Stained teeth and faulty crowns

H.R,51-year-old bank manager and sport enthusiast has come into our clinic and said: “I am ashamed to smile and I want to improve my esthetics. I have no pain or trouble eating. I am highly interested to fix my situation and I am willing to do what it takes”. This case presents the use of periodontal plastic surgery, zirconia crowns and laminates.

Diagnosis was made: bone inflammation due to failing root canal treatment, caries underneath old crowns, gum infection around faulty restorations, excessive gum appearance during smiling, hopeless teeth on the upper right quadrant with loss of bone volume. Midline deviation resulting in an unesthetic appearance. On top of which, all the teeth looked stained, probably as a result of high amounts of fluoride when the teeth were developing.

Treatment planning included: root canal retreatment, decay removal, gum treatment that included plastic surgery to reshape the gums. Hopeless teeth were replaced with dental implants. Due to lack of sufficient bone a bone augmentation was done prior to implant placement. Permanent restoration included conventional porcelain fused to metal crowns on posterior teeth and esthetic zirconia crowns on the anterior region on teeth that had lost their natural tooth color and needed to be masked with a crown. Other teeth received laminates as well to improve esthetics.     

H.R treatment lasted about a year. During that time, we achieved: a mouth free from decay, healthy gum tissue, correct occlusion and an esthetic appearance. The patient’s high motivation helped the team during treatment in order to achieve our final goal. The treatment ended 7 years ago. H.R keeps coming in for regular dental cleaning and checkups.