Reducing Crown Remakes: Common Causes and a Shared Checklist

Every remake costs the practice chair time and costs the patient another appointment. Most of them trace back to a handful of causes, and most of those can be caught before the case ever reaches our bench. Here is what we see, and what helps on both sides.

The most common causes

When we look back at the cases that return, they tend to fall into a few groups.

• Margins. An unclear or incomplete margin on the scan or impression is the single most common issue. If we cannot see it, we have to interpret it.
• Shade. A shade that matched under the operatory light can look different in daylight, and a dark stump can change how a translucent material reads.
• Fit. Distortion in an impression, a pulled or torn margin, or a model that was poured late can all show up as a crown that rocks or will not seat.
• Occlusion. A bite registration that does not reflect how the patient closes leads to a crown that is high or out of contact.
• Communication gaps. A missing tooth number, an unclear material choice or no note about a special request can send a case in the wrong direction.

None of these are unusual. They happen in every practice and every lab. The goal is to make them rarer.

A shared checklist

We find it helps when the practice and the lab work from the same short list.

Before the case leaves your office

1. Margins are visible all the way around, with adequate retraction.
2. The opposing arch and bite registration are captured and match.
3. The tooth number, material and shade are on the prescription form.
4. The stump shade is noted, especially for e.max or anterior work.
5. Photos with a shade tab are attached for anything in the smile line.
6. Special requests are written down, not assumed.

When the case arrives at the lab

1. We confirm the prescription matches what we received.
2. We check margins and the bite before we design.
3. If something is unclear, we call you before we start, not after.
4. Every case is personally inspected before it leaves the lab.

If you send digital scans, our guide to sending digital scans to a dental lab covers the details that matter most.

When shade is the concern

Shade remakes are among the most frustrating because the crown can fit well and still be wrong for the patient. For high-esthetic anterior cases, a custom shading consultation with Ron Salvatore, either at our Revere lab or in your office, is often the most reliable way to avoid a second try.

How to report an issue

If a case does not seat, does not match, or does not meet your expectations, tell us as soon as you can. The more we know, the faster we can resolve it.

Please include:

• The case number and patient name or ID
• A short description of what you are seeing
• Photos, intraoral if possible, showing the issue
• The models or a new scan if the fit or bite is in question

Please let us know within 10 business days of delivery, as outlined in our refund policy. That window lets us review the case while the details are still fresh on both sides.

We review every report ourselves. Often a short phone call clears up the cause, and it helps us prevent the same issue on the next case.

Working together on the next case

Remakes are rarely one side's fault. They usually come from a small gap that neither side noticed. A consistent checklist, clear notes and a quick call when something looks off will prevent most of them.

If you would like to talk through a case or a recurring issue, call us at 781.853.0777 or submit a case online.