Single Crown Restoration
A middle-aged female in good health presented with tooth No. 9 positioned lingually and inferiorly to teeth Nos. 8 and 10 with tight proximal contacts. The position of tooth No. 9, which was caused by trauma, prevented the patient from closing her mouth normally. She also had pain and sensitivity involving this tooth.
That day, I numbed tooth No. 9 with local anesthetic. Using my fingers, I repositioned No. 9 to a more buccal and normal eruption position even to teeth Nos. 8 and 10, allowing the patient to close her mouth normally.
Four days after the initial visit, I took x-rays and diagnosed irreversible pulpitis. Because of the nature of the trauma to tooth No. 9, the patient was informed of the possibility that teeth Nos. 8 and 10 might need future root canal therapy. We discussed several treatment options, including extraction, implant, and crown on No. 9. Porcelain veneers or composite bonding for Nos. 7, 8, and 10 were the secondary treatment options, while fabricating the crown on No. 9.
We chose the conservative root canal therapy, buildup, and crown on tooth No. 9 because it gave a long-term solution to a tooth that was not compromised by decay or periodontal disease. From a patient and esthetic standpoint, the main concern was to save tooth No. 9. The patient did not want to alter the position, shape, or color of the surrounding teeth.
The challenge of this case was creating a crown that blended with the remaining upper anterior teeth, which were in different positions buccally and lingually, and also had different shade patterns.
In the end, the patient was happy with the shape, position, and shade of the new crown for No. 9. As a dentist, I thought that the crown fi t well on the margins and it had a good shade that blended with the surrounding teeth, but I was not happy with the tooth?s shape and position. The patient has the final say, and she was happy with the new crown.
This was not your typical patient who wanted to improve her smile. Even though she had upper anterior teeth that were out of position, she wanted only her front tooth restored to its original position.