Tapananon Alisa, Kamolroongwarakul Pongrapee, Buranaprasertsuk Phonlakorn
Phyathai 2 Hospital Dental Center, Phyathai 2 Hospital, Bangkok, Thailand, Phone: +66 26172444, e-mail:
Phyathai 2 Hospital Dental Center, Phyathai 2 Hospital, Bangkok, Thailand, Orcid: https://orcid.org/0009-0000-4808-7537.
J Contemp Dent Pract. 2025 May 1;26(5):512-518. doi: 10.5005/jp-journals-10024-3881.
This clinical case report describes the multidisciplinary treatment workflow for a complex rehabilitation case to correct skeletal class II malocclusion, bilateral congenitally missing premolars, and improve the esthetic smile in tetracycline-stained teeth.
The anterior esthetic zone plays a crucial role in the overall appearance of a patient's smile. Tooth discoloration and congenitally missing premolars are frequently reported in young adults, affecting both esthetics and function. The tetracycline-stained teeth and visible absence of premolars can impact a patient's self-esteem by creating noticeable gaps in the smile. Missing premolars may also cause the remaining teeth to shift, impair the ability to chew effectively, which may lead to uneven wear or malocclusion. Treatment options require a multidisciplinary approach involving an orthodontist, an oral surgeon, and a prosthodontist.
A 34-year-old female presented to a private hospital with complaints of chewing difficulties due to bilateral congenitally missing premolars and was unsatisfied with her smile due to tetracycline-stained teeth. She had a history of taking tetracycline for respiratory infections over the past 30 years. This clinical case report describes the treatment workflow for this complex rehabilitation case, utilizing digital planning to correct skeletal class II malocclusion and create sufficient restorative space for the missing premolars (teeth 12, 13, 20, and 29 according to the universal numbering system) to allow for implant placement with clear aligners. The esthetic smile was enhanced using CAD/CAM technology to fabricate final lithium disilicate restorations. Follow-up over 18 months confirmed the success of the treatment, with the patient expressing satisfaction with both the functional and esthetic outcomes.
A multidisciplinary management for the treatment of a complex rehabilitation case involving orthodontic treatment before implant placement and subsequent restorative intervention resulted in predictable outcomes with minimal tooth reduction. This technique provided functional stability, improved esthetics, and increased patient satisfaction.
With careful planning and precise execution, the gradual incorporation of digitally guided orthodontic-restorative planning, in conjunction with CAD/CAM technology, can simplify the treatment workflow, leading to accuracy and predictability in complex rehabilitation cases. How to cite this article: Tapananon A, Kamolroongwarakul P, Buranaprasertsuk P. Minimally Invasive Multidisciplinary Management of Tetracycline-stained and Congenitally Missing Teeth. J Contemp Dent Pract 2025;26(5):512-518.
本临床病例报告描述了一个复杂康复病例的多学科治疗流程，该病例旨在矫正骨性II类错牙合、双侧先天性前磨牙缺失，并改善四环素牙患者的美观笑容。
前牙美学区在患者整体笑容外观中起着至关重要的作用。牙齿变色和先天性前磨牙缺失在年轻人中经常出现，影响美观和功能。四环素牙和明显的前磨牙缺失会在笑容中造成明显间隙，从而影响患者的自尊心。前磨牙缺失还可能导致其余牙齿移位，损害有效咀嚼的能力，进而可能导致牙齿磨损不均或错牙合。治疗方案需要正畸医生、口腔外科医生和修复医生的多学科方法。
一名34岁女性因双侧先天性前磨牙缺失导致咀嚼困难，且因四环素牙对自己的笑容不满意，前往一家私立医院就诊。她在过去30年中有因呼吸道感染服用四环素的病史。本临床病例报告描述了这个复杂康复病例的治疗流程，利用数字化规划矫正骨性II类错牙合，并为缺失的前磨牙（根据通用编号系统为牙齿12、13、20和29）创造足够的修复空间，以便使用透明矫治器进行种植体植入。使用CAD/CAM技术制作最终的二硅酸锂修复体，增强了美观笑容。18个月的随访证实了治疗的成功，患者对功能和美观效果均表示满意。
对于涉及种植体植入前正畸治疗和后续修复干预的复杂康复病例，多学科管理可实现可预测的结果，且牙齿减少最少。该技术提供了功能稳定性，改善了美观，并提高了患者满意度。
通过精心规划和精确执行，逐步将数字化引导的正畸 - 修复规划与CAD/CAM技术相结合，可以简化治疗流程，在复杂康复病例中实现准确性和可预测性。如何引用本文：Tapananon A, Kamolroongwarakul P, Buranaprasertsuk P. Minimally Invasive Multidisciplinary Management of Tetracycline-stained and Congenitally Missing Teeth. J Contemp Dent Pract 2025;26(5):512 - 518.
