I would like to thank Dr. George Vasilakis for his comments. Regarding placing copings on overdenture teeth, they can reduce recurrent caries. In the case that was presented here, however, it would have been difficult to do copings.
The decay removed on tooth no. 31 was subgingival and in a distal lingual location. The preparation was satisfactory for an alloy, but would have required crown lengthening if any cast restoration were to be placed. The distal lingual location would have been extremely challenging for a crown lengthening procedure to be performed successfully.
With the patient’s health concerns and financial constraints, given the additional costs of the cast coping and surgery, the placement of a coping was not considered as an alternative treatment. The beneficial use of fluoride was explained to and used by the patient in this overdenture situation to help reduce the risk of caries.
I can appreciate Dr. Vasilakis’ response to the Universal/National tooth numbering system used in the United States. The numbering can be confusing for international readers. The American Dental Association may need to be the one leading any recommended changes in this area.
