Noninvasive interdisciplinary treatment of a dischromic partially worn dentition

Abstract

According to the classic concepts of prosthodontics the treatment of a patient presenting severely worn and dischromic dentition would involve a complex and demolitive treatment including periodontal surgery, endodontic therapy, posts and cores, and crowns; nowadays these problems can be solved with noninvasive procedures that allow preservation of dental and periodontal tissues. This article describes the interdisciplinary team approach (orthodontist, dental technician, prosthodontist) for the treatment of a patient showing attrition of the mandibular incisors in a deep bite relationship, contraction of the posterior sextants of both arches, diastemas in the anterior region of the maxilla, and highly dischromic teeth. The gingival tissue levels and the tooth malposition were corrected by orthodontic therapy, the abraded and the healthy dischromic teeth were restored with 20 additional veneers (the molars were the only teeth not involved in the restorative phase); tooth structure, tooth vitality, and bone level were maintained. No provisional restorations were delivered and no anesthesia was necessary either for tooth preparation or final impression. A protocol is shown to treat in a conservative and comfortable manner the structural and esthetic problems in a patient presenting highly dischromic teeth, worn mandibular incisors, and diastemas on the maxillary sextant.

Keywords: adhesion enamel; bruxism; dental technology; dischromic dentition; minimally invasive dentistry; orthodontics; prosthodontics; tooth wear.