inforMED
InjuryEMA

RELYX ULTIMATE ADHESIVE RESIN CEMENT

Received Sep 25, 2015

Report 9611385-2015-00031 · MDR key 5104647

Device

Generic name

Dental Cement

Catalog number

56890

Product problems

  • Appropriate Device Problem Term/Code Not Available

Patient

60 YR

  • No Code Available

Narrative

Additional Manufacturer Narrative

SINCE THIS EVENT INVOLVED THREE MEDICAL DEVICES, THREE MANUFACTURER REPORTS ARE BEING SUBMITTED. THIS REPORT DESCRIBES THE SECOND DEVICE. MANUFACTURER REPORT NUMBERS 3005174370-2015-00069 AND 9611385-2015-00032, DESCRIBE THE FIRST AND THIRD DEVICE, RESPECTIVELY.

Description of Event or Problem

ON (B)(6) 2015, A DENTIST REPORTED THAT A (B)(6) FEMALE PATIENT REQUIRES ENDODONTIC TREATMENT OF TOOTH #4. THIS TOOTH HAD A CROWN MADE FROM 3M ESPE LAVA ULTIMATE CAD/CAM RESTORATIVE FOR CEREC, WHICH WAS SEATED WITH 3M ESPE RELYX ULTIMATE CEMENT AND 3M ESPE SCOTCHBOND UNIVERSAL ADHESIVE ON (B)(6) 2013. THE CROWN DEBONDED ON (B)(6) 2015, AND THE PATIENT REPORTED TEMPERATURE AND PRESSURE SENSITIVITY. THE PATIENT IS SCHEDULED FOR ENDODONTIC TREATMENT ON (B)(6) 2015.