PhotoCast 1 — A Patient with Severe Pain in the Left Mandibular Region After a New Crown

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Clinical Analysis and Identifying the Source of the Pain

I tried to reproduce the pain.

Tooth 6 has furcation involvement, but probing it with the explorer did not exactly reproduce the pain.

Passing the explorer between the two splinted crowns did not reproduce the pain either.

Passing dental floss between teeth 4 and 5 reproduced the pain.

The problem and the source of the pain is the open contact.

Treatment Correction Options and Protocol

There are two ways to correct this: removing the two splinted crowns (accepting the possibility that tooth 6 may turn out to require extraction) and then prosthetic treatment with a correct contact.

The other option is adding composite to the distal of tooth 4; if space is insufficient, a small amount of porcelain could perhaps be removed from the mesial of the crown on tooth 5 to create space for the composite.

Precautions and Final Considerations

The only point of caution is that these crowns are not our own work, and any manipulation of them may have subsequent consequences.