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Stage 1: Root Canal Retreatment
Before restorative treatment, the existing root canal filling in the upper right central incisor was reassessed and retreatment was indicated.
Using magnification and contemporary endodontic techniques, the previous filling material was removed, the canal system was cleaned and disinfected, and a new root filling was placed.
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Stage 2: Internal Whitening and General Whitening
Internal whitening, sometimes called the walking-bleach technique, was used to address discolouration within the root-treated tooth.
This was combined with supervised home whitening for the remaining teeth. Completing this stage before crown fabrication allowed the later ceramic shade to be selected against the stabilised tooth colour.
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Stage 3: Post and Core Reconstruction
Following the whitening phase, the upper right central incisor was rebuilt with a tooth-coloured fibre post and core where additional retention was required for the planned crown.
The weakened and repeatedly fractured composite restoration on the upper left central incisor was replaced to provide a stable core for its final restoration.
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Stage 4: Custom e.max Ceramic Crowns
The upper central incisors were restored with individually made e.max ceramic crowns. The laboratory prescription considered the agreed shade, tooth proportions and smile line.
Before fitting, the crowns were assessed clinically for fit, margins, shade, symmetry and bite contacts. They were then bonded following patient approval.
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Post-Treatment Support and Maintenance
The patient received home-care guidance covering daily plaque control around the crown margins, regular dental reviews and professional hygiene appointments.
She was advised to avoid biting hard objects directly with the treated front teeth and to use a protective mouthguard or occlusal appliance if recommended following bite assessment.