Restoring a Fractured Central Incisor: A Challenge to Overcome
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 4
Abstract
Restoring a single central incisor should aim at preserving the affected tooth as well as re-establishing function and esthetic. This clinical report describes a patient with compromised smile due to the fracture of the tooth number 11which was immediately restored by resin waiting for the healing process after the trauma. A zirconia based ceramic restoration was performed. Basic guidelines were followed to guarantee a natural mimicry of the restoration.he maxillary central incisors have an effect on the visual aspect of a person either positively or negatively. In fact achieving a natural mimicry of the single maxillary central incisor restoration with the adjacent dentition is a real challenge. Thus an accurate match of a single incisor crown with the supporting tissues leads to a near mirror image [1]. When the central incisor is decayed or fractured, the situation is complicated as it needs a prior reconstruction. Currently, fiber posts and cores solve the problem thanks to their elastic behavior. Their modulus of elasticity is similar to that of dentin, unlike metal or ceramic posts [2,3]. The restoration will be instantly compared with the natural counterpart. Hence the slightest differences of shape and color will be immediately perceived. Knowing that the patient’s expectations in this case are normally very high, this integration of the restored central tooth is more challenging for both the clinician and the ceramist. This may be one of the most critical procedures in esthetic restorative dentistry [1]. To match natural adjacent teeth, all ceramic crowns offer better potential than metal-ceramic ones [4]. Ceramic materials are promising allowing natural mimicry thanks to their optical properties. There is a wide range of available. The correct one must be chosen. Zirconia based crowns are more and more selected as they ally improved mechanical properties, enhanced soft tissue biocompatibility promising longevity and esthetics [5-8]. Nevertheless, the laboratory technician should give due care to the appropriate thickness of ceramic [9,10] as well as to the shade selection. Numerous guides have been developed through the years in order to enhance shade selection and facilitate the communication with the ceramist. The VITA 3D master shade guide is recommended: it is the only one which allows the assessment of the luminosity being the most important component. Special shade tabs are also required for the opalescence, fluorescence and translucency of natural teeth [11,12].
Authors and Affiliations
Hadyaoui Dalenda, Azouzi Ines, Kalghoum Imen, Belhssan Harzallah
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