Conflict of interest
Certain situations require the dentist to remove an anterior tooth. These conditions may include dental trauma, advanced periodontal disease, extensive root resorption, and endodontic failure. Whenever an anterior tooth is lost, the clinician should provide an immediate replacement to avoid aesthetic, masticatory, and phonetic difficulties and to prevent the drift of adjacent teeth. Conventional solutions to this problem have included the fabrication of a provisional restoration using the adjacent teeth as abutments, removable temporary acrylic prostheses, and resin-bonded bridges (Daly, 1983; Ashley and Holden, 1998; Safirstein et al., 2001). Various treatment modalities are available for the replacement of lost anterior teeth, such as orthodontic closure of the edentulous space with fixed appliances, ap4 of an osseointegrated dental implant, and the classical approach of a conventional fixed partial denture and removable prosthesis (Foitzik et al., 2007; Sangur et al., 2010). Each of these approaches has its own specific advantages and disadvantages in terms of usage, aesthetics, and compatibility.
A fixed, acid-etch bridge offers several advantages over removable appliances, including enhanced aesthetics, ease of use, and avoidance of having to become accustomed to a removable prosthesis (Fahl, 1998; Smidt, 2002; Chafaie and Portier, 2004). This approach would also permit the patient’s natural crown to be used as a pontic for an immediate bridge (Belli and Ozer, 2000), with little or no need for complicated laboratory procedures. The use of the extracted natural crown as a pontic provides the advantage of having the right size, shape, texture, and colour. Moreover, the patient is comforted by the presence of his or her natural tooth. The use of a modified resin-bonded bridge with a natural-tooth pontic provides additional advantages of aesthetic maintenance, tooth conservation, cost effectiveness, and preservation of the lost tooth’s gingival architecture.
A 24-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with a complaint of a mobile maxillary right central incisor. The medical history of the patient was not significant. Dental history revealed an episode of trauma in the maxillary anterior region 5years ago. On clinical examination, the maxillary right central incisor showed grade III mobility, and the adjacent (left) central incisor was tender to percussion (Fig. 1a). The adjacent teeth were checked for vitality, and the maxillary left central incisor showed no response. For the right central incisor, radiographic examination revealed extensive root resorption and periradicular bone loss (Fig. 1b). X-rays also displayed widening of the periapical periodontal ligament of the left central incisor.
The present era of dentistry relies extensively on aesthetic principles because of increasing patient demands. A restorative dentist should try to meet these demands, while simultaneously considering the patient’s socioeconomic status. Immediate replacement of lost anterior teeth prevents psychological and social trauma to the patient. A resin composite may be used to splint the pontic to sound neighbouring teeth as a provisional restoration until the final prosthesis is fabricated. One major advantage of retaining the patient’s natural crown is brown algae the patient can better tolerate the effect of tooth loss (Ashley and Holden, 1998).