Patient Presentation and Initial Concerns:
The patient initially presented with several dental concerns, including:
● Missing Teeth: The patient had a few missing teeth in their dental arch.
● Severe Tooth Wear: The patient had experienced severe tooth wear, primarily caused by a daily morning habit of drinking limewater over a period of ten years. This erosive wear had led to the loss of all the enamel on most of his upper and lower teeth.
●
Treatment Approach:
The treatment approach involved addressing these concerns through a combination of restorative and prosthodontic procedures:
Preventative Advice and Regimen:

The initial step included providing the patient with comprehensive preventative advice and a preventive dental regimen. This aimed to address and halt the progression of enamel erosion and tooth wear.

Upper Arch Restoration:
● The unsavable teeth were extracted and an immediate denture made for the patient initially while waiting for the gums to heal .
● Crowns/Onlays: Teeth that could be saved in the upper arch were restored using crowns and onlays. Crowns are restorations that cover the entire tooth, while onlays are more conservative restorations that cover only a portion of the tooth.
● Metal Denture: To replace the missing teeth in the upper arch, a metal denture was designed and fabricated. Dentures are removable prosthetic appliances used to replace missing teeth.
Lower Arch Restoration:
● Resin Bonded Bridges (Sticky Bridges): To replace the missing front teeth in the lower arch, a minimal-preparation approach was employed. Resin bonded bridges, often referred to as "sticky bridges," are a conservative option for replacing missing teeth, particularly in the front region.
● Onlays and Crowns: In the posterior region of the lower arch, gold or non-precious metals, onlays, and crowns were utilized for the restoration of damaged or worn teeth.
Reorganization of Bite: The treatment approach involved opening the patient's bite, referred to as a "reorganized" approach. This change in the bite provided the necessary space for the placement of restorations.
Treatment Outcomes:
The described treatment plan successfully addressed the patient's concerns, resulting in the following outcomes:
● Preservation of Teeth: Teeth that could be saved in the upper arch were preserved through the use of crowns and onlays.
● Replacing Missing Teeth: The metal denture in the upper arch and resin bonded bridges in the lower arch effectively replaced the missing teeth, restoring functionality and aesthetics.
● Conservative Restorations: The use of resin bonded bridges, onlays, and crowns, including metal restorations, allowed for a more conservative approach to tooth restoration.
● Improved Oral Health: The preventive advice and regimen provided helped improve the patient's oral health and addressed the issue of enamel erosion.
● Patient Satisfaction: The patient expressed satisfaction with the treatment outcomes, indicating their happiness with the result.
This case demonstrates a comprehensive approach to addressing severe tooth wear, missing teeth, and enamel erosion, with a focus on both functional and aesthetic restoration, ultimately resulting in improved oral health and patient satisfaction.