PMC4251642_01
The intraoral view of the patient before treatment.
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The remaining anterior incisors were clinically normal, and no signs of alveolar bone fracture were detected; however, gingival bleeding was present (Figure 1).
The radiographic view of the patient before treatment. (a) Arrow marks the horizontal root fracture. (b) Arrow marks the enlarged periodontal space of right and left maxillary teeth.
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The periodontal spaces of both maxillary central incisors were enlarged (Figures 2(a) and 2(b)).
Repositioned coronal fragment and applied rigid splint.
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Following administration of local anesthetics, the coronal fragment was repositioned with digital pressure and the success of repositioning was confirmed radiographically before the rigid splint was applied with composite resin material (Filtek Supreme XT, 3M Espe, USA) (Figure 3).
The radiographic view of the patient after root canal treatment.
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Then a moistened cotton pellet was placed on the MTA surface, and the endodontic access cavity was filled with temporary restoration (Cavit-G, 3M Espe, USA) (Figure 4).
(a) Right lateral view before restorative treatment. (b) Frontal view before restorative treatment. (c) Left lateral view before restorative treatment.
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(a) Wax-up of the build-up of teeth on maxillary arch stone cast. (b) Silicone index to mark the palatal filling contour.
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A silicon index was made using the study cast to determine the index during composite treatment (Figures 6(a) and 6(b)).
(a) Right lateral view after restorative treatment. (b) Frontal view after restorative treatment. (c) Left lateral view after restorative treatment. Pink color composite used at the edges of zenith level of 22 and 23.
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To improve the surface texture, the restorations were finished and polished with a mixture of coarse diamonds (837LH014, Meisinger, Germany), composite finishing carbides (HM245012, HM244010, Meisinger, Germany), and various grits of polishing discs (Sof-Lex, 3M Espe, USA) (Figures 7(a), 7(b), and 7(c)).
((a), (b)) Stretched smile before and after restorative treatment.
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Endodontic and aesthetic restorative treatments were completed, and the patient's oral hygiene motivation was improved significantly (Figures 8(a) and 8(b)).
After 15-month radiographic control examination.
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The clinical condition of the restorations and the patient's oral hygiene were in good condition at the 15-month follow-up examination (Figure 9).