Single-tooth rehabilitation: a multidisciplinary approach: a case report

Abstract

Extensive coronal destruction represents a restorative challenge that often requires a multidisciplinary approach to achieve functional rehabilitation. Subgingival lesions compromise isolation and the restorative margin, making the re-establishment of the biologic width essential prior to definitive restoration. This study aimed to present the single-tooth rehabilitation of an element with severe coronal loss, detailing an integrated clinical sequence involving crown lengthening, pre-endodontic dentin sealing, endodontic retreatment, and semidirect adhesive rehabilitation. A 33-year-old female patient attended the dental clinic reporting pain and a fractured tooth. Clinical examination revealed extensive coronal fracture and a previously treated root canal with probable contamination. The proposed treatment included crown lengthening to expose sound structure, followed by pre-endodontic dentin sealing for protection and reinforcement of the remaining substrate. Endodontic retreatment was then performed through desobturation, reinstrumentation, and new obturation. Finally, an adhesive biobase and semidirect restoration were completed. The integrated approach between periodontics, endodontics, and adhesive dentistry proved effective in restoring function, esthetics, and tissue stability, enabling the predictable rehabilitation of an extensively compromised tooth. The interdisciplinary approach involving Periodontics, Endodontics, and Adhesive Dentistry was fundamental in achieving clinical predictability and long-term tissue stability. Clinical crown lengthening was decisive in reestablishing an adequate periodontal relationship, allowing proper exposure of healthy dental structure. Pre- endodontic dentin sealing, combined with endodontic retreatment, significantly contributed to reducing microleakage, increasing adhesive bond strength, and protecting the remaining tooth structure. Furthermore, the semi-direct restorative technique provided a favorable balance between mechanical strength, structural preservation, and clinical effectiveness, establishing itself as a conservative and durable alternative with a lower risk of structural failure.