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J Esthet Restor Dent. 2018 Jan;30(1):22-29. doi: 10.1111/jerd.12336. Epub 2017 Sep 19.

Multidisciplinary full-mouth rehabilitation with soft tissue regeneration in the esthetic zone.

Author information

1
Department of Prosthetic Dentistry, University Hospital, Ludwig-Maximilians-University, LMU Munich, Munich, Germany.
2
Master Dental Technician (MDT), Platform Laboratory, Munich, Germany.
3
Department of Periodontology, Center for Dental, Oral and Maxillofacial Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.

Abstract

OBJECTIVE:

Oral rehabilitation often requires a multidisciplinary approach including restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension. The presence of gingival recessions can be associated with numerous factors, such as brushing or preparation trauma and persistent inflammation of the gingiva due to inadequate marginal fit of restorations. Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Especially in patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted.

CLINICAL CONSIDERATIONS:

This case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long-term polymethyl methacrylate provisionals as a communication tool between all parts involved. All-ceramic crowns were inserted after periodontal healing as definitive rehabilitation.

CONCLUSIONS:

Complex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician.

KEYWORDS:

ceramic; connective tissue graft; minimally invasive restorations

PMID:
28925546
DOI:
10.1111/jerd.12336

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