Restorative & Materials · patient case question
Given the wear facets and the esthetic demand, which material is MOST appropriate for the replacement?
Patient case: Failing anterior crown in a bruxer
Patient: 49-year-old woman.
Chief complaint: My crown feels loose and it does not match my other teeth.
History: Crown placed approximately twelve years ago. Partner reports night-time grinding.
Findings: Porcelain-fused-to-metal crown on a maxillary anterior tooth with a visible metal collar at the margin and gingival recession. The crown is markedly brighter and whiter than the adjacent teeth, which are distinctly yellow. Generalized wear facets on the posterior teeth. The crown moves on digital pressure.
Show answer and explanation
Correct answer: D. Monolithic zirconia
- A. A thin feldspathic veneer will not survive parafunction and does not replace a full-coverage restoration.
- B. Gold has excellent mechanical properties but is unacceptable esthetically on an anterior tooth.
- C. Repeating the metal-collar design reproduces exactly the complaint that brought her in.
- D. CORRECT. Monolithic zirconia gives high flexural strength for a parafunctional patient with no metal substructure, so there is no dark cervical line now or after further recession. Lithium disilicate has the edge esthetically where translucency matters most, but strength is the governing concern in a bruxer.
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