Abstract: Objective: This article presents a case about a right upper central incisor with chronic apical periodontitis, which achieved infection control, aesthetic adjustment and functional recovery, through personalized comprehensive diagnosis and treatment. Diagnosis and treatment: The chief complaint tooth was the abutment of the old fixed bridge. After the old fixed bridge was removed, the right upper central incisor was treated with microscopic endodontic treatment. After 8 months, there was still lesion after root canal therapy. The over filling, cyst-like change and possible extra-root infection were corrected through apical microsurgery. During the period, regular periodontal initial treatment was performed, and other wedge-shaped defects were filled with composite resin. Functional suitability and aesthetic diagnosis wax pattern was used for aesthetic adjustment and functional adaptation. The patient chose the fixed bridge considering the course of treatment, cost, aesthetics, function and prognosis. Results: The periapical inflammation of the right upper central incisor was controlled, and the function and aesthetics of tooth defect and dentition defect were well restored. Conclusions: Through one-step personalized comprehensive diagnosis and treatment, the communication cost and referral times between different specialties of the patient were reduced.

Key words: chronic apical periodontitis, comprehensive diagnosis and treatment, apical microsurgery, abutment, fixed bridge