Patient 56

Classic case of a long standing fractured restoration on tooth 3.7 (#18) and overerupted 2.7 (#15). A crown preparation on heavily restored 3.7 with limited interocclusal space required heavy occlusal reduction paired with enameloplasty cum dentinoplasty on 2.7 resulting in tactile hypersensitivity. The amalgam restoration on 2.7 was planned for replacement anyways. The goal was to attempt to not need to complete elective endodontics on 2.7 if it could be avoided. A monolithic Zenostar zirconia crown with areas of occlusal minimal thicknesses of 0.5mm (ideally this should always be 1.0mm as a minimum) was fabricated and the opposing occlusion ordered to be reduced further by the laboratory. The Zr crown was prepared for “bonding” via the APC approach (Markus Blatz) and cemented using Panavia SA Plus via a total etch technique (Photobond DC – Kuraray). The 2.7 was restored after removal of the amalgam and reduction of areas of dentin exposure further using a layered approach with Voco Grandio SO with relatively flat occlusal anatomy. All in all, the pulpal vitality has been preserved in 2.7 whilst hopefully allowing a long service life of the Zr crown on 3.7.