Esthetic and functional management of an ankylosed central incisor with a conservative restorative approach

In this case report, we share a conservative and simple restorative management approach for a relatively complex esthetic situation on an adult patient with an ankylosed maxillary central incisor in infra-occlusion. A 37-year-old healthy female patient presented for a consultation with a chief complaint of an unappealing smile. The intraoral exam revealed tooth #8 (FDI 11) was in obvious and significant infra-occlusion due to altered eruption. Periapical radiographs of this area were non-contributory and all teeth responded within normal limits to pulp vitality tests. After review of several treatment options, the patient opted for a conservative restorative approach in which a partial ceramic veneer was planned for the ankylosed tooth, while composite resin was used on the contralateral central incisor to achieve a symmetric and pleasant result. Clinical Significance: A relatively complex clinical problem was satisfactorily resolved with a very conservative option in which composite resin and a ceramic veneer were used to restore an asymmetric smile.