Single crown

Cracked tooth
,
Erosion
,
Gingival recession
,
Unsatisfactory restoration
Courtesy of Dr D. Colson, 2022
Highlighted picture of treatment

Treatment Summary

Patient Information

  • Age: 69
  • Gender: female

Diagnosis

  • Erosion
  • Cracked tooth on 3.7 (LL7)
  • Gingival recession on 3.7 (LL7)
  • Unsatisfactory restoration on 3.7 (LL7)

Total Treatment Visits

  • 2

Treatment planning

First Appointment:
A consent form was signed for a monolithic zirconia crown on tooth #47. A preliminary alginate impression was taken in order to fabricate a temporary after the crown preparation. The reason for the crown preparation was a furcation, a large filling with multiple fracture lines and missing tooth structure at the distal. Local anaesthetic was administered, 4 cc Xylocaine 2% with epinephrine 1:100,000. After the tooth was prepared, ozone air was placed on the prep and coated with Clearfill bond and light cured. Retraction cords were used to allow good visibility of the margins of the preparation to enable a quality scan for the crown fabrication. The iTero scanner was used to capture the preparation of tooth #47, inclusive of 1st and 4th arches and a bite registration. The tooth was temporized with Luxatemp A2 and due to the Christmas holiday season, Fleck’s cement was used to ensure stability of the temporary until the cementation appointment in the new year
The occlusion was adjusted and the restoration was polished. The shade for the crown was Vita D2. The case was submitted to a designated lab for fabrication.

Second Appointment:
The patient presented for cementation of the crown 37. No local was necessary for this appointment as the patient was comfortable. The temporary was removed and the crown was tried in. It was checked for tight contacts, optimized occlusion and acceptable esthetics by the dental team and the patient. A bitewing xray was taken to verify the interproximal fit of the crown. Once the above criteria was met, the tooth was micro etched and Universal bond was applied to seal the dentinal tubules, lightly air dried and light cured. The internal portion of the crown was treated with Z Prime for 1 minute. The crown was filled with Rely X Unicem translucent, placed intraoral on the tooth #47 preparation and the cement was light cured around the margins after flossing and brushing away excess cement. Once the cement was cured, the excess was removed. Again occlusion was checked with articulating papers thin and thick for centric and balancing side contacts respectively. The restoration was polished with Shofu porcelain polishing discs where the adjustments had been made.
Special comments: The margin of crown was designed to be concave as recession was 4 mm at furcation on buccal surface for ease of plaque control and to optimize and stabilize the periodontal condition of the tooth.

Comments

Crown designed for optimal position as the patient will proceed with Invisalign.

Images

Initial and final

InitialFinal
After picture of treatment
Before picture of treatment
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iTero Scans

Initial Final
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Radiographs

Initial Final
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Progress Images

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