Expert: Mark Bornfeld DDS - 8/2/2006

Question
I have two crowns seated with temporary cement. I was having sensitivity and thought that if temporary cement was used the crowns could be easily removed. Everything seems fine but I'd like my dentist to reseat the crowns with permanent cement. She has used the jujube method with no success. Should I just leave them on with temporary cement and not worry about it? Are there issues with leaving crowns on long-term with temporary cement?

Answer
Dear Leslie Albrecht,

Ideally, your dentist should remove the crowns and re-cement them with a permanent luting cement. Temporary cement is not as resistant as permanent cement to breakage from chewing forces, and it is more susceptible to dissolution from saliva as well. Breakdown of the temporary cement seal may permit the leakage of decay-causing bacteria under the crown, creating an unsanitary condition.

Offsetting the factors that argue for the removal of the temporarily cemented crowns is the potential for damage to either the crowns or the teeth from more aggressive attempts at crown removal. It is true that the crowns may be removed safely by cutting them off with a drill, but that technique will unavoidably require that the crowns be re-fabricated. As an alternative, it may make more sense to wait a week or two for weakening of the cement bond and having your dentist try to remove the crowns again. I'd be lying if I said I haven't occasionally run into this problem, and I have used this strategy to good effect.

Just a suggestion to your dentist: I have come to regard the Richwill Crown Remover (the "jujube method") as unreliable, and have had much more consistent success with one of the new pneumatic crown removers made by manufacturers such as Practicon or Dent Corp. I don't usually make third-person suggestions to other dentists, but this device has made my life much simpler, and might be of use in your case.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY