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3) what material?
options
MODBL composite
full coverage bonded crown (no need for core because the
crown is bonded) (Emax)
core buildup (to regain walls that are lost) and conventional
cemented crown (FCZ, Gold or PFM)
Material
Treatment Concerns
MODBL composite (difficult to place and at best considered a temporary patch and patient said he
wanted the best)
MODBL Onlay saving the MB and DL cusp (Good option and was debating this but the remaining
cusps looked a little fragile so I thought it best to cover them, he has a history of fracturing cusps off
and the DB cusp already looks like it is about to go.
Bonded Crownlay with margin at height of contour on B and L (Emax) (My choice)
full coverage bonded crown (no need for core because the crown is bonded) (Emax) ( another good
option but the facial and lingual had a lot of tooth structure that was healthy so may be a little too
aggressive. Increase chance of endo when margins are placed near the tissue and need 1mm margin
at the tissue level causes about 70% more reduction in tooth structure compared to a crownlay. Less
enamel preserved to bond to. Takes longer to prep. harder to clean margins at the tissue.
core buildup (to regain walls that are lost) and conventional cemented crown (FCZ, Gold or PFM)
Standard old school option, if you do a core you have to get a margin 2mm apical to the core. this will
cause the margin to be very sub gingival on the mesial and distal and can be a violation of biological
width (we will talk about this later) have to hide margins at or below the tissue on the facial, can cause
a difficult final impression and a less accurate crown.