Ratowanie korzeni oraz przywracanie funkcji uzębienia i uśmiechu / Saving the roots and restoring the function of dentition and the smile

It is very common to see in practice patients with old prosthetic treatments that are failing. The biggest problem rise from the fact that the tooth that support the old bridges are affected by decays under the bridge work and the healthy tooth structure is deep under the soft tissue. One solution is to extract and place implants but it is a more invasive procedure, more time consuming and also more expensive. We also have to keep in mind that usually patients have multiple problems and we have to balance the costs to be able to rehabilitate them completely.

In this clinical case report we will outline the procedures and materials for rebuilding several teeth with post an cores for a patient that required the removal of the upper bridges.

Case report

An 53 years old patient presented for treatment with failing upper bridges. The panoramic x-ray highlighted several problems with the supporting teeth. The gingival tissue sur­rounding the failing bridges was very inflamed with significant bleeding on probing. The teeth number 7,8 and 10 had extensive decay under the gingival margin and required crown lengthening to be performed. Endodontic retreatment is required on teeth number 3,7,8 and 10 due to periapical lesions.

The first step after the removal of the anterior bridge was to perform an crown lengthening procedure to expose the sound tooth structure of at least 1,5 to 2 mm supra-gingival for an optimum ferrule effect and create a more pleasing gingival architecture. When an abutment has a post, a retentive ferrule causes forces placed on a crown to transmit to the cemento–enamel junction (CEJ) area; if the abutment fails, it tends to fail via a horizontal fracture. However, if an abutment has a post b...