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Posts Under Prosthodontics

The patient presented with two fractured central incisors. The right central incisor was endodontically treated and covered with a failed PFM crown. Unfortunately, the tooth was no longer restorable and required extraction. The treatment options were reviewed including a discussion regarding the state of the remaining anterior teeth. The patient chose to proceed with a fixed bridge restoration to restore the entire anterior segment from canine to canine. The patient also chose to extract the left central incisor.

Here are the pre-operative images of the anterior segment:

The central incisors were extracted and the remaining anteriors were prepared as bridge abutments (i.e. teeth 13, 12, 22 and 23). A temporary bridge was fabricated using Luxatemp and cemented in place with TempBond NE. The temporary was contoured to include ovate pontics for teeth 11 and 21 (right and left central incisors) to give the teeth a natural emergence profile. Below are the preparation and temporary photos taken 4 weeks after inital treatment. Normally, a longer healing period would be used, but in this case the patient had limited time constraints.

For the definitve restoration, a zirconia framework was chosen for both its esthetic nature and strength. The patient's deep bite and heavy occlusion required that lingual reduction of the abutment teeth be maximized. The opposing teeth were also recontoured to improve contour, contact and esthetics. Below are the final photograhs taken immediately post cementation.

In the lingual view, you can see the monochromatic, opaque nature of the zirconia framework. It provides excellent blockout of the dark, underlying abutment teeth resulting in a more life-like and vital appearing restoration. Layered procelain was added to the facial surface of the bridge to give the smile its natural color, reflection and translucency.