Triple-cure glass ionomer

[Robert Tucker]

I have a cusp broken on my UR6 (16 – ISO, 3 – universal notation). I have had a number of standard GICs placed, probably in the region of about 10, and they've all broken after a couple of weeks or a few months. The tooth is broken sub-gingivally and my dentist doesn't think he can get a composite filling on it because he doesn't think he can keep the tooth dry enough.

I've asked about trying a resin-reinforced GIC, GC Fuji II LC looks to me about the best, but he doesn't stock it or any other resin-reinforced GIC and doesn't want to buy one just for me, of course.

What should I go for? Should I look around for a dentist who does have resin-reinforced GICs? Should I expect the dental profession to say that a prosthetic crown is the only way to treat the tooth now? The owner of the practice I go to has even suggested the tooth might easily warrant extraction.

The tooth is root-filled and already has substantial composite repair.

Sorry about the grunge in the photo – I only went to the hygienist about a month and a half ago.

 

[MattKW]

A resin GIC won't make any difference. I'd suggest you place 2 (or even 3) posts in the RCT, and rebuild in amalgam. Also shorten the buccal cusps by ~1mm. The filling doesn't have to be back to full size with cusps, but it can work satisfactorily. Nothing really goes well under the gum, but amalgam isn't as fussy as composite or GIC. The long term chances for this tooth are poor, and a crown won't make it better. I've got a number of patients with half teeth still functioning after 10 years.

 

[Robert Tucker]

Oh, I had an all porcelain crown fitted last November/December.

 

[MattKW]

Woah! Sorry about that. I hadn't looked at date of your thread. Best wishes.