Reparation of a broken incisor with metal post and zircon crowns

Our female patient aged 38 presented to our clinic with the following requests:

  • her right maxillary central incisor chipped off on bite.
  • She was hopeful that the chipped tooth could be salvaged, and that no tooth extraction would be required.
  • Aesthetic restoration was a top priority
  • She desired to have whiter teeth.
  • As part of a future treatment she wanted to have her missing teeth replaced (restoration of mastication).

 First treatment (3 workdays)

The condition of teeth was thouroughly examined in the first session. The examination demonstrated that the central incisor could be salvaged, with no vertical root fracture evidenced. Since the filling inside the tooth was in a perfect conditon, it required no replacement, only the tooth required to be reinforced with a cast metal post and core. Post and core reinforcement rules out full ceramic crowns (E. Max) since the greyish black hue of the post and core may show forth underneath the crown. We therefore decided for a metal-free zirconia crown. Since the adjacent central incisor had also been filled, we jointly decided with the patient in favour of both incisors being crowned in the interest of an even better looking result.

After preparing the teeth a precision impression was taken thereof which was forwarded to the dental technician along with all the patient’s requests. The photographs enable the dental technician can manufacture a shape best going with the face. A gnathological treatment was also performed as part of which bite registration was performed with a bite gauge and face-bow registration was conducted with an Artex face-bow to enable the dentist to precisely determine occlusion and for the tooth replacement to have an appropriate bite. Professional tartar removal, polishing and office teeth whitening was performed with ZOOM 2 LED in order to match the colour of the zirconia crowns to the clean, whitened adjacent teeth to achieve a perfect smile.The preparation, test-fitting and cementing of zirconia crowns is a high precision process. Our patient is perfectly satisified with her new teeth, is at ease to smile again and has, as a result, regained her self confidence. The dental treatment continues with the replacement of missing molars with dental implants in order to restore masticatory function following aesthetics.

 

A previous panoramic radiograph recorded at a consultation prior to the incisor chipping off

Metal-free replacement with the zirconia crowns fixed on the gypsum cast. The surface morphology is readily discernible.

The inside of the zirconia crowns. The white zirconia framework onto which the ceramic is sintered is readily visible.

Custom-made cast metal post and core adapted to the given circumstances. The residual tooth stump or prep is elongated and reinforced with a post and core to accommodate the crown.

Front view of the cast metal post and core onto which the zirconia crown is secured

The custom-made cast metal post and core prepared by the dental technician

The tooth preparation (prep) with dilated gingival sulcus prior to cementing the cast post and core and crown.

The cast metal post and core cemented in place.

The metal-free zirconia crowns on teeth number 11 and 21 (front central incisors) in the mouth, cemented in place.

Follow-up panoramic radiograph with the post and core and zirconia crowns cemented in place

Further images on the finished crowns: