Esthetic Rehabilitation of Traumatically Fractured Maxillary Central Incisors Using Custom Cad-cam Zirconia Post and Core: A Case Report

Abstract

Traumatic fractures of maxillary anterior teeth can cause substantial functional and aesthetic impairment, particularly when extensive coronal tooth structure is lost after endodontic treatment. This case report describes the aesthetic rehabilitation of a 22-year-old woman with Ellis Class III fractures of teeth 11 and 21 following a road traffic accident two years earlier. Both teeth had been endodontically treated and were asymptomatic, with satisfactory obturation and no radiographic evidence of periapical pathology or root resorption. Approximately 3–4 mm of coronal tooth structure remained, with a 2–3 mm ferrule. Post spaces were prepared using Gates Glidden drills and Peeso reamers while preserving 4–5 mm of apical gutta-percha. After gingival retraction, a single-step addition-silicone impression was made with Aquasil. The impressions were scanned with a Dentsply Sirona laboratory scanner, and custom one-piece zirconia post-and-core restorations were designed in inLab software and milled using an inLab MC X5 unit from CEREC Zirconia ML blocks in shade A2. The restorations were finished, sandblasted, evaluated intraorally, and cemented with dual-cure resin cement; postoperative radiographic assessment confirmed satisfactory adaptation. Definitive prosthetic rehabilitation was subsequently completed. At the three-month follow-up, the clinical outcome remained satisfactory. Within the short follow-up period of this case, the CAD-CAM-fabricated custom zirconia post-and-core approach provided satisfactory adaptation and supported aesthetic rehabilitation of the extensively damaged anterior teeth.