0 Evaluation & Diagnosis
1 Progress & Completion
2 Follow-Up & Outcome

Patient cases:

Single-unit restorations

(Maxilla / Anterior)

Replacement of maxillary lateral incisor metal-ceramic crown with an all-ceramic crown

Lead:

Charles Goodacre

A 49-year-old female patient was unsatisfied with the high opacity of her right lateral incisor. Furthermore, she was advised that the replacement of the over-contoured crown would improve her periodontal health.

The existing metal-ceramic crown was replaced by an IPS Empress all-ceramic crown. To improve the fit and the general aesthetics of the crown, the tooth was re-prepared to change the feather-edge finish line to a small shoulder finish line. The crown was bonded with a resin cement.

Evaluation & Diagnosis

Initial situation with less than optimal periodontal health around the lateral incisor crown.

Close up of crown showing the poor gingival response.

Periapical radiograph showing the fit and overcontouring of the existing crown.

Progress & Completion

Removal of crown. Display of feather edge finish line.

Repreparation of the tooth to change from a feather-edge finish line to a shoulder with a rounded axiogingival line age to permit better cervical color without overcontouring of the crown.

Tooth preparation at placement appointment after gingiva responded favorably to provisional crown contours and smoothness.

10 provisional crown M Hoffman.JPG

IPS Empress all-ceramic crown with slightly undercontoured form subgingivally.

Another view showing the subtle subgingival undercontouring that produces a very slight S-shaped cervical contour.

Colored lines that show the S-shaped contour and where the slightly undercontoured marginal area transitions to a normal contour at the desired gingival margin location.

Crown on die showing marginal fit, cervical contour and surface smoothness.

Crown bonded to tooth.

Black and white image showing value.

Closeup image with black background to show translucent areas.

Postplacement smile.

Periapical radiograph post cementation.

Follow-Up & Outcome

Clinical situation at 6-year follow-up.

Periapical radiograph at 6-year follow-up.

Questions

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Team members

Prosthodontist

Thomas Kepic

Periodontist

Satoshi Sakamoto

Dental technician

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