Sectioning & Removal of Existing Bridge with Root Canal Treatment and Full Zirconia Bridge Reconstruction (#13–#23)
Non-Surgical
Chief Complaint
Patient required removal of existing compromised crown and bridge, completion of root canal treatment, and fabrication of a new full zirconia bridge.
Clinical Findings
Existing crown on #14 and bridge from #13 ↔ #23 indicated for removal.
#13 and #14 required root canal treatment.
Calcified canal observed in #14.
Existing restorations and bridge not salvageable.
Pre-operative CBCT reviewed showing no acute pathology.
Treatment Plan
Section and remove crown #14 and bridge #13 ↔ #23.
Complete RCT for #13 and #14.
Post & core buildup for #13 and #14.
Prepare and fabricate a full zirconia 7-unit bridge from #13 ↔ #14 ↔ #23.
Digital impressions, occlusal records & provisionalization.
Pre-operative Assessment
Detailed discussion of risks, procedure, alternative options, and RCT success rate (85–95%).
Informed consent obtained for RCT #13 and #14.
Pre-operative CBCT reviewed for root morphology, canal calcification, and bridge assessment.
Anesthesia
Local anaesthesia administered.
Patient draped and isolated with rubber dam (RDI).
Surgical Procedure
Root Canal Treatment (#13 & #14):
Access cavity prepared; old restorative materials removed.
Pulpectomy performed under ×10 magnification.
Canals located, negotiated, and widened.
#13:
IAF #15 H-file at 20.0 mm using apex locator.
WL established; cleaning and shaping to #35.
Obturation via vertical condensation and GP backfill.
Fiber post cemented with 3M RelyX Unicem.
Core buildup using GC G-ænial Universal Flo (B1) + 3M Filtek Z350 XT (A2B).
#14:
Calcified canal; canal located using diamond-coated ultrasonic tip under magnification.
IAF #10 H-file at 16.0 mm using apex locator.
WL established; cleaning and shaping to #25.
Obturation with vertical condensation & GP backfill.
Core buildup with EverX Flowable (Dentin) + GC G-ænial Universal Flo (B1).
Irrigation protocol: EDTA, hydrogen peroxide, Milton.
Occlusion checked and adjusted; finishing and polishing completed.
Prosthodontic Phase:
Sectioning and removal of crown #14 and bridge #13 ↔ #23.
Tooth preparation for 7-unit full zirconia bridge (#13–#23).
Gingival troughing and hemostasis achieved using 980 nm laser.
Full arch digital scans taken (upper & lower).
Digital occlusal records captured.
Shade selected: 3M2.
Provisionalization with temporary bridge; cemented and adjusted with GC G-ænial Universal Flo (A2).
Post-operative Assessment
Post-op CBCT taken showing dense root fillings and cores.
Patient stable with no complications.
POI (positive outcome indicators) for both RCT and provisional bridge.