Message in a Bottle Mailbag: Cement for crowns that come off, plugging access holes (without cotton)

THE MESSAGE IN A BOTTLE MAILBAG is a monthly feature of the e-newsletter, Pearls for Your Practice: The Product Navigator. Each month, Editorial Director Joshua Austin, DDS, MAGD, answers reader-submitted questions to help you navigate your dental product decisions (and more!).

This month, he responds to a question about the cement he likes to use for crowns that have come off, shares what he uses to plug his implant and endo access holes (it's not cotton!), and discusses the talk he gave at Dentsply Sirona World.

Question

Jason from Mississippi asked: What is your go-to cement for a crown that has come off a couple of times?

Answer

Good question, Jason. I think we have all had frustrations with keeping crowns on short, nonretentive preparations. I used to choose C&B Metabond Quick (Parkell Inc.) for these situations. I love the product, but mixing it is complicated and time consuming. You need a frozen ceramic dappen dish. You have to work fast to get the restoration in place. We don’t use it often, which means we spend a lot of time reading directions and getting our materials together. While no one can argue with the results, I needed to find something a little simpler.

We still use C&B Metabond Quick for the tough situations, but for the more standard "crown that won’t stay on" scenarios, I found Panavia V5 (Kuraray America Inc.). I have used Panavia V5 for approximately 100 crowns so far and have not had a single one come off. Most of these involved shorter preps that weren't the most retentive, with minimal taper and maybe a groove or box. There has been some sensitivity but nothing awful. I think Panavia V5 is a simple option for these situations. Give it a try.

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Question

Glenn from Nebraska wrote: What do you use to plug your implant and endo access holes? There has to be something newer and better than a wad of cotton.

Answer

Indeed there is, Glenn! I use plumber's tape (or "Teflon tape") from Home Depot. It costs less than $2, and the roll lasts for months. I have read that bacteria can’t grow on it because they can’t adhere to it. I have never seen a study confirming that, but it makes sense. Old cotton pellets pulled out of implant access holes or endo teeth are often black and nasty. I have yet to experience that using the Teflon tape. It’s cheap and better than a cotton pellet. Great combination!

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Question

Ashley from California wrote: I saw your talk at the Dentsply Sirona World general session at the start of the meeting. You were amazing. What was that like? Were you nervous? What kind of response did you get?

Answer

Aw, thanks, Ashley! That is very nice of you. It was a surreal experience. I had never presented in front of 8,000 people before, and I will never get a chance to do so again. It was the biggest stage in all of dentistry. I rehearsed and practiced in preparation for it. That’s not something I usually do, but this was different. This was a 15-minute, TED-style talk. It needed to be succinct and tell a story. There wasn’t any space for ad-libbing. I rehearsed it so much that my fiancée was sick of hearing it as we approached the meeting. There was some personal strife heading into the meeting, but overall, it was a positive experience. The feedback was overwhelming. My breakout session that afternoon was packed with people—standing room only, people sitting in the aisles. I still can’t believe it happened. It didn’t change my life in any amazing way, but it was an experience I will never forget. Thank you for being a part of it.

Editor's note: Do you have a question for Dr. Austin? Is there a product you'd like to see him review? Or would you like to submit your own Pearl? Send an email to [email protected]. You might just see it in the e-newsletter, Pearls for Your Practice: The Product Navigator! If you're not a Product Navigator subscriber, click here to sign up.