The BAARD Institute
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01/22/2026
Happy when I can deliver for friends and family as well as colleagues and mentors…..
Patient presented with biting pain and sensitivity on UL 1st molar…. Visual exam confirmed cracked distal marginal ridge - pan on release with bite stick as well….. Meisal composite looked like it had better days….
Treatment plan overlay (gave a Veneerlay/ 3/4 crown as option to match veneers) - patient preferred tooth matched contralateral side…..
Prepped for overlay - vertical mesial-distal crack(s) noted - cracks were greatly reduced and/or removed
Immediate Dentin Sealing & Resin Coating with Clearfil SE Protect & Majesty Flow
E. Max D3 HT bonded with Warm Clearfil AP-X
Patients biting symptoms immediately resolved
Sorry I haven’t posted cases in a while - need to get back to it - been living on the story feed 😅 I have a back log I will work through
Part 2 of Overlays & Onlays vs Crowns: When are they indicated?
For classic indications we can look to the great Prosthodontist Schillingburg from his 3rd edition of “Fixed Prosthodontics” where he said that Crowns are indicated when there is a need for “Maximum Retention” and/or enough damage to where Metal Onlays or Overlays are insufficient to replace missing tooth structure….
In other words, in the Adhesive Age of Dentistry the only true indication is 360 degrees of damage to the tooth OR Adhesive Dentistry is not an option due to limitations with the Practice, Patient, and/or Operator (Dentist)…..
The Clinical Literature supports the favorable success of Ceramic Partial Coverage vs Full Coverage for in terms of Meta-Analyses:
Partial Coverage: Morimoto 2018: 95% Success at 5 years & 91% at 10 years
Full Coverage Crowns: Pjetursson 2007 – posterior all-ceramic crowns, ~84% survival at 5 years
Kassardjian 2016 – pooled 3–5 year data, posterior all-ceramic crowns, ~9.1% failure (and clearly increasing with time)
Main failure mode for Ceramic Crowns, Overlays, & Onlays - Fracture
Sailer et al., 2015 - Cumulative 5-year loss of retention:
Zirconia Crowns: 4.7%
Metal-ceramic Crowns: 0.6%
Leucite/Lithium disilicate glass ceramic Crowns: 1.0%
Videography:
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1496 N. Higley Rd.
Gilbert, AZ
85234
