Rich Rosenblatt I started to hum the song, "Should I Stay or Should I Go" when I was thinking about this blog topic. I blogged last week about being able to salvage a case on a patient who had a broken veneer and came in to my office to fix it. As I was writing the blog I had a patient call that I did a case on about 18 months ago. This is an elderly woman who had a tooth that had a very guarded prognosis. It was #7, it had large decay near the nerve and there was not much tooth structure left to bond to. There was a good amount of bone loss, but her daughter really wanted to save the tooth as long I could. I told them I'd try and do a build-up and crown and see what I could do. I did the case last year and all seemed well. I had seen her for a few recalls and it was holding up fine. They called last week and she broke it. When she came in, it appeared that there was a de-bond. The buildup I did was pristine. I decided that I'd find the old case on my CEREC machine and just mill it and see if the margins were ok. In about 10 minutes, I was able to take the crown out of the milling unit, try it in and have a perfect fit. I was so happy that I saved the case. It was a time-saver for me as well as for my patient. We were able to get her out of the office in less than 30 minutes, start to finish.
This story made me think about the question, "Should I have or should I throw?" Should I save all my old cases on my machine or should I delete them? I have to say that this kind of thing has not happened to me often. When bonding, you normally would not be able to just re-mill. There would likely be some re-prepping to get the old porcelain and resin cement off the tooth.
From time to time, as in this case, you will get an ideal case to re-mill. Another instance of when this has happened to me over the years is with implant cases. I have had about three in the eight-plus years I've been doing CEREC break. This was mainly because I was using conventional porcelain blocks over the metal abutment. There was no choice early on in my CEREC career. The great thing was, when these restorations failed and the patient called me to tell me their crown broke, I was able to mill and characterize a new one by the time they came into the office that day and it fit perfectly over the metal abutment.
I do not feel that my machine is slowed down any by keeping the files. After a few years, I have saved them to an external drive just in case, so if they are removed from my machine, I still have them. If you ask me if you should save all your cases, I say, "If you save you'll avoid trouble, and if you throw there will be double." Terrible Clash parody, I know, but save your cases. In my opinion the pros definitely outweigh any possible cons.
