Cacciò Carlotta, Tallarico Marco, Lumbau Aurea Immacolata, Ceruso Francesco Mattia, Pisano Milena
Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy.
Department of Dentistry "Fra G.B. Orsenigo-Ospedale San Pietro F.B.F.", 00189 Rome, Italy.
Reports (MDPI). 2025 Jul 8;8(3):105. doi: 10.3390/reports8030105.
Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow-including intraoral scanning, aesthetic previewing, and mandibular motion analysis-was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome.
牙周受损患者美学区域的修复重建面临复杂的临床挑战,需要在美学、功能和生物学需求之间进行仔细协调。本病例突出了数字牙科、多学科协作以及定期维护在牙周受损患者复杂修复重建中取得长期成功的益处。本病例报告描述了一名39岁男性患者的数字化微创修复,该患者患有III期牙周炎、咬合差异、牙齿松动和切牙间隙。采用了全数字化工作流程,包括口内扫描、美学预览和下颌运动分析,以指导诊断、治疗计划制定和修复体制作。使用生物导向方法(BOPT)进行保守的牙齿预备,并结合定制的临时修复体,以在整个临时阶段支持软组织调节和功能控制。下颌运动追踪有助于设计个性化的前导,以改善咬合并纠正深覆合。切牙间隙最初保留,然后在治疗后期根据美学模拟和患者偏好进行关闭。在临时阶段需要进行一次意外的牙髓治疗,但未发生其他并发症。在四年的随访中,患者牙周和咬合状况稳定,临床指标改善,对美学效果高度满意。