Clinical Case in collaboration with Dr. Azer Mammadov and Dr. Ali Asadov (DT)
The anterior zone of the mouth plays a critical role in a person’s esthetic appearance and overall confidence. Restoring a single tooth in this highly visible area presents unique challenges for dental professionals especially when other teeth need esthetic restoration too .
The intricacies of achieving perfect color matching, maintaining natural tooth translucency, and ensuring seamless integration with surrounding dentition require a sophisticated blend of scientific knowledge, artistic skill, and advanced materials.
This article explores the complexities involved in anterior single-tooth restoration, highlighting the combination between using an implant, zirconia and composite, to achieve natural-looking results while preserving functionality and patient satisfaction.
All the pictures in this article were taken using a smartphone and SmileLite, the lighting system that you can attach to any phone (SmileLine, Switzerland, powered by StyleItaliano).
Fig.1
A 40-year-old patient visited our clinic seeking a solution to her esthetic problem. Several teeth required restoration, and the upper right central incisor (tooth #11) exhibited root resorption and significant mobility. It was decided to extract tooth number 11.
Fig.2
Tooth number 11 was extracted, and direct implantation was decided.
Fig.3
An implant was placed (C1 from MIS), and due to the loss of vestibular cortical bone, it was covered with bone graft material covered with a membrane.
Fig.4
After surgery, the crown of the extracted tooth was used as a provisional restoration by bonding it to the adjacent teeth with composite added to the buccal surface, ensuring it was out of occlusion.
Fig.5
Four months after surgery, the patient was seen. A healing abutment was placed, and a digital scan was performed using a scan body placed over the implant.
The scanner used in this case was Helios 680 (Eighteeth, Changzhou, China).
The provisional restoration was adapted to the healing abutment and bonded again to the adjacent teeth.
Fig.6
A view of the provisional restoration bonded to the adjacent teeth and out of occlusion.
Fig.7
A zirconia abutment (Aidite 3D Pro Zir, Qinhuangdao, China) was placed over the implant. At this point, all old restorations were removed, and caries were cleaned to prepare for the restoration of the adjacent teeth.
Fig.8
A new PMMA provisional was prepared on the zirconia abutment.
The mesial gingival part of tooth 21 was restored with composite, following the cervical convexity of the 11, to minimize the black triangle between the central incisors as much as possible.
Fig.9
All cavities were restored with composite.
Note the emergence profile of the gum, which followed the Zirconia abutment anatomy.
Fig.10
The zirconia crown (Aidite 3D Pro Zir) was cemented on the abutment, and you can see the perfect match with adjacent teeth.
Note the closure of the black triangle between the 11 and 21.
Fig.11
The before and after pictures demonstrate the integrity of the final restorations, which combine implants, composite, and zirconia. The pictures were made using a smartphone and SmileLite lighting device.
Conclusions
In summary, the integration of new materials and advanced techniques in everyday dentistry significantly enhances efficiency and predictability.
These innovations not only streamline dental procedures but also improve the quality of patient outcomes.
Most importantly, they expedite everyday practice, allowing dental professionals to deliver exceptional care more swiftly and effectively.
Bibliography
- Serra-Pastor, B., Bustamante-Hernández, N., Fons-Font, A., Solá-Ruiz, M. F., Revilla-León, M., & Agustín-Panadero, R. (2021). Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study. Journal of Clinical Medicine, 10(16), 3482.
- Budhwar, P., Yadav, R., & Rao, P. L. (2019). Aesthetic Management of Discoloured Anterior Teeth with Zirconia: A Case Report. Journal of Applied Dental and Medical Sciences, 5(1), 1-6.
- Ribeiro Martin, Leandro Lécio de Lima Sousa, Tiago Garcia Margu. “Aesthetic Rehabilitation with a Dental Implant in an Upper Central Incisor.” SVOA Dentistry, 2021.
