Journal of Jilin University(Medicine Edition) ›› 2022, Vol. 48 ›› Issue (4): 1058-1064.doi: 10.13481/j.1671-587X.20220429

• Clinical medicine • Previous Articles    

Multidisciplinary aesthetic restoration of anterior dental area of patient with failed treatment experience: A case report and literature review

Degeng XIA1,Qingyu ZHANG2,Junjun JIAO1,Tingrui XU2,Tianyi ZHANG1,Yang ZHONG1,Zhulan ZHAO2,Ning MA1(),Li ZHANG2()   

  1. 1.Department of Periodontics, Stomatology Hospital, Jilin University, Changchun 130021, China
    2.Department of Emergency, Stomatology Hospital, Jilin University, Changchun 130021, China
  • Received:2022-01-10 Online:2022-07-28 Published:2022-07-26
  • Contact: Ning MA,Li ZHANG E-mail:man@jlu.edu.cn;zhang_li99@jlu.edu.cn

Abstract: Objective

To explore the difficulties and solutions of aesthetic restoration of anterior teeth and clarify the significance of multidisciplinary therapy, and to provide the experience and reference for the diagnosis and treatment of similar difficult cases.

Methods

A case of aesthetic restoration in anterior tooth area successfully completed by multidisciplinary therapy after failing bridge crown restoration was selected and followed up for 3 years. Combined with the relevant literature review, the effect of multidisciplinary therapy on the aesthetic restoration of consecutive affected teeth in the anterior area was analyzed from the perspective of “pink and white aesthetics”.

Results

One 30-year-old female patient was admitted due to repeated loss of 12—22 bridge crown. The specialist examination showed that 12—22 tooth crowns were in the state of preparation; the X-ray image showed lamina dura of 12, 21, 22 was the alveolar bone crest - enamel cemental junction was <2 mm, the alveolar bone on the distal side of 11 was absorbed into 1/3 of the neck in angular shape, 11, 21, 22 had secondary caries, and the root canal treatment had been completed; the periodontal probing depth of 11 was 8 mm on the labial side, 5 mm on the distal side, 3 mm on the proximal and palatal side, which presented a narrow and deep bone defects in the two walls of the labial and distal sides, tooth mobility (Degree 3);the gingival margin of 12, 21, 22 were slight swelling, the periodontal probing depth was <3 mm, tooth mobility (-). Crown lengthening (12, 21, 22), extraction (11) and site preservation simultaneously were planned, and 12—22 fixed bridge repair was performed 3 months later. Due to the personal reasons, the patient failed to perform the fixed bridge repair on time, and 11 months later, the patient proposed switching to implant repair 11. The CBCT results showed that the width of alveolar bone in the lip-lingual direction of 11 was<5 mm, and the gingival margin of 12, 21, and 22 were enlarged in the coronal direction and at the same level as the shoulder. Therefore, 12, 21, 22 single-crown restoration after gingivoplasty was planned, implantation were performed in 11 and guided bone regeneration (GBR) was performed simultaneously on its labial side. Finally, the position of the gingival margin was stable and the bone mass was sufficient. The color and shape of 12—22 all-ceramic single crown are similar to natural teeth, and the alveolar ridge fullness was good, the gingival was pink and tough without inflammation, and the gingival margin was continuous conch shape with left and right symmetry.

Conclusion

Multidisciplinary therapy provides an effective solution to the aesthetic repair problem of continuous multiple teeth in the anterior area, which not only better restores the patients’pronunciation and mastication function, but also achieves the satisfactory aesthetic effects.

Key words: Anterior dental area, Aesthetic restoration, Crown extension, Guided bone regeneration, Planting

CLC Number: 

  • R781.45