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Special Issues
July/August 2022
Volume 43, Issue 1

Restoring Esthetics, Health, and Function in Severely Worn Dentition

Wynn H. Okuda, DMD

A 33-year-old female patient presented with a history of severe grinding and malocclusion that had developed over time. She had previously received orthodontic treatment with clear aligner therapy for 1.5 years to refine teeth positioning. Because of the severity of breakdown due to her bruxism, at the time of her presentation she required full-mouth reconstruction to restore the health, function, and esthetics of her teeth. Using esthetic temporary prototypes, the author created a smile design for the patient's anterior teeth to provide optimal esthetics and re-establish functional guidance planes that had been lost. In addition, the patient's vertical dimension was recaptured to a comfortable position. The anterior porcelain upper and lower veneers were bonded with Choice 2 (BISCO, luting resin and All-Bond Universal® (BISCO) adhesive. For optimal occlusal durability, full-contour zirconia crowns were used on all molars, and to maximize adhesive strength, Z-Prime Plus (BISCO) was used as a primer in the zirconia crowns and TheraCem® (BISCO) was used as a bonded luting cement. Through the execution of contemporary technique in cosmetic and restorative dentistry and utilization of state-of-the-art material science, the health, function, and esthetics of this patient's dentition were optimally restored for long-term success.

Key Takeaways

To create predictable results for comprehensive cosmetic restorative cases, it is important to perform a thorough diagnostic work-up prior to treatment.

To execute a comprehensive full-mouth cosmetic reconstruction, esthetic temporary prototypes may be used to ensure that the patient's needs are met and predictable results are achieved.

Reliable, state-of-the-art dental adhesives, luting resins, and bonding protocols are vital to achieve optimal long- term outcomes.

About the Author

Wynn H. Okuda, DMD
Past President (2002-03) and Fellow, American Academy of Cosmetic Dentistry; Fellow, International Congress of Oral Implantologists, Fellow, International College of Dentists; Founder, Pan Pacific Dental Academy; Private Practice, Honolulu, Hawaii

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