Case with extensive coronary destruction of the cervical region
Author: Dr. Fabio Lorenzoni
The patient came to the dental office, reporting the frequent falling out of the provisional crown of tooth 21, which had a provisional post cemented inside the root canal.
A Whitepost DCE 2.0 fiberglass post was used, cemented with Allcem Core and Ambar Universal APS as the adhesive system. The fiberglass post sleeve was reconstructed with Vittra APS composite in shade DA2 .
Subsequently, the patient requested tooth whitening.
Then, a treatment plan was established involving the cementation of a lithium disilicate crown on tooth 21, with teeth 13, 12, 11, 22, and 23 received the cementation of veneers.
The veneers were cemented with Allcem Veneer APS and the crown was cemented with Allcem Core. The adhesive used was Ambar Universal APS in both cases.
STEP BY STEP
Initial image. Note the lack of finishing and polishing of the buccal surfaces of the anterior teeth (the patient had removed the orthodontic brackets a few days ago) and quality of the provisional crown
Periapical X-ray image where it is possible to observe that this tooth had a temporary metallic post cemented in the root canal, which needed to be replaced.
Frontal image of the coronary remnant (quite darkened) after the removal of the provisional crown and the provisional metallic post.
Incisal image of the coronary remnant. Note that the root canal (especially in the cervical third) was quite wide. The prosthetic preparation of the coronary remnant was performed before cementation of the fiberglass post.
Periapical X-ray image showing the unobstructed depth of the root canal.
Incisal image where it is possible to observe that the thickness of the cement line will be reduced due to the larger diameter of this fiberglass post, since the Whitepost DC-E posts have a larger diameter in their cervical portion.
Front image where it is possible to see the relationship between the fiberglass post and the coronary remnant.
After acid etching, the root dentin was treated with the Ambar Universal APS adhesive. After that, the cement AllCem Core was applied inside the root canal through its applicator tip. Then, the fiberglass post Whitepost was inserted into the root canal and, after excesses removal, it was photoactivated.
An abutment was created with Vittra APS composite in shade DA2. This abutment followed the principles of retention and stability of prosthetic preparations.
Incisal view showing the palatal face of the prosthetic preparation.
Periapical X-ray image after cementation of the fiberglass post.
Frontal image showing teeth 13, 12, 11, 22 and 23 prepared for veneer and tooth 21 prepared for full crown. The preparations fot veneers were minimally invasive.
Initial and final appearance of the case.