RESTORING FUNCTION AND AESTHETICS WITH ALL CERAMIC ZIRCONIA CROWNS, ROOT CANAL TREATMENTS AND A DENTAL IMPLANT

CASE STUDY VIII– RESTORING FUNCTION AND AESTHETICS WITH ALL CERAMIC ZIRCONIA CROWNS, ROOT CANAL TREATMENTS AND A DENTAL IMPLANT

 

INTRODUCTION: A 60-year-old male patient visited Smile Delhi – The Dental Clinic, New Delhi, with concerns about severely worn front teeth, discomfort while chewing, and recurring pain accompanied by an abscess in the upper right back tooth region. The patient was also concerned about an existing crown that had developed decay underneath, compromising both function and oral health.

Following a comprehensive clinical examination, a multidisciplinary treatment plan was developed to restore the patient’s oral function, eliminate infection, and rehabilitate his smile. The treatment included root canal treatment, full-mouth crown rehabilitation, dental implant placement with bone grafting, restorative fillings, and a custom night guard. The result was a healthier, stronger, and more aesthetically pleasing smile with improved long-term stability.

 

PATIENT BACKGROUND: The patient presented with significant wear of the anterior teeth, affecting both appearance and function. Over time, the excessive wear had altered the shape and length of the front teeth, resulting in an aged appearance and compromised bite function.

In addition to the worn dentition, the patient reported persistent pain and swelling in the upper right molar region. Clinical examination also revealed an old crown with recurrent decay beneath it, contributing to infection and discomfort. The patient sought a comprehensive solution that would address both the immediate dental concerns and the overall condition of his dentition.

 

INITIAL ASSESSMENT & DIAGNOSIS:  A detailed clinical examination was performed to evaluate the condition of the patient’s teeth, bite, and supporting structures.

The assessment revealed:

• Severe wear of the upper and lower anterior teeth.
• Infection and abscess associated with the upper right second molar.
• Recurrent decay beneath an existing crown restoration.
• Structural compromise of multiple teeth requiring full-coverage restorations.
• A non-restorable upper right first molar requiring extraction and replacement.
• Occlusal wear patterns suggestive of excessive grinding forces, indicating the need for long-term protection through a night guard.

Based on these findings, a comprehensive rehabilitation plan was recommended to eliminate infection, restore the worn dentition, replace the missing tooth with a dental implant, and protect the final restorations from future wear.

TREATMENT PLAN: The recommended treatment plan consisted of multiple phases designed to restore both function and aesthetics while ensuring long-term stability.

The treatment included:

1. Root canal treatment for:
   • Upper right second molar.
   • Lower left first molar.
2. All ceramic zirconia crowns extending from:
   • Upper right first premolar to upper left first premolar.
   • Lower right first premolar to lower left first molar.
3. Extraction of the upper right first molar followed by immediate dental implant placement.
4. Bone grafting at the implant site to enhance stability and support healing.
5. Composite restoration for the upper left second premolar.
6. Fabrication and delivery of a custom night guard to protect the new restorations from excessive occlusal forces and nighttime grinding.

The treatment was carefully staged over multiple appointments to achieve predictable healing and optimal restorative outcomes.

TREATMENT PROCESS:

Phase 1 – Crown Preparation and Temporary Restorations

14 February 2026

Treatment commenced with the preparation of teeth requiring crowns. The upper teeth from the upper right first premolar to the upper left first premolar and the lower teeth from the lower right first premolar to the lower left first molar were prepared.

Following tooth preparation, high-precision impressions were obtained, and temporary crowns were fabricated and placed to maintain function, aesthetics, and patient comfort during the laboratory phase.

Phase 2 – Endodontic Treatment and Implant Placement

16 February 2026

Root canal treatment was successfully completed for the upper right second molar and lower left first molar to eliminate infection and preserve these strategically important teeth.

During the same appointment, the upper right first molar was extracted and replaced with a dental implant. To improve primary stability and support long-term implant success, bone grafting material was placed around the implant site.

The procedure was completed successfully, and post-operative instructions were provided to support healing.

Phase 3 – Final Restorative Phase

19 February 2026

After confirming satisfactory healing and restoration fit, the definitive all ceramic zirconia crowns were cemented. These restorations re-established proper tooth anatomy, function, and smile aesthetics.

A composite filling was also placed on the upper left second premolar to restore structural integrity and prevent future complications.

Phase 4 – Protective Appliance Therapy

20–21 February 2026

During the follow-up visit, healing was assessed and found to be progressing satisfactorily.

Impressions were taken for a custom-made night guard designed to protect the newly restored teeth and crowns from excessive biting forces and parafunctional habits.

On 21 February 2026, the night guard was delivered and adjusted for optimal comfort and effectiveness.

 

 

RESULTS & OUTCOME: The treatment successfully addressed all of the patient’s concerns, including pain, infection, tooth wear, and compromised restorations.

The completed rehabilitation provided:

• Elimination of infection and abscess-related discomfort.
• Restoration of severely worn anterior teeth.
• Improved bite function and chewing efficiency.
• Replacement of the compromised upper right first molar with a stable dental implant.
• Enhanced aesthetics through full-mouth crown rehabilitation.
• Improved support and protection through a custom night guard.
• Long-term preservation of remaining natural teeth.

The patient reported significant improvement in comfort, function, and confidence following completion of treatment. The final restorations restored natural tooth proportions while maintaining harmony with the patient’s facial features and occlusion.

Before

After

PATIENT FEEDBACK:

 

DENTIST’S INSIGHT: This case demonstrates the importance of addressing both disease and function when planning comprehensive dental rehabilitation. The patient’s worn dentition, infected molar, and failing restorations required a coordinated approach involving endodontic treatment, implant dentistry, restorative dentistry, and preventive care.

By combining root canal therapy, implant placement with bone grafting, full-mouth crown rehabilitation, and protective appliance therapy, it was possible to restore not only the patient’s smile but also the long-term stability of the dentition. Careful treatment sequencing and attention to occlusal management were key factors in achieving a successful outcome.

 

 

CONCLUSION: Comprehensive dental rehabilitation can dramatically improve both oral health and quality of life when multiple dental concerns are addressed through a coordinated treatment approach. In this case, the combination of root canal treatment, dental implant therapy, full-mouth crowns, and a custom night guard successfully restored function, aesthetics, and comfort.

If you are experiencing worn teeth, recurring dental infections, missing teeth, or failing restorations, the team at Smile Delhi – The Dental Clinic in New Delhi can create a personalized treatment plan to help restore your smile and confidence.

Book a consultation today to learn more about your treatment options and begin your journey toward a healthier smile.