Oops I Did it Again! Insufficient Reduction

It’s regrettable to me that after preparing and impressing a tooth for a crown, the laboratory will notify me that the tooth had insufficient reduction. How can that still be happening? My first (fleeting) thought is that the technician has it all wrong. I mean, I made the provisional and it looked fine when I cemented it. We are myopic when we evaluate our preps and often, we might be feeling rushed, hungry and tired – or just know enough is enough. And that step somehow gets overlooked. That being said, the laboratory won’t go forward with the restoration without guidance with how you want them to handle it.

Fabricating Reduction Copings with Ease

Thank goodness DuraLay or GC Pattern resin can be used very accurately to fabricate reduction copings. This is indeed one of the best time savers in dentistry because I suspect we all know the hassle for you and the patient of re-prepping and impressing. It is generally not A LOT more reduction ... maybe an edge, a corner or a slightly deeper occlusal prep refinement; most often doesn’t require the administration of anesthesia to make the adjustment. The reduction coping is slipped over the crown and should be snug fitting. The tooth is reduced to the plane of the adjacent edges of the pattern resin; I will use a slow speed green stone or a football-shaped diamond and this step is accomplished in five seconds.

The only circumstance that I won’t use a reduction coping is when I am doing a veneer seat. The veneer is too thin and fragile to risk seating it on a re-prepped tooth. I don’t like to admit that I do have to occasionally resort to this successful technique, but I am really grateful that it exists and that my lab technicians are helpful and supportive in this way. It’s a great alternative – quick, easy, predictable and one to keep in your bag of tricks ... I mean armamentarium!

Mary Anne Salcetti, DDS, Spear Visiting Faculty and Contributing Author. [www.maryannesalcettidds.com]