Reconstruction Of Maxillary Central Incisor With Gingivectomy And Crown Restoration

Repairing extensively damaged incisors poses a significant obstacle. The existence of a suitable ferrule reduces the influence of the post system and the ultimate restoration on the function of endodontically treated teeth. In this case, a fractured maxillary central incisor was restored with a post and crown, and an adequate ferrule was obtained through gingivectomy. A 78-year-old patient came to the clinic with the chief complaint that her upper right front tooth was broken. Through clinical examination, the upper right central incisor showed a class III crown fracture. Endodontic treatment, gingivectomy, and crown restoration were planned. After the endodontic treatment, the dentin walls were coated with cement (RelyX Ultimate). For bonding, 35% phosphoric acid was used for etching, dentin walls and posts were rinsed and gently dried, followed by application of the adhesive system (Single Bond Universal). The resin core system (Nexcore) was used for restoration. A gingivectomy was performed before crown restoration. While it may be challenging to obtain a ferrule encircling the entire margin in certain clinical circumstances, having an incomplete ferrule of 0.5 mm or more significantly improves fracture resistance compared to having no ferrule at all. By performing gingivectomy, it was able to secure a 360-degree ferrule about 1-1.5 mm before the final impression of the crown. In certain clinical situations where a complete ferrule cannot be obtained, a partial ferrule may be considered. Crown lengthening procedures, including a simple gingivectomy, can be used to obtain an adequate ferrule.