0 Evaluation & Diagnosis
1 Progress & Completion

Patient cases:

Single-unit restorations

(Maxilla / Anterior)

Replacement of fractured maxillary central incisor

Lead:

Charles Goodacre

Initial crown preparation was extended to the bone level, violating the biologic width and creating adverse biologic response. Crown was removed and tooth prepared for new crown. Inspection of tooth did not reveal that tooth was cracked. Initial good mucosal response was not sustained and became progressively worse. Periodontist reflected the flap and crack was detected. Tooth was extracted and implant placed. Mucosal recession was experienced due to bone loss associated with cracked root.

Evaluation & Diagnosis

Tooth #9 (US) / #21 (FDI) with existing preparation.

Pre-treatment periapical radiograph.

Revision of existing preparation.

Initial acceptable gingival response after one week that was not sustained.

Progress & Completion

1-month after crown delivery: beginning recession of soft tissue.

Flap reflected & detection of crack.

Extracted tooth with crown.

Immediate implant placement.

Placement of cover screw and augmentation with bone substitute.

Healed site with healing abutment.

Healed site after removal of healing abutment.

Insertion of individualized abutment and cemented crown.

4-week follow-up.

Master cast of re-prepped tooth and coping.

Final veneered crown on master cast.

Individualized abutment.

Final veneered crown.

Crown is mimicking the extracted tooth.

Insertion of individualized abutment and cemented crown.

Questions

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Team members

Prosthodontist

Thomas Kepic

Surgeon and Periodontist

Satoshi Sakamoto

Dental Technician

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