The Richmond Crown Returns: A Laser-Assisted Approach to Restoring a Grossly Fractured Maxillary Central Incisor

Abstract

Extensive coronal destruction following trauma or caries presents a recurring challenge in prosthodontic rehabilitation, particularly in the esthetic zone. A multidisciplinary approach combining traditional post-core systems with contemporary surgical adjuncts ensures optimal long-term outcomes. This paper reports the management of a grossly fractured maxillary central incisor using a Richmond crown following diode laser-assisted crown lengthening. A 21-year-old male patient presented with pulpal necrosis and apical periodontitis in tooth 21. After nonsurgical endodontic therapy, post space preparation was performed while preserving a 5 mm apical seal. Diode laser gingivectomy allowed for biological width preservation and adequate ferrule creation. An indirectly fabricated Richmond crown was luted using glass ionomer cement. Six-month follow-up confirmed the restoration's stability, periodontal health, and patient satisfaction. This report highlights the relevance of combining historically proven techniques like the Richmond crown with minimally invasive adjuncts, offering a conservative, cost-effective, and esthetically superior alternative to implants. It emphasizes the need for clinicians to revisit classical restorative methods, especially in cases with significant structural compromise.