inforMED
InjuryEMA

RELYX ULTIMATE ADHESIVE RESIN CEMENT

Received Nov 5, 2015 · Event occurred Sep 16, 2014

Report 9611385-2015-00073 · MDR key 5206264

Device

Generic name

Dental Cement

Catalog number

56890

Product problems

  • Appropriate Device Problem Term/Code Not Available

Patient

42 YR

  • No Code Available

Narrative

Additional Manufacturer Narrative

THE OTHER 13 PATIENT-SPECIFIC EVENTS PROVIDED BY THIS OFFICE ARE BEING REPORTED SEPARATELY. SINCE THIS EVENT INVOLVED THREE MEDICAL DEVICES, THREE MANUFACTURER REPORTS ARE BEING SUBMITTED. SECTION OF MANUFACTURER REPORT NUMBERS 3005174370-2015-00102 AND 9611385-2015-00074, DESCRIBE THE FIRST AND THIRD DEVICE, RESPECTIVELY.

Description of Event or Problem

ON (B)(6)2015, A REPRESENTATIVE FROM THE DENTAL OFFICE PROVIDED PATIENT-SPECIFIC INFORMATION; INITIALLY, THIS OFFICE INDICATED "A COUPLE" OF PATIENTS REQUIRED ROOT CANAL TREATMENT. IN TOTAL, THE OFFICE HAS NOW PROVIDED INFORMATION ON 15 ROOT CANALS INVOLVING 14 PATIENTS. THIS REPORT DETAILS A (B)(6) MALE PATIENT WHO RECEIVED A CROWN MADE FROM 3M ESPE LAVA ULTIMATE CAD/CAM RESTORATIVE FOR CEREC ON TOOTH #15 ON (B)(6) 2014. THIS CROWN WAS SECURED WITH 3M ESPE RELYX ULTIMATE ADHESIVE RESIN CEMENT AND 3M ESPE SCOTCHBOND UNIVERSAL ADHESIVE. ON (B)(6) 2014, THE PATIENT REPORTED TEMPERATURE SENSITIVITY AND PAIN; HE WAS REFERRED FOR ENDODONTIC TREATMENT AT THAT TIME. THE ENDODONTIC PROCEDURE WAS PERFORMED ON (B)(6) 2014. THE PATIENT'S STATUS IS CURRENTLY REPORTED AS FINE.