PMC4093645_01
Preoperative appearance with provisional, esthetically unpleasant restoration on tooth 21 and glass-ionomer cement on 21
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F1A
Clinical examination revealed an oblique crown-root fracture of tooth 11 with the fracture line extending subgingivally at the mesiopalatal aspect (Figs 1A and B).
Palatal view
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F1B
Extrusive force was provided by an orthodontic wire (Fig. 2).
Orthodontic extrusion:edgewise brackets in the intercanine segment
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F2
Afterward periodontal plastic surgery was performed to correct the discrepancy of the gingival margin due to coronal migration of the connective tissue (Figs 3 and 4).
After 3 weeks, around 3.5 mm of extrusion had been achieved. Coronal migration of soft tissue is notable
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F3
Afterward periodontal plastic surgery was performed to correct the discrepancy of the gingival margin due to coronal migration of the connective tissue (Figs 3 and 4).
Situation immediately after periodontal plastic surgery
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F4
A provisional crown was placed for 2 months to stabilize the soft tissue (Figs 5 and 6).
Placement of a provisional acrylic crown for 2 months on tooth 11 to stabilize the soft tissue
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F5
A provisional crown was placed for 2 months to stabilize the soft tissue (Figs 5 and 6).
Appearance after 4 weeks of soft tissue stabilization
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F6
The left incisor was restored directly using composite material IPS Empress Direct (Ivoclar Vivadent) (Figs 7 to 9).
Tooth 21 after removal of provisional composite restoration
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F7
The left incisor was restored directly using composite material IPS Empress Direct (Ivoclar Vivadent) (Figs 7 to 9).
Direct composite restoration with layering technique (IPS Empress Direct, Ivoclar Vivadent, Schaan, Liechtenstein)
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F8
The left incisor was restored directly using composite material IPS Empress Direct (Ivoclar Vivadent) (Figs 7 to 9).
Direct composite restoration:final result
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F9
Good esthetics was achieved (Fig. 10).