To address the patient's concerns, we devised a multidisciplinary treatment plan involving endodontics, periodontics, and prosthodontics:
Initial Assessment and Planning:
We performed a wax-up and a mock-up in the mouth to visualize the proposed treatment outcomes and ensure feasibility.
Crown Lengthening Surgery:
To achieve sufficient crown height, we performed surgical crown lengthening on the lower anterior teeth using a surgical stent. This procedure was carried out by a periodontal colleague.
Endodontic Treatment:
The patient was referred to an endodontist for elective root canals on all four lower anterior teeth. This was necessary to provide a solid foundation for the subsequent restorative work.
Temporary Restorations:
Once the root canal treatments were completed, the teeth were prepared, and temporary restorations were placed. These temporaries allowed us to assess the occlusion and aesthetics, ensuring the patient was satisfied with the interim results.
Definitive Impressions and Final Restoration:
After confirming stability and patient satisfaction with the temporary restorations, we took definitive impressions for the final prosthesis.
The patient was restored with an increased occlusal vertical dimension (OVD) using porcelain-bonded crown and bridgework on both the upper and lower teeth.
Outcome
The comprehensive approach resulted in a significant improvement in both function and aesthetics. The patient was delighted with the outcome, enjoying a restored smile and improved dental health. The collaboration between endodontics, periodontics, and prosthodontics ensured a successful full mouth rehabilitation, enhancing the patient's confidence and quality of life.