An Urgent Fix
Problem: this patient attended as an emergency having snapped his tooth off. He was referred across from the general dentist to see if there was any viable prosthodontic solution that would allow conservation of his teeth, even if as a temporary measure. His complex medical history meant that extractions were not desirable without further medical management so the immediate options were limited. However an impending public meeting required a prompt intervention either way.
Solution: careful assessment of his bite allowed us to design an immediate pseudo ‘bridge’ utilising composite resin to address the immediate cosmetic concern while maintaining a non-invasive approach, avoiding surgery. The understanding was that this would eventually fail but that a more definitive plan would be devised. Bonding and composite sculpting techniques were optimised to ensure a scrupulous union to the tooth remnant. Oral hygiene access to maintain the reconstruction was factored into the design to give it the best chance for longer term survival.
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Discussion Points: on initial presentation this looked like a hopeless scenario, which would otherwise result in extraction of the fractured tooth. However circumstances were not favourable for this and after some consideration, including assessment of nerve status, discussion with the patient led to an agreement to try this more simple interim solution. This still allowed for easy access to the tooth remnant if the need arose. The approach also accommodated for cosmetic improvement of the compromised adjacent teeth. As always the remit was to remain as sensitive as possible to the general aesthetic parameters and so shade/colour and stain details were adjusted to create a homogeneous natural appearance. The outcome given its ‘temporary’ nature superseded all expectation and continues to function well.