Looking for computerized occlusal analysis in Limerick

ufo11

Hi All,

Background:
I had root canalled a molar tooth (LL7) about 15 years ago. Since a big portion of the tooth was replaced by amalgam I finally decided to get it crowned as a pre-emptive measure. Apart from a small gum pocket which was not progressing I had no other issues with this tooth. About a month ago I got an alloy cast post & core and a PFM crown for this tooth.

current issue:
The crown was initially too high and my dentist filed some amalgam from the opposing tooth to adjust the bite. I was not completely satisfied with it but she said I need to give it some time to get used to. This tooth does not feel too high any more but my bite on the left side still feels not right and I feel too much pressure on my third molars now. I want to see a dentist for bit adjustment but would much rather to go to a dentist who has one of these T-scan devices (tekscan.com/occlusal-analysis-system) as the old carbon paper method is not working for me.

Questions:
1. Can I find a dentist in Limerick who has access to one of these T-scans?
2. The crowned tooth (or its surrounding gum) has become sensitive to hot/cold and pressure, and the food clogging in its surrounding gum pocket has become worse, so I wonder if I did the right thing by crowning it in the first place. The reason I ask is because I have another molar which is root canalled and I was thinking to crown it as well but not I am not sure about that.
3. what is the most suitable type of crowns and cast post & core for molar teeth(e.g. alloy/gold/zirconia PFM)

Thanks

Oral Surgeon

ufo11 wrote: »

Hi All,

Background:
I had root canalled a molar tooth (LL7) about 15 years ago. Since a big portion of the tooth was replaced by amalgam I finally decided to get it crowned as a pre-emptive measure. Apart from a small gum pocket which was not progressing I had no other issues with this tooth. About a month ago I got an alloy cast post & core and a PFM crown for this tooth.

current issue:
The crown was initially too high and my dentist filed some amalgam from the opposing tooth to adjust the bite. I was not completely satisfied with it but she said I need to give it some time to get used to. This tooth does not feel too high any more but my bite on the left side still feels not right and I feel too much pressure on my third molars now. I want to see a dentist for bit adjustment but would much rather to go to a dentist who has one of these T-scan devices (tekscan.com/occlusal-analysis-system) as the old carbon paper method is not working for me.

Questions:
1. Can I find a dentist in Limerick who has access to one of these T-scans?
2. The crowned tooth (or its surrounding gum) has become sensitive to hot/cold and pressure, and the food clogging in its surrounding gum pocket has become worse, so I wonder if I did the right thing by crowning it in the first place. The reason I ask is because I have another molar which is root canalled and I was thinking to crown it as well but not I am not sure about that.
3. what is the most suitable type of crowns and cast post & core for molar teeth(e.g. alloy/gold/zirconia PFM)

Thanks

pm sent

btkm8unsl0w5r4

A T scan will really show nothing, its more of a tool to dazzle than to actually do anything useful. I used one a fair bit at one point and it added nothing to my practice. Sounds like there is still a bit of interference which is easily tested and often easy to adjust. The food packing is not so easily fixed without replacing the crown or removing the wisdom tooth.

The best post and core is no post and core, if you have to have one then it really doesn't matter what its made of the only thing that matters is that is fits well and that there is sufficient remaining tooth structure.

Best thing for the crown to be made of varies. Full Gold is really ideal except for its colour. Metal ceramic is a compromise but generally the best choice, Zirconia is not good IMHO (poor aesthetics, de-lamination issues, hard to retreat, need a lot of preparation), all ceramic can work in some cases also.

SO the general rule is that as a patient you should try not to get caught up in technical issues, or the use of gadgets, or the use of technical terms,

Modern technology can be a great slave to a poor master. Find a good dentist who you can trust to make all these decisions and will apply technology and materials properly. I have seen great results using only basic tools, I have seen rubbish results using the "latest technology" its the person moving the drill or moving the mouse that matters.

ufo11

Layla Unkempt Ratchet wrote: »

A T scan will really show nothing, its more of a tool to dazzle than to actually do anything useful. I used one a fair bit at one point and it added nothing to my practice. Sounds like there is still a bit of interference which is easily tested and often easy to adjust. The food packing is not so easily fixed without replacing the crown or removing the wisdom tooth.

The best post and core is no post and core, if you have to have one then it really doesn't matter what its made of the only thing that matters is that is fits well and that there is sufficient remaining tooth structure.

Best thing for the crown to be made of varies. Full Gold is really ideal except for its colour. Metal ceramic is a compromise but generally the best choice, Zirconia is not good IMHO (poor aesthetics, de-lamination issues, hard to retreat, need a lot of preparation), all ceramic can work in some cases also.

SO the general rule is that as a patient you should try not to get caught up in technical issues, or the use of gadgets, or the use of technical terms,

Modern technology can be a great slave to a poor master. Find a good dentist who you can trust to make all these decisions and will apply technology and materials properly. I have seen great results using only basic tools, I have seen rubbish results using the "latest technology" its the person moving the drill or moving the mouse that matters.

@Layla Unkempt Ratchet - thank you very much for sharing your insight.

I had made a mistake in my first post, the crown is fitted to LL6 not LL7.

Re the T-scan, I was quite impressed by the online presentation on their website, as it seems to indicate the contact points on each individual tooth and estimate the exerted force. Also, my thinking was that adjusting the height of an individual tooth could also affect the dynamics of the others (as it seems to be the case for me), and therefore getting an overall view of contact points and forces using this device could help more effective adjustment. @Oral_Surgeon has given me the contacts for a prosthodontist in Limerick which I am going to see this week.

Re the food packing issue, I was hoping that fitting a crown reduces it and not make it worse. I think, I would give it another few months before considering crown replacement, as I suppose there is no guarantee that the next crown would solve the problem either.

Re post & core, I have been told that I need one for UR5. I did a bit a research online, and apparently the literature suggest that gold and fibre-reinforced composite post & core could be superior due to their bio-compatibility and lower fracture/failure rate (e.g. see dentalnews.com.br/downloads/artigos-cientificos/pinos-RTD/Ferrari_%20Clinical%20evaluation%20of%20fiber-reinforced%20epoxy%20resin.pdf)

I appreciate your point re not getting caught up with technical terms, issues, and gadgets, but my personal experience suggest that as a patient I would be better off informing myself as much as possible and adopting a "trust, but verify" approach. Having said that, I do realize that reading a few articles on PubMed would not give me a thorough/objective understanding of all the parameters involved.

" its the person moving the drill or moving the mouse that matters." I fully agree!

Thanks