inforMED
InjuryEMA

RELY ULTIMATE ADHESIVE RESIN CEMENT

Received Oct 1, 2015

Report 9611385-2015-00035 · MDR key 5116972

Device

Generic name

Dental Cement

Catalog number

56890

Product problems

  • Appropriate Device Problem Term/Code Not Available

Patient

58 YR

  • No Code Available

Narrative

Additional Manufacturer Narrative

SINCE THIS EVENT INVOLVED THREE MEDICAL DEVICES, THREE MANUFACTURER REPORTS ARE BEING SUBMITTED. SECTION OF THIS REPORT DESCRIBES THE SECOND DEVICE. SECTION OF MANUFACTURER REPORT NUMBERS 3005174370-2015-00071 AND 9611385-2015-00036, DESCRIBE THE FIRST AND THIRD DEVICE, RESPECTIVELY.

Description of Event or Problem

ON (B)(6) 2015, A DENTIST REPORTED THAT A PATIENT REQUIRED A ROOT CANAL. THIS TOOTH HAD A CROWN MADE FROM 3M ESPE LAVA ULTIMATE CAD/CAM RESTORATIVE FOR CEREC WHICH WAS SEATED ON (B)(6) 2014, USING 3M ESPE RELYX ULTIMATE CEMENT AND 3M ESPE SCOTCHBOND UNIVERSAL ADHESIVE. DURING THE WEEK OF (B)(6) 2015, THE PATIENT PRESENTED WITH PAIN AND UPON REMOVAL OF THE CROWN, RECURRENT DECAY TOO EXTENSIVE TO ALLOW FOR RESTORATION WAS NOTED AND THE PATIENT WAS REFERRED FOR ENDODONTIC TREATMENT.