Rehabilitation of anterior teeth I—combination of complete and partial coverage restorations
This case discusses improving/idealizing tooth position, tooth proportion, and tooth color in the maxillary anterior sextant using porcelain laminate veneers (PLV) and all-ceramic, full-coverage restorations. In this case Procera alumina crowns were placed on the maxillary lateral incisors (7 and 10), and PLVs were placed on the central incisors (8 and 9).
CASE STORY
A 33-year-old male presents to the dental office with a chief complaint of “I am not happy with my smile and the position of my front teeth and I want a quick solution.” He continues to explain that orthodontic treatment was recommended ilmis early teens, but at that time finances did not allow for this option.
For more information regarding anterior restorations, refer to Cases 11-15.
Figure 1: Pretreatment frontal view.
Figure 2: Pretreatment incisal display.
Figure 3: Tooth preparation completed: central incisors for PLV, lateral incisors for full-coverage crowns.
Figure 4: Final restorations.
LEARNING GOALS AND OBJECTIVES
- Provide an aesthetic result to idealize tooth position/arrangement and tooth shape and shade, using contemporary restorative materials.
- Care and maintenance for a PLV and all- ceramic, full-coverage restorations
Medical History
- No contributory findings noted
Dental History
- The patient received routine preventive dental care, which included biannual exams, prophylaxis care, and routine radiographs.
- His oral hygiene is good and his caries index is low.
Medications and Allergies
- Takes 1 multivitamin daily
- Penicillin allergy
- Sulfa allergy
Review of Systems
- Vital signs:
- Blood pressure: 118/78
- Heart rate: 70 beats/minute
- Respiration rate: 16 breaths/minute
Social History
- Smoking: no history of smoking or recreational drug use
- Alcohol: patient is a social drinker—approximately 4 glasses of wine per week
Significant Extraoral Findings
- No significant findings
Significant Soft Tissue Findings
- Lips appear a bit dry, symmetrical, and normal shape, size, and color
Clinical Findings/Problem List
- Misaligned maxillary incisors
- Tooth proportions
Diagnosis
- Misaligned maxillary teeth
Clinical Decision-Making Determining Factors
- To provide the patient with an aesthetic result without orthodontic intervention, proper diagnosis, thorough evaluation, and a comprehensive treatment planning are fundamental. This case report presents the strategy of a comprehensive evaluation, diagnosis, and treatment focusing on the patient’s slightly compromised position and discoloration of the anterior maxillary dentition. Orthodontic treatment to align teeth is often not a preferred option for the adult patient, due to a variety of reasons, most commonly time and cost of treatment (Rosenstiel, Ward et al. 2000; Terry and McGuire 2002).
- The veneering of teeth can correct both tooth size and position discrepancies by providing an illusion of alignment of the maxillary central incisors (Snow 1999; Ward 2007).
- As mentioned in previous chapters (11-13), the biggest challenges in anterior aesthetic />
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