Case 1: Post Core and Zirconia Crown on #24 - Part I

Treatment Plan

Tooth #24

• Remove PFM Crown and Metal Post Core (Twice Crown Replacement)

• RCT Periapical Lesions (root good prognosis)

• Opting for metal post-core and zirconia crown (fiber quartz post-core is not possible due to previous metal posts. Metal post-core will ensure the longevity of survival rate and with zirconia crown masking the metal core for esthetic purpose)

Tooth #38 and #48 Wisdom Tooth Removal

• Thin buccal plate

• Completed eruption

Tooth #35, #36, #37, #45, #46, #47

• Remove bridge

• Zirconia Crown Replacement

• Implant for missing #6 teeth

Figure 1. Initial Situation, the 27 y.o. patient presented 2-piece metal post-core with PFM crown. The #24 tooth was dignosis with asymtomatic periapical lesions with existing of possible medicated material in canal orifice.

Figure 2. As the canal is calcified, no.10 k-file was used to scout the canal. Canal calcification in the middle third.

Due to time constraints, Intracanal medication (VitaPex) was placed in the canal and sealed with Caviton. Patient was recalled 3 days after to resume the procedure.

Figure 3. 2 buccal and lingual canals were located. Both canals were enlarged to 25 Kfile and Red Knob Protaper Hand File. Irrigate with NaOCL and Saline. The procedure was performed using Protaper files with EDTA.

Working Length: 14 mm for both canals

Figure 4. Permanent Intramedication (Vitapex) was placed at the root apex. Obturation was buck-filled using the vertical warm condensation technique. (Yellow GP for Buccal Canal and Red GP for Palatal Canal). Palatal canal seal apically 5mm to prepare 9mm post space for metal post core.

Provisional crown was provided for the patient by imitating canine morphology, for preventing occluding to the antagonist tooth.