Immediate dentoalveolar restoration of hopeless endodontically-treated maxillary central incisor compromised with trauma in anamnesis
DOI:
https://doi.org/10.56569/UDJ.3.1-2.2024.173-185Keywords:
immediate dental implant loading, dental trauma, invasive cervical resorption, atraumatic tooth extractionAbstract
Background. Realization of immediate dentoalveolar restoration approach in the projection of maxillary frontal region considered to be one of the hardest one, taking into account role of not only long-term functional but esthetic parameters that dictate success of end result. Case report described below represents successful complex approach of using immediate dentoalveolar restoration after applied conservative treatment modalities have been failed, while also blending such with mini-invasive veneering of contralateral tooth to obtain the most acceptable esthetic outcome.
Objective. To present effectiveness of immediate dentoalveolar restoration approach in case of replacing hopeless central incisor compromised by trauma factor in anamnesis, while following the most conservative treatment plan.
Case report. Female patient 29 years of age referred to clinical dentist with the chief complaint of tooth 2.1 unesthetic appearance. Patient complained on grayish color of tooth in general and occurrence of pink staining along cervical margin on the vestibula side, which she has noticed during last several months. Considering trauma fact in anamnesis, pink discoloration, clinically visualized defect in tooth structure and CBCT-identified defect inside the tooth crown and root, assumption of traumatic cervical invasive resorption was made. Two weeks after controlled extrusion was started intracanal post got totally extruded from tooth root, while tooth itself remained at its primary position. Considering young age of the patient, relatively favorable adjacent tissue conditions and personal consent of the patient it was agreed to provide future treatment with implant placement and screw-retained implant-borne crown following immediate dentoalveolar restoration protocol of intervention. Ten weeks after primary surgical intervention secondary soft tissue augmentation was provided and new provisional crown with modified and adaptive coronal contour was manufactured. To prevent any color mismatching it was decided to cover adjacent teeth with ceramic veneer. Such approach also optimizes possibilities to obtain full harmony in form between two adjacent incisors if one of them is restored by implant-borne crown.
Conclusion. The immediate dentoalveolar restoration technique epitomizes a patient-centered therapeutic approach, wherein the dental practitioner is required to execute the atraumatic extraction of the pathological tooth, subsequently place a dental implant, augment both hard and soft tissues in the peri-implant area, and install a provisional restoration, thereby achieving a predictable functional and aesthetic result within a singular visit. Further interventions, such as soft tissue grafting or the veneering of adjacent natural teeth, may be conducted subsequently to enhance the aesthetic appearance of the smile, particularly when immediate dentoalveolar restoration is performed on the anterior maxillary dentition. Given the intricate nature of the procedures involved in immediate dentoalveolar restoration, it is imperative that these interventions be carried out by a highly skilled dentist to ensure the attainment of the most reliable outcomes.
Ethical aspects
Authors confirm that they have followed all relevant ethical norms and requirements during the treatment described within present case report and preparation of present manuscript. Authors obtained full patient’s agreement regarding publication of following case report, and such was approved by corresponding consent form signed by the patient personally. No information in present case report may disclose any personal data about the patient, which further may be used for patient’s personal identification. Any information related to patient’s identity disclosure was either deleted or anonymized within present case report.
Authors confirm that they have followed CARE guidelines while preparing present case report with intention for further publication.
Conflict of Interest
Author does not have any potential conflict of interests that may influence the decision to publish this article.
Funding
No funding was received to assist in preparation and conduction of this research, as well as in composition of this article.
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