This patient presented to our office with a very loose upper right lateral incisor. The patient was not experiencing significant pain or discomfort in the area, but she noted that the tooth was very loose and she was worried that it might come out on its own. The opposing tooth was a porcelain crown with a bite that was too high. The patient had noted this at the time of delivery, but assumed it would resolve on its own. When the patient would bite down, the lateral incisor would move noticeably. The lateral incisor was also rotated out of the ideal position.
After a consultation with the periodontist, it was determined that the tooth could not be saved and needed to be extracted. Impressions were taken of the upper and lower jaw and mounted on an articulator. The tooth was cut back, then re-created to more ideal contours in wax, which was then used as a guide for the shaping of the temporary restoration. The temporary restoration was fabricated using multiple shades of composite material in layers. At the time of delivery, the temporary tooth was cut back so that no pressure would be placed on the underlying bone graft. The temporary Maryland Bridge was bonded to the backs of the adjacent teeth using composite material. The bite was adjusted by shortening the overly long opposing porcelain crown of the mandibular right canine. The shade is a little light, but can be adjusted in the near future when there is greater stability in the bone graft site, if the patient desires.