Does 3D Tooth Sculpting Require More Tooth Reduction Than Traditional Methods?

Does the 33D dental carving treatment require more tooth structure to be removed during "molar" treatment compared to traditional methods?

Hello, Doctor.
I have a dental issue with a large molar in the back of my lower right jaw that has developed a cavity.
After undergoing root canal treatment and getting a crown, it has been 15 years, and now it has flared up again.
The pain in my tooth and cheek is so severe that I couldn't sleep for two or three days.
Upon visiting the dentist, I was diagnosed with an apical cyst.
The doctor suggested extracting the tooth, but I still hope to save it.
Thus began a year of treatment and waiting, during which the cyst shrank and the bone healed, which made me very happy! However, there are issues with getting the crown back on.
The doctor explained the steps: 1.
The outer part of the tooth needs to be ground down again, and 2.
The middle also needs to be ground down to place a post for added strength.
After hearing this, I felt disheartened! Everyone knows that a tooth that needs to be filled is ground down so many times; how much longer can it last? Because I hope not to have too much of the tooth ground away, I have temporarily given up on traditional treatment.
I would like to inquire about 3D dental sculpting treatment.
I know that 3D dental sculpting also requires grinding the tooth: 1.
Does the general 3D dental sculpting treatment require more tooth structure to be removed during the "grinding" process compared to traditional treatment? 2.
If the 3D dental sculpting filling is bonded to the tooth using an adhesive and the filling is successful, but after several years it unexpectedly becomes inflamed again and requires root canal treatment, how would you handle this situation? 1.
Is there another method to remove the crown that is bonded on top? 2.
Or is it only possible to forcibly remove the filling? Thank you, Doctor!

rhan, 20~29 year old female. Ask Date: 2014/11/05

Dr. Zeng Guanghui reply Dentistry

1.
3D dental sculpting treatment involves using an intraoral scanner connected to a computer for 3D imaging of the teeth that require crowns or fillings due to decay.
The necessary crown or filling is visualized as data, and then a milling machine is used to fabricate the restoration from a block of material.
This method is more precise than traditional impressions sent to a technician for casting and fabrication of crowns or restorations, while the milling process is similar to conventional treatments.
2.
3D dental sculpting for fillings utilizes acid etching and resin bonding agents to adhere the restoration to the tooth.
3.
If a filling becomes inflamed again after several years, the crown must be removed, and root canal treatment should be performed.
Once the symptoms have resolved, a new crown can be fabricated.

Reply Date: 2014/11/05

More Info

When considering whether 3D tooth sculpting requires more tooth reduction than traditional methods, it's essential to understand the differences in techniques and materials used in both approaches.
1. Tooth Reduction in 3D Tooth Sculpting vs. Traditional Methods:
3D tooth sculpting, also known as CAD/CAM (computer-aided design and computer-aided manufacturing) dentistry, utilizes advanced technology to create dental restorations. This method involves scanning the tooth and using software to design the restoration, which is then milled from a block of material. The precision of this technology often allows for a more conservative approach to tooth reduction. In many cases, the amount of tooth structure that needs to be removed can be less than that required for traditional methods, which often involve creating a mold and sending it to a lab for fabrication. However, the actual amount of tooth reduction can vary based on the specific case, the extent of decay, and the type of restoration being placed.
In your situation, where significant tooth structure has already been compromised due to decay and previous treatments, the dentist may still need to remove a considerable amount of tooth structure to ensure a proper fit and retention of the restoration, regardless of whether it's a traditional crown or a 3D sculpted one. Therefore, while 3D sculpting can be less invasive in many cases, it does not universally mean that it will always require less tooth reduction.

2. Handling Future Complications with 3D Sculpted Restorations:
If a 3D sculpted restoration becomes problematic years later, such as developing an infection requiring root canal treatment, the approach to managing the restoration will depend on several factors. Typically, if the restoration is bonded to the tooth using adhesive materials, the dentist will first assess the situation.
- Removing the Restoration: In many cases, dentists can carefully remove the bonded restoration without damaging the underlying tooth structure. This is done using specialized instruments designed to minimize trauma to the tooth. The dentist will take care to preserve as much healthy tooth structure as possible during this process.

- Direct Removal: If the restoration is severely compromised or if there is significant decay underneath, it may be necessary to remove the restoration more aggressively. This could involve drilling or cutting away the restoration, which may result in additional loss of tooth structure.
After the restoration is removed, if root canal treatment is required, the dentist will perform that procedure to address the infection. Once the tooth is treated and the infection is resolved, a new restoration can be placed, whether it be a new crown or another type of restoration.

In conclusion, while 3D tooth sculpting can offer advantages in terms of precision and potentially less tooth reduction, the specific circumstances of each case will ultimately dictate the amount of tooth structure that needs to be removed. Additionally, if complications arise with a 3D sculpted restoration, there are methods available to address these issues while aiming to preserve as much of the natural tooth as possible. It's crucial to maintain open communication with your dentist about your concerns and treatment options to ensure the best possible outcome for your dental health.

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