| Patient: |
40 year old, Female |
| Concerns: |
- Seeking cosmetic dental treatment for tooth discoloration relating to upper front teeth.
- Trauma from previous fall lead to the need for root canal and crown treatment – dislike dark grey appearance at the gum line.
- Missing teeth in lower jaw – would like to improve eating and chewing abilities.
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| Diagnosis:
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- Individual tooth analysis from all aspects reviewed issues of
- Infected endodontic (root canal) treatment with chronic apical periodontitis / periodontal disease (gum and bone infection).
- External invasive root resorption in upper left central incisor tooth – unrestorable.
- Aesthetic / Cosmetic Challenges
- Dark tooth discoloration with greying through thin gum and bone from endodontic (root canal) treatment and metal support of preexisting porcelain fused to metal dental crowns (PFM crowns).
- High lip / smile line with full display of gum support around front teeth – demonstrating different zenith (gum height) from varying extent of recession (gum shrinkage).
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| Management:
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- Dismantle and investigation of all preexisting dental crowns to determine the restorability of remaining teeth (saving teeth where possible if prognosis is favourable).
- Temporary dental crowns and upper acrylic partial denture based on smile makeover design with diagnostic wax up – to allow for daily function whilst treatment takes place in stages.
- Collaborative dental treatment with other dental specialists
- Endodontist – Root canal retreatment and internal tooth whitening / bleaching of upper right lateral and central incisor teeth.
- Periodontist – Extraction (removal) of upper left central incisor tooth (temporary denture replacement) and dental implant placement.
- Conventional tooth supported dental ceramic crowns on upper right lateral and central incisor teeth and dental implant crown for the replacement of extracted (removed) upper right central incisor tooth.
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