Emergency front tooth repair

One of the most challenging situations in cosmetic dentistry is this: a single front tooth in need of emergency repair.

In this particular case, a front tooth (Tooth #7) has fractured close to the gum line and our patient is leaving tomorrow on vacation for a few weeks, so she would like something done right away, while causing the minimum discomfort for the upcoming trip.

There used to be a porcelain-fused-to-metal (PFM) crown on this tooth, which the patient has lost. The part of the tooth holding the crown has fractured off, but the root remains, and it is seemingly in good shape (no decay). The tooth already had a root canal treatment done years before and there’s no pain.

Challenge accepted!

Usually, the available options in cases like this are:

1) remove the tooth out and place an implant supported crown in its place,
2) remove the tooth and replace with a fixed bridge,
3) remove the tooth and replace with a “flipper” (removable partial denture),
4) keep the tooth and place a post inside the root with a new crown.

We immediately discarded any option involving extracting the tooth, as this could make the upcoming trip and long flights uncomfortable. Having decided to keep the tooth, we proceeded to place a post and make a new same-day porcelain crown (commonly referred to as CEREC crowns).

A porcelain crown (IPS e.max CAD, from Ivoclar) was fabricated with our E4D milling system in about an hour. The crown was then custom colored to give it an appearance matching the existing natural teeth. All of the work was accomplished in one morning.

Our patient was absolutely amazed to see how close the crown matched her own teeth. It looked better than the crown she had before, she told us. It’s now been two years, and the crown is still in place.

This case shows how cosmetic dentistry is not all about bright-white, perfectly straight teeth. A lot of the cosmetic dentistry that we do here at Smiles of Boca is just like this case: simple, fast and affordable.

It’s said that the best cosmetic dentistry is the one that goes unnoticed and we are proud of all the unnoticed smiles that carry our name.