natural finish, and Interproximal Relief was confirmed (Fig. 4).

Mike said “My crown is so comfortable; I don’t feel anything.”

  Fig. 1  Using the Black Diamond Strip, the mesial proximal contact is adjusted, and the crown sinks down to rest on the abutment. Because the periodontal membrane on a normal tooth allows for 0.10 mm of lateral movement and the Black Diamond Strip is only 0.07 mm ± 0.02 mm in thickness, the Strip is able to adjust and create perfect proximal contacts.

Fig. 1 Using the Black Diamond Strip, the mesial proximal contact is adjusted, and the crown sinks down to rest on the abutment. Because the periodontal membrane on a normal tooth allows for 0.10 mm of lateral movement and the Black Diamond Strip is only 0.07 mm ± 0.02 mm in thickness, the Strip is able to adjust and create perfect proximal contacts.

  Fig. 2  X-Ray shows the margins seated completely before cementation.

Fig. 2 X-Ray shows the margins seated completely before cementation.

  Fig. 3  Cement debris trapped in the interproximal space is removed completely using the White Serrated Strip.

Fig. 3 Cement debris trapped in the interproximal space is removed completely using the White Serrated Strip.

  Fig. 4  The proximal surface is polished to a natural finish with the Gray Final Polishing Strip, and Interproximal Relief is confirmed.

Fig. 4 The proximal surface is polished to a natural finish with the Gray Final Polishing Strip, and Interproximal Relief is confirmed.