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.
Oral rehabilitation often requires a multidisciplinary approach in 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
- preparation trauma
- persistent inflammation of the gingiva
- inadequate marginal fit of restorations
- functional problems
- Metabolic diseases
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. Patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted.
Our patient was dissatisfied with the appearance of her anterior restorations and also complained about functional problems. This publication provides a documented overview of the planning and implementation of a multidisciplinary treatment concept.
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.
An essential part of the treatment is the regeneration of soft tissue by means of connective tissue transplants. Only after successful periodontal healing could all-ceramic crowns be used as definitive rehabilitation.