Gingiva discoloration

Dear colleagues, 

I would like to share this case with you: 

A 43-year old female patient was referred to our clinic because of an unpleasant situation in the upper front region.

She wishes an esthetic improvement of the tooth 21, which was root canal treated many years ago.

In the picture you recognise the grayish discoloration of the surrounding gingiva and the opaque, unesthetic PFM crown.

The x-ray shows a massive post and an apical radiolucency.

How would you proceed?

1) Would you perform a revision of the root canal treatment after post removal and restore the tooth with a new crown?

      How would you treat the discoloration of the gingiva?

2) Would you extract the tooth 21 and place an implant?

3) Would you propose an other treatment option?

Thank you  for your comments!

Best regards


02.11.2016, 10:08

Dear  Riccardo

Thanks.  My work is not beautiful but my Technician is very excellent work.

I did not treat root canal treatment in my case.  I only changed from metal cores to fiber cores.

There is nothing abnormality finding for X-ray, CBCT and patient's claim. (Sorry, I do not have these dates now)

Well,  I thought your patient has medical history of apicoectomy. Because The Root apical figure is straight. 

If she has not medical history of apicoectomy, I think that this tooth will be  poor prognosis. (root apical is absorbed)

I support that to extract the tooth 21 and place an implant. 



11.11.2016, 20:42

Deat Toshihiko

Thank you very much for your case. You achieved a beautiful result!

I think your material choice make absolutely sense. I'll take it into consideration!

Would you try to remove the post in order to treat the apical periodontitis (revision of the root canal treatment)?


Best regards


09.11.2016, 14:25

Dear Riccardo

I would like to share my case. My patient claim to improve an esthetic zone too.

She did not need root canal treatment. I just restored new clowns to chose zirconia coping.

Because her root colours change to dark.

I would be happy if my opinion become a help.

Best regards 


03.11.2016, 14:15