THE CASE FILES CASE 007 — MAXILLARY CENTRAL INCISOR

The front tooth that stayed.

At 62, with a fractured front tooth and a failed root canal beneath it, extraction and an implant seemed inevitable. The patient asked for one more opinion first.

RESTORATIVE ✦ MODERATE 90 MINUTES
One-year recall — stable tooth with definitive crown restoration
Fractured maxillary central incisor with significant coronal tooth loss
BEFORE AFTER
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The front tooth that stayed
CASE 007 — RESTORATIVE · TORRANCE
THE PLATES — FULL SEQUENCE
THE CASE

One tooth's journey, in four beats.

01
THE PROBLEM

One recommendation: pull it.

A 62-year-old Redondo Beach patient with a fractured central incisor over an inadequately filled root canal. Another provider had reasonably recommended extraction and an implant.

02
THE PICTURE

The tooth had more to give.

The exam found sound root structure below the fracture, no infection at the tip, and enough tooth for a ferrule — the conditions where saving beats replacing.

03
THE WORK

Three phases, ninety minutes.

The old, void-riddled filling removed and the canal properly resealed; a fiber post bonded into the root for reinforcement; a composite core built up ready for the crown.

04
THE RETURN

A year later, indistinguishable.

Crowned by her own dentist, the tooth matches its neighbor in color and contour — asymptomatic, stable bone, and a fraction of an implant's cost and timeline.

THE PROTOCOL
  •   Old gutta-percha removed with solvents and ultrasonics under magnification
  •   Canal re-instrumented, disinfected, and sealed with warm vertical compaction
  •   Post space prepared, keeping a 4–5mm apical seal
  •   Fiber post bonded adhesively — flexes with the tooth, unlike metal
  •   Composite core built with a 2mm ferrule for the crown
  •   Definitive crown at the patient's own dentist within weeks
WHAT THIS CASE TEACHES

What this case teaches.

SECOND OPINION "Hopeless" is an opinion Another provider had reasonably recommended extraction and implant. Specialist evaluation found enough root to build on — the patient kept their tooth.
MATERIALS Fiber, not metal A fiber post flexes like dentin instead of concentrating stress — lower fracture risk, bondable, retrievable, and invisible under the crown.
HONESTY Extraction stayed on the table Had retreatment failed, implant remained the backup. Trying to save the tooth first cost nothing but the attempt — and it worked.
CLINICAL DISCLAIMER: PRESENTED FOR EDUCATIONAL PURPOSES WITH PATIENT CONSENT. IDENTIFYING INFORMATION REMOVED PER HIPAA. INDIVIDUAL RESULTS VARY. ALL IMAGES REPRESENT ACTUAL PATIENT TREATMENT.

Told extraction is the only way?

Get the second opinion before the tooth is gone. Extraction is always available later; saving isn't.