RELYX ULTIMATE ADHESIVE RESIN CEMENT
Received Nov 5, 2015 · Event occurred Feb 26, 2015
Report 9611385-2015-00081 · MDR key 5206308
Device
Product problems
- Appropriate Device Problem Term/Code Not Available
Patient
56 YR
- No Code Available
Narrative
Additional Manufacturer Narrative
THE OTHER 13 PATIENT-SPECIFIC EVENTS PROVIDED BY THIS OFFICE ARE BEING REPORTED SEPARATELY. THIS EVENT INVOLVED THREE MEDICAL DEVICES, THREE MANUFACTURER REPORTS ARE BEING SUBMITTED. THIS REPORT DESCRIBES THE SECOND DEVICE. MANUFACTURER REPORT NUMBERS 3005174370-2015-00106 AND 9611385-2015-00082, 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) FEMALE PATIENT WHO RECEIVED A CROWN MADE FROM 3M ESPE LAVA ULTIMATE CAD/CAM RESTORATIVE FOR CEREC ON TOOTH #30 ON (B)(6) 2015. THIS CROWN WAS SECURED WITH 3M ESPE RELYX ULTIMATE ADHESIVE RESIN CEMENT AND 3M ESPE SCOTCHBOND UNIVERSAL ADHESIVE. ON (B)(6) 2015, THE CROWN DEBONDED AND THE PATIENT WAS REFERRED FOR ENDODONTIC TREATMENT; NO FURTHER DETAILS WERE PROVIDED AS TO WHY THE ENDODONTIC TREATMENT WAS RECOMMENDED, AS THE OFFICE NOTED THAT NO DAMAGE TO THE TOOTH OCCURRED AND REPORTED NO OTHER SYMPTOMS. THE ENDODONTIC TREATMENT WAS PERFORMED ON (B)(6) 2015.