Gil Alfonso, Morón-Conejo Belén, Bonfanti Mónica, Martínez-Rus Francisco, Pradies Guillermo
Associate Faculty at University of Southern California and University International of Catalunya, Sant Cugat del Valles, Spain.
Analysis of Techniques, Material and Instruments Applied to Digital Dentistry and CAD/CAM Procedures Research Group, Complutense University of Madrid, Madrid, Spain.
J Esthet Restor Dent. 2025 Mar;37(3):792-800. doi: 10.1111/jerd.13416. Epub 2025 Jan 28.
This case report presents the interdisciplinary retreatment of a patient with a worn full-mouth rehabilitation using defect-oriented restorations, horizontal preparations, and vertical dimension of occlusion (VDO) increase.
A 58-year-old woman with a previous full-mouth rehabilitation presented with worn dentition, loss of VDO, and reduced posterior support. Examination revealed signs of parafunctional habits, tetracycline-stained teeth, and compromised aesthetics with exposed discolored teeth and open embrasure spaces. Additionally, the veneers showed wear and ceramic chipping. The retreatment started with a diagnostic phase, including a wax-up and mock-up to guide the treatment plan. Mucogingival surgery was performed to correct gingival recession according to the restorative margins established by the mock-up. The full-mouth rehabilitation involved increasing the VDO through anterior crowns and veneers, posterior overlays, and dental implant restoration. Horizontal chamfer preparations ensured sufficient thickness for the ceramic material, allowing for durable adhesive restorations.
The interdisciplinary approach, combining diagnostic, surgical, and prosthetic phases, enabled the successful retreatment of this complex case, restoring function and aesthetics. A 2-year follow-up confirmed the stability and positive outcomes of the rehabilitated dentition.
This interdisciplinary approach provides an effective strategy for managing complex full-mouth rehabilitations, integrating aesthetics, function, and periodontal health through defect-oriented preparation techniques.