What is the most appropriate way to close the diastema?

Correct answer: A. Crowns on both #8 and #9

• A. CORRECT for this specific tooth combination. Tooth #8 is ROOT TREATED with a discoloured crown, and a root-treated anterior tooth that needs both shade correction and width increase is better served by full coverage — it protects the weakened tooth, masks the intrinsic discoloration reliably and gives predictable control of the emergence profile. Matching #9 with a crown gives a symmetrical, predictable aesthetic result across the midline.
• B. A veneer on #8 must bond to a root-treated, discoloured, possibly dehydrated substrate and may not fully mask it. Veneers would be the more conservative choice if BOTH teeth were vital and undiscoloured, which is the usual answer — but that is not this case.
• C. Extraction and implant placement is exactly what should be AVOIDED. Elective bone surgery in a patient on four years of a nitrogen-containing bisphosphonate is the trigger for MRONJ. There is no indication to remove a restorable tooth.
• D. Orthodontics is genuinely the most conservative option and is worth raising with the patient. It is not what the recall item was testing, and in a 67-year-old with a fixed aesthetic complaint and an already-compromised #8 it is often declined.

Note: ⚑ The bisphosphonate is the hinge of this case: it does not change how you restore the teeth, but it firmly excludes any option involving extraction or implant surgery. Note that the exam wants you to recognise the constraint, not to over-treat.