25 years old female patient come to clinic asking for restoring her teeth , I told her I will try my best to save them better than extraction indeed
Initial situation showing the 2 premolars that covered partially by the gingiva with massive destruction in tooth structure
Buccal view
Preoperative x ray shows the status of the roots with good crown root ratio ,status of the bone ,periapical lesion in the first premolar
1st visit I start with first premolar ,First of all gingivectomy done , 1mm of bone removed in the interdental aspect between First and second premolar, isolation with rubberdam and I you can isolate it you can fix it
Because I use the b4 clamp on the tooth to get good isolation I build every missing wall alone so I build the distal wall first and then the mesial wall
Pre endo build up of First premolar with First visit endo treatment
Buccal view showing the build up
6 days later ,look to the healing of the gingiva ,let's restore the second premolar
2nd visit ,As the same with 1st premolar I do to 2nd premolar, isolation, pre endo build up and 1st visit endo treatment
The premolars now completely built and the margins elevated, now we are ready to complete the endodontic treatment prior to overlay each one 😁
Buccal view showing the build up , now we have a good composite build up , waiting for the healing
40 days later , look to the healing ✨️
3rd visit , Isolation , endodontic treatment
Endodontic treatment for both , single cone obturation with bioceramic sealer (Neosealer), temporary filling
4th visit , One week after obturation and 53 days from the beginning of the treatment ,look to the healing ✨️ this is the days of the preparation
Overlay preparation for both premolars , always macro-core build up for endodontically treated premolars for extra retention as the surface area for Bonding here less than that in the molars
Buccal view of the preparation, you can see the macro core , finish line and also the gingival Healing 😍
X ray after D.M.E and biobase preparation
Impression taking and temporization
The overlay on the Cast
5th visit, after one week of preparation and 60 days from the beginning of the treatment, finally the cementation day ,healing as it should be
Isolation, biobase air abraded
Cementation of 2nd premolar, access removal and before the curing I will insert the 1st premolar overlay and cure them together
Cementation of the 1st premolar with heated composite
Curing for both ,immediate result
Buccal view after 60 hard days 😅
Immediate result
Buccal view 😍
Occlusal view ,no high spot detected
8 days later, gingival Healing in progress ✨️
8 days later
Lingual view
Post DME and preparation X ray , you can see the macrobuild up ,bone level and DME
Final x ray showing the fitness of the restoration 😍
Final x ray , hope you like it
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