Complex Cases Need Joined-Up Thinking
A broken-down tooth is rarely just a restorative question. Endodontic status, periodontal support, remaining tooth structure and material choice all affect the plan, and the evidence for each sits in a different place. BossCE works best here as a single place to pull that evidence together: you bring the clinical findings, and BossCE helps you weigh the options, check the literature and explain the choice to your patient.
How a Consultation Session Works
There is one AI assistant, used in a sequence of focused questions within the same conversation. It remembers the last few exchanges, so each question builds on the previous one.
| Step | You provide | BossCE helps with | Output |
|---|---|---|---|
| 1. Case summary | Your examination findings, radiographic findings and patient factors | Organising the problem list and identifying the key decisions | Structured case summary |
| 2. Evidence check | The specific question (for example, restorability or ferrule) | Summarising current evidence and guidelines, with sources | Evidence summary with Key Sources |
| 3. Options | Your preferred approaches | Comparing options on prognosis, sequence, time and cost drivers | Option A vs Option B comparison |
| 4. Communication | Request for a patient explanation | Drafting plain-language option summaries | Patient-ready draft you edit and approve |
The findings come from you. BossCE can describe an uploaded radiograph, but it cannot measure ferrule height, dentine thickness or bone levels, so give it your own measurements.
Worked Case: Broken-Down Upper First Premolar
Clinical findings (from the clinician): 48-year-old patient, tooth 24. Previously root-treated five years ago. About 1.5 mm of supragingival dentine remains on the palatal wall only; buccal and mesial walls are at or below the gingival margin. Probing depths 3 mm or less, Class I mobility. The radiograph shows an adequate apical seal but an underfilled coronal two-thirds, no periapical radiolucency, and mild horizontal bone loss.
Step 1: Case Summary
“Here are my findings for tooth 24: [paste findings]. Summarise the problem list and the key decisions I need to make, including the main factors affecting restorability.”
Expect a list covering inadequate circumferential ferrule, the quality of the existing root filling, the remaining tooth structure, and the decision between keeping and replacing the tooth.
Step 2: Evidence Check
“What does current evidence say about the importance of ferrule height for root-filled premolars restored with posts and crowns, and how much ferrule is generally considered necessary?”
“When is endodontic retreatment indicated for a tooth with an adequate apical seal but an underfilled coronal canal that is about to receive a new post and crown?”
Step 3: Compare the Options
“Compare two options for tooth 24: (A) retreatment, ferrule gain by crown lengthening or orthodontic extrusion, fibre post and composite core, and a full-coverage crown; (B) extraction with ridge preservation and a delayed single implant. Compare prognosis, number of visits, healing time, main risks and when each is the better choice.”
A good answer will make clear that gaining a circumferential ferrule matters more than the choice of post, that crown lengthening on a premolar has periodontal and aesthetic trade-offs, and that ridge preservation followed by a healing period of several months is a common pathway before implant placement. Check the Key Sources before relying on specific figures.
Step 4: Draft the Patient Explanation
“Write a short, plain-language explanation of Options A and B for the patient, including the benefits, risks and time involved for each. Avoid jargon. Do not recommend one option over the other.”
Edit the draft so it reflects your own recommendation, your fees and your clinic’s protocols before sharing it.
Checklist for Complex Case Sessions
- Anonymise: no names, ID numbers, dates of birth or faces in text or uploads.
- Bring your measurements: state ferrule height, probing depths and mobility yourself rather than asking the AI to estimate them from an image.
- One decision per question: focused questions give clearer, better-sourced answers.
- Check the sources: open the Key Sources for any recommendation you plan to act on.
- Follow the IFU: confirm posts, cements and graft materials against the manufacturer’s instructions for use.
- New patient, new session: click Clear Discussion before starting a different case.