RESUMEN
OBJECTIVE: The combination of partial edentulism and a worn anterior tooth in the esthetic zone can be a challenge for the dentist. This clinical situation requires extensive knowledge of soft and hard tissue management, surgical planning and execution for implant therapy, and conservative tooth preparation with ideal bonding protocols for the tooth-supported prosthesis. Moreover, an optimal selection of the final restorative materials is imperative to manage occlusal forces and fulfill the patient's esthetic demands. MATERIALS AND METHODS: The patient presented with partial edentulism on site 11, a worn incisal edge, and facial defects on tooth 21. Minimally invasive implant therapy for site 11 was performed with a papilla-sparing flap design that only included the edentulous site, and the soft tissue contouring was started for an immediate provisional restoration. A suturing technique was executed that aimed at maintaining an interproximal papilla. Conservative veneer preparation was performed on tooth 21 in order to bond the restoration to the enamel structure. Final restorations included a custom abutment with a lithium disilicate fused to zirconia crown for the implant on site 11 and a lithium disilicate veneer on tooth 21. CONCLUSIONS: A well-planned single implant and a ceramic veneer restoration was able to fulfill the patient's esthetic expectations. The selection of materials for the final restoration was crucial to manage the occlusal forces and to mimic the shade and shape of the adjacent teeth.
Asunto(s)
Implantes Dentales , Estética Dental , Coronas , Materiales Dentales , Estética , HumanosRESUMEN
Este reporte de caso clínico describe el manejo exitoso de una aparente lesión endoperio en un incisivo lateral izquierdo mandibular, que fue tratado únicamente con endodoncia convencional en una sola sesión. El objetivo de este caso clínico fue demostrar que un diagnóstico adecuado, seguido de la remoción de los factores etiológicos como la presencia de bacterias y su comunicación entre el conducto radicular y los tejidos periapicales, resolvió la enfermedad sin necesidad de llevar a cabo tratamientos innecesarios. De esta forma se restauró la salud y función del órgano dental que se había visto afectado por una aparente lesión endoperio.
This case report describes the successful management of an apparent endoperio lesion on a mandibular left lateral incisor that was treated only with conventional endodontic therapy in one session. The aim of this case is demonstrate that proper diagnosis, followed by removal of etiological factors such as bacterias and their communication between root canal and periodontal tissue will prevent the need for unnecessary interventions and will restore health and function on a tooth with severe attachment loss caused by an apparent endoperio lesion.