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Comprehensive aesthetic rehabilitation for tooth wear and TMJ dysfunction

Comprehensive aesthetic rehabilitation for tooth wear and TMJ dysfunction

Complaints:

Unsatisfactory smile aesthetics, including severe tooth discoloration, uneven tooth shape, chipping in the anterior region, and an overall worn appearance of the teeth. The patient also reported morning fatigue of the masticatory muscles.

Diagnosis:

Aesthetic defect of the anterior teeth: discoloration, wear of the incisal edges, altered tooth anatomy, and enamel microchips. Overloading of the anterior teeth and temporomandibular joint-related muscular dysfunction.

Treatment:

T-Scan analysis was used to assess occlusal overload, and deprogramming was performed to determine the optimal position of the lower jaw. A comprehensive diagnostic assessment was carried out, including a photographic protocol and digital 3Shape scanning. Based on the collected data, a digital smile design was created, the shape of 20 future restorations was planned, and Wax-Up models were fabricated for treatment approval. Tooth preparation was performed under the control of a Seiler operating microscope. Permanent metal-free E.max ceramic restorations were then fabricated and bonded.

In this case, the patient was concerned about severe tooth discoloration, chips in the anterior region, irregular tooth shape, and a worn appearance of the teeth.

In addition, morning fatigue of the chewing muscles and signs of functional overload of the dentofacial system were noted.

During the examination, enamel discoloration, wear of the incisal edges, microchips, and alterations in the anatomical shape of the teeth were identified.

A temporomandibular joint and muscle dysfunction associated with improper distribution of chewing forces was also diagnosed.

Treatment began with gnathological diagnostics using the T-Scan system and chewing muscle deprogramming to determine the optimal position of the lower jaw.

After a comprehensive examination and digital 3Shape scanning, future smile design was performed, and a Wax-Up was created to approve the shape of the future restorations.

Then, under the control of an operating microscope, the teeth were prepared and permanent metal-free ceramic veneers were bonded.

Result:

The proper tooth shape was restored, chips and enamel discoloration were eliminated, and the smile regained its natural aesthetics and harmonious proportions.

After normalization of the occlusal contacts, the overload on the anterior teeth was reduced, discomfort in the chewing muscles decreased, and the smile gained a younger and healthier appearance.

Learn more about comprehensive smile restoration with veneers.

Treatment was performed by:

The prosthetic stage was performed by prosthodontist
Oleksandr Haidaienko