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"A 48 year old patient presented in good health and requested cosmetic treatment options for a misaligned and darkly stained maxillary anterior dentition. The patient was dissatisfied with the esthetics of her current dental condition. Tooth #11 had been avulsed and re-implanted 10 years earlier. The tooth had a mesiolabial rotation and overlapped tooth #21. It also had the typical non-vital darkening relative to her other teeth. Clinical and radiographic examination revealed tooth #11 had a large area of internal root resorption in the cervical third of the root. An endodontic consultation revealed a hopeless prognosis and a recommendation for extraction. The treatment plan consisted of extracting the coronal third of the root of tooth #11 along with its crown and inserting Perio-Glass (a synthetic bone graft material) to maintain the labial palatal width of bone. The apical aspect of the clinical crown was recontoured to form an ovate pontic and rebonded in place for the ovate site to heal for 4-6 weeks. A Vectris™ framework from 12-21 and six IPS Empress® Veneers from 13-23 finalized the treatment. The SMILES evaluation sheet indicated that some of the principles of smile design had been violated resulting in the patient's unesthetic smile. She selected the Enhanced mould of teeth from the LVI Smile Catalog. The patient was very pleased with the final result." - Dr. A. Mancuso
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