Clinical case 1
A 44-year-old female patient complained of pain under the crown of her tooth, and during the initial consultation she stated that she assumed that the tooth under the crown was destroyed. She was also interested in what could be done to the teeth adjacent to the problematic crown, as they had turned brown and were chipped and cracked
Diagnosis and treatment plan


At the first stage, a CT scan was performed, which revealed resorption of the tooth under the crown and confirmed that it could not be saved. The neighboring teeth were also severely decayed, but for an accurate prognosis, a microscopic revision was performed to remove all fillings and caries-affected tissues.
In the process of revision, it became clear that the tooth tissue had been destroyed deep under the gingiva, and although technically possible to restore them, the risks of gingival inflammation and subsequent destruction of teeth and bone were too great. Therefore, the patient was recommended to have the damaged teeth extracted with a one-stage (immediately after extraction) implantation. The patient agreed to the proposed treatment plan, which included the extraction of three teeth and the placement of two implants, followed by a highly esthetic zirconia dental bridge
Removal and one-stage implantation


First, it was necessary to gently and as non-traumatically as possible remove the roots of the destroyed teeth, the extraction procedure took about an hour, after which bone grafting (the wells of the teeth were filled with bone material) and implantation were performed, which took a little more than 40 minutes. After the procedures, impressions were taken for the placement of temporary crowns
Placement of temporary crowns on implants


Using the impressions taken at the previous stage, temporary structures were made and 3 days after implantation, the temporary crowns were already placed on the patient, followed by suture removal a few days later. For the next stage, a pause is necessary to allow the implants to integrate (take root), in this case the next appointment was scheduled after 2.5 months
Placement of permanent zirconia crowns


After removing the temporary structures, the examination showed that the gingival papillae had formed, the gingival contour around the implants had an optimal height and width, which means that in this case there was no need to perform gingival plasty, everything was fine as it was. Therefore, impressions were taken for the fabrication of a permanent zircon construction. Based on the impressions, the technicians made a beautiful and, most importantly, properly functioning bridge prosthesis, which took another 5 days. The fixation of the prosthesis itself on the implants lasted no more than half an hour and now the crowns are indistinguishable from natural living teeth to the naked eye – the advantages of high-quality work and highly aesthetic zircon.
In parallel, on the left side, where there were also problems, we repaired the canals and restored the teeth with crowns, without implants. Our work is now complete, function and aesthetics are restored

