Pseudo Realignment of Maxillary Anterior Teeth Utilizing All-Ceramic Components
Irfan Ahmad, BDS
After reviewing this case study, the reader should:
- Understand the process of realigning anterior teeth with all-ceramic materials
- Understand the methods and alternatives to using and placing all-ceramic restorations
In optimal circumstances, orthodontic therapy should be utilized to move teeth within the jaws and place them in an aesthetic, functional position. The principal limitation of this treatment modality is the unaesthetic appearance of the orthodontic appliances, although the maintenance of oral hygiene and potential relapse of treatment are also relevant concerns. In these instances, a restorative approach that permits repositioning or "pseudo" realignment may provide an effective alternative to conventional orthodontic therapy, moving the tooth crown only without altering the position of the root.
Minor discrepancies in tooth position can be corrected by veneer restorations in a relatively conservative approach. In severe instances of malposition, a more radical treatment is necessary. In order to achieve the desired position for the definitive crown restoration, this procedure may require intraradicular support and repositioning of the core of the post/core complex to a specified angle. If severe malalignment is present in unfilled roots, elective endodontic (eg, post and core procedures) treatment may be required. Since a metal core imparts a low value on a restoration, a conventional post and core cannot be utilized in the anterior dentition with all-ceramic prostheses without compromising the patient's aesthetics.
The recent introduction of a zirconium oxide post may provide a suitable alternative to the use of metal intraradicular posts. The improved aesthetic and mechanical properties of this post allow it to be cemented directly to a tooth-colored core and enable its use with all-ceramic crown restorations.
*Private practice, North Harrow, United Kingdom.
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