Complex esthetic and functional rehabilitation

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Fig. 2a: Lateral view from the left at dynamic occlusion: traumatic contacts during functional movements have led to extensive loss of enamel and exposure of dentin

Fig. 2b: Lateral view from the right at dynamic occlusion: loss of canine guidance and severe destruction of maxillary and mandibular anterior teeth

Fig. 3a: Frontal view at protrusion: traumatic contacts have led to substantial changes in the morphology of the teeth.

Fig. 3b: Frontal view at protrusion following the restoration: the function and esthetics of the dental morphology has been restored.

Fig. 4: Onlays made of leucite-reinforced glass-ceramic (IPS Empress Esthetic). The minimum layer thickness of the occlusal surface is 1.5 mm.

Fig. 5: Adhesive placement of the restorations in the mandible using the total-etch technique and rubber dam isolation

Fig. 6a: Onlays on teeth 34 to 37 after adhesive cementation in 2004 (cf. Fig. 4)

Fig. 6b: Onlays on teeth 34 to 37 in the summer of 2015, after having been in situ for eleven years (cf. Fig. 6a)

Fig. 7a: Preoperative situation: mandibular anterior teeth showing substantial changes in proportion and exposure of dentin due to a reduction in VDO.

Fig. 7b: Layered veneers (IPS d.SIGN) in the mandibular anterior region after adhesive cementation

Fig. 7c: Mandibular veneers in the summer of 2015: a severe wear facet has formed on tooth 43 over the eleven years since the veneers were placed (cf. Fig. 8b).

Fig. 1: Preoperative situation: severely impaired esthetic appearance due to a loss of vertical dimension of occlusion (VDO) and the formation of a reverse smile line due to extensive loss of tooth structure

Figs 8a to f: Portrait pictures taken more than eleven years after the placement of the restorations. The esthetic and functional requirements of the patient have been and continue to be fully satisfied.