Re-treatment of a Central Incisor With Vertical Root Fracture

In the case described here, a healthy 38-year-old female patient presented to the practice with soft-tissue swelling overlying the distal papilla of tooth No. 9. The swelling was resulting from an undetected vertical root fracture that had caused internal damage from the presence of chronic granulomatous tissue. By the time the fracture was detected and acted upon, the osseous and gingival architecture had remodeled to such an extent that, after healing, there was a complete loss of the distal papilla. Subsequently, this led to a cascade of restorative and reconstructive challenges in order to restore the patient's smile.

In addition to this hard- and soft-tissue dilemma, there were flaws inherent in the existing smile that had been previously created with bonded porcelain crowns and veneers. The smile had to be assessed in order to identify these flaws and determine how they could best be corrected. Therefore, a systematic approach was undertaken to evaluate the existing smile, its inherent flaws, and the changes that needed to be made to restore it to its former glory.

Hanno Venter, BDS
Master
International Congress of Oral Implantologists
Orange Moose Dental
Bundaberg, Australia