Wednesday, December 8, 2010

A hole

Today, I did my biggest restoration (filling/simen gigi/tampalan gigi) so far. It's as the picture above - blue colour represents the filling and light yellow colour represents the tooth structure left. That's what I got since my patient's previous dentist gave her temporary restoration and the cavity was readily huge. The floor of the cavity even extended beyond gingival margin (the axial wall was so near to the pulp it's already red in colour)! I had to give local anaesthesia to her. I have to admit that I panicked. I dropped a tweezer and a whole syringe (along with it's empty cartridge and A NEEDLE STILL ATTACHED TO IT!!!). Ash jenkers aren't reliable after all. This was my first time of doing a restoration twice! The amalgam (the metal-ish thing used as a filling material) just couldn't be condensed to form the distal slope of its buccal cusp and since Assoc. Prof. Dr. Sam'an Malik Masudi (endodontist) suspected the temporary filling was zinc oxide eugenol (ZOE), I had to restore the cavity using amalgam. If it's composite resin, it'd be way easier and I wouldn't have to remove the sound tooth structure occlusally. I wonder who temporarily filled it with ZOE... Well, anyway, considering composite resin, unless I pack it layer by layer, the restoration will suffer from major microleakage. I'm glad that the restoration was hm... looked pretty :P Poor prognosis, son. Nonetheless, yet another valuable experience gained today. Towards using tooth-coloured restorations!

Come to think of it... although we have gone through only a few conservative dentistry sessions (due to hols and hols and hols :P), I've been getting a lot of somewhat tough cases for a beginner. Yes, the theory is there, but practical-wise... that's just an almost different story by itself. They weren't easy, frankly, but I'm grateful to be able to experience them early :) Alhamdulillah.

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