Clinical Case: Functional and esthetic treatment of a complex case through minimally invasive indirect adhesive procedures

About the Case

The 60-year male patient presented with occlusal dysfunction resulting in pathological occlusal wear and abfractions, sore facial and masticatory muscles,  recessive gums and inadequate crown on tooth 21 and large composite fillings on tooth 11. The patient refused orthodontic treatment but agreed to occlusal therapy through extensive rehabilitation. After atlas correction by a specialized therapist the new bite position was defined and tested with an occlusal splint for 3 month. For the necessary VDO increase most of the teeth had to be prosthetically restored. Based on the digital wax-up a mock-up with 3M™ Protemp™ 4 Temporization Material was created to test function and esthetics. Minimally invasive dental preparations were performed through the mock-up and 3M™ Impregum™ Polyether was used for the precision impression. For the anterior teeth feldspathic ceramic restorations and for the posterior teeth lithium disilicate restorations were prepared and bonded with 3M™ RelyX™ Universal Resin Cement and 3M™ Scotchbond™ Universal Plus Adhesive.

From an esthetic and functional point of view this complex restoration can be considered a success despite the lack of orthodontic pre-treatment. The patient is very happy with the result.