Restoration of incisal half with edge-up technique using ceramic partial crown in turner's hypoplasia: A case report
An 18-year-old female patient reported to conservative dentistry clinic with a chief complaint of mutilated front teeth compromising esthetics []. After taking an elaborate history which revealed that the patient had a trauma to the deciduous teeth when she was 1-year-old. Gingiva was inflamed and patient had edge to edge bite. On clinical intraoral examination, patient's oral hygiene was moderate with generalized gingival inflammation and partially mutilated and discolored upper central incisors. Vitality tests of all the teeth showed positive response for thermal and electric pulp testing indicating the vital status of the pulp. The radiographic examination showed no abnormality of the hard tissue at the periapical area. Diagnosis was made as Turner's hypoplasia of upper two central incisors with proximal caries. Treatment planning was done after considering many factors such as conservation of tooth structure, esthetics, occlusion, and economy.\nDuring the initial appointment, thorough oral prophylaxis was done. Impressions were made with alginate impression material (Zelgan Plus, Dentsply India Pvt. Ltd, India). Study models were prepared. Proximal caries were removed and composite resin build up with Filtek™ Z250 (3M ESPE, Dental Products, St. Paul. U.S.A) was done to restore the hypoplastic defects and the carious defects. Tooth preparation was done to receive edge-up, all ceramic partial crowns for both the upper central incisors.[] Deep chamfer finish lines were given using SC850-018, supercoarse, round end taper diamond point (IQ Dental Supply Inc.). Finish lines were kept at the junction of middle third and cervical third of the crown to include all the enamel defects and to also conserve the remaining healthy tooth structure to remain untouched. Tooth reduction was done for about 1 mm all around to accommodate ceramic material. Bite was corrected by occlusal contouring of the lower teeth. Secondary impressions were made using vinyl polysiloxane impression material (Dentsply Caulk, USA) and custom made acrylic temporary crowns were cemented with a zinc oxide eugenol (Dental Products of India, Mumbai, India) temporary luting cement material. Ceramic edge-up partial crowns were prepared using pressable all ceramic material (Cergo Kiss, Dentsply, India). Teeth were polished with pumice and cleaned thoroughly to remove eugenol, if any. Crowns were checked for occlusion and cemented with resin cement Rely X™ Veneer cement (3M ESPE, Puerto Reco). Crown margins were polished with ceramic polishing kit (Shofu, Inc., Japan) []. Six months follow-up showed the crown margins are in satisfactory condition [].