PMC6488716_01
Frontal view shows inflamed gingiva, faulty restorations with recurrent caries, square tooth type, not ideal Golden proportion and length to width ratio.
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Intra oral examination revealed that the patient had inflamed gingiva, all his upper anterior teeth were restored with faulty restoration and deep recurrent caries as seen in Fig. 1.
(A) Shows lower occlusal view, (B) upper occlusal view.
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Tooth #17,16,21,45 was previously root canal treated (substandard) with asymptomatic apical periodontitis, he also had multi defective restoration in all his mouth as seen in Fig. 2.
Peri-apical X-ray for tooth #21 shows short metal threaded post, recurrent caries, substandard RCT (loss of coronal seal).
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Peri-apical X-ray for tooth #21 shows short metal threaded post as seen in Fig. 3.
(A) After removing the old faulty restoration and metal threaded post, (B) metal threaded post.
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The obvious challenge in this case was how to restore severely damage tooth#21 after removing old metal threaded post as seen in Fig. 4.
Veneers preparation for the canines, crown preparation for the incisors, gold cast post and core for tooth#21.
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Tooth #21with greatest loss of coronal tooth structure was judged to be a candidate for gold cast post-and-core restoration as seen in Fig. 5.
(A) Shows Right lateral view after treatment, (B) left lateral view, (C) upper occlusal view, (D) lower occlusal view, (E) frontal view.
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Usual tooth preparation was carried out to fabricate all ceramic crowns in all the endodontically treated teeth and veneers for the upper canines as seen in Fig. 6.
(A) Before starting treatment, (B) after complete comprehensive and esthetic treatment.
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