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After the old filling was removed the decay underneath became evident.(dark brown stain)
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Once the nerve was removed evidence of a fracture was noted and the patient was advised to extract and remove the tooth. Patient was extremely apprehensive and was adamant to save the tooth and would not want removal at all. Prognosis was deemed to be guarded at best.
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The nerve was removed and nerve chamber was filled by root canal treatment.(depicted in fig.4)
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Given the fact that there was a fracture without bleeding silver filling was used to build the inside of the tooth. The radiograph will show all areas of treatment as very light.
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Below you will see the visible silver area prepared for a crown to cover and provide stability.
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7) Lab fabricated gold crown |
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The reason for gold in this instance was obviously functionality rather than looks. Considering the patient was aware of the fact that next failure would constitute the loss of the tooth, he chose gold due to it being one of the longer lasting dental materials. It has been 5 years so far without any sign of discomfort or failure. This case was a DECISION BY THE PATIENT approach.
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