Re: Pain days after CEREC restorations

From: Dr. Steve (drsteve_at_I.give.up.on.the.spam.com)
Date: 06/27/04 

Date: Sun, 27 Jun 2004 13:30:43 GMT

No way to tell from where I sit. So, this is not even close to a diagnosis.
Only a guess. The steroid may simply make the inflammation in the bone
better, as there would be no blood flow inside the tooth if the tooth was
dead. This could make the area feel better. Your dentist should test the
tooth for vitality and act appropriately. In my office, if a patient gets
RCT on a recent CEREC, they get a pre-formed porcelain inlay (Cerana)
cemented into the access opening for free, or a new CEREC altogether. 

-- 
`~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
Stephen Mancuso, D.D.S.
Troy, Michigan   USA
=+=+=+=+=+=+=+=+=+=+=+=+=
.
"jstolzen" <jsmail63-js01@yahoo.com> wrote in message
news:afe439ad.0406251119.664e4dff@posting.google.com...
> Dr. Steve - a quick update on the case..
>
> My DDS prsecribed oral steroids (Methylprednisolone, 4 mg over 21
> tablets) on 6/23 to reduce the inflammation.  I've been on them for 3
> days now, and the pain has been reduced greatly.  (At about 7:30 am on
> 6/24, I had almost no pain at all - even though the last pain med I
> took was 600 mg of OTC Advil the night of 6/23 at about 10:30 PM).
> The evening (9 PM'ish) of 6/24 I had "some" minor pain - but nothing
> like I had days back.  Today I know it's there, but it's definitely
> not throbbing like it was.
>
> The 6/23 steroid dose was 6 pills.  6/24 was 5 spread out over the
> course of the day.  6/25 is 4, and so on.
>
> I'm wondering if the relative "pain free" night of 6/23 and AM of 6/24
> was due to the larger dose of steroid, and if the pain is going to
> return as I whittle down to the lower doses at the end of the steroid
> program.  Is it logical to assume that the Methylprednisonlone has
> gotten the inflamation under control, and that it "shouldn't" come
> back if the source of irritation (deep CEREC restoration a week ago
> and possible occlusion due to bad bite) is no longer affecting it?
>
> I'm still taking 600 mg of Ibuprofen 4x/day to help reduce
> inflammation, and haven't taken a break from this all week.
>
> I realize you can't tell much without a physical diagnosis, but does
> it sound like we've "caught the problem in time" and the Pulpitis (I
> assume that's what it is?) is going down?  Will it possibly/likely get
> worse as the oral steroid treatment winds down?  Also - how would
> someone know if I needed RCT without opening the teeth back up?
> (There's some pretty expensive CEREC restorations on them and I'd hate
> to see an Endo have to cut through these to try to find which one of
> the teeth [if any] actually did need RCT).  [Percussion tests don't
> seem to reveal much - if anything - as to which of them may still be
> hurting at all).
>
> Thanks again for your help!
>
> Jim
>
> "Dr Steve" <nospam@home.net> wrote in message
news:<HdICc.28129$eH1.13266645@newssvr28.news.prodigy.com>...
> > Oh, BTW, the porcelain does not have the same characteristics as stacked
> > porcelain.
> >
> > -- 
> > ~+--~+--~+--~+--~+--
> > Stephen Mancuso, D.D.S.
> > Troy, Michigan, USA
> > ....................................................
> >
> > This posting is intended for informational or conversational purposes
only.
> > Always seek the opinion of a licensed dental professional before acting
on
> > the advice or opinion expressed here.  Only a dentist who has examined
you
> > in person can diagnose your problems and make decisions which will
affect
> > your health.
> > ......................
> > "Etukee" <etukee@aol.com> wrote in message
> > news:20040624104208.16860.00000314@mb-m20.aol.com...
> > > Doc, it is my understanding that the materials used in cerec
restorations
> >  are
> > > the same as other restorations (*lab process) that they are bonded
> > > conventionally as are the lab processed restoration and require the
same
> >  type
> > > of tooth reduction. To what would you attribute the lack of
sensitivity?
> > > elizzy

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