Combined Orthodontic and Restorative Minimally Invasive Approach to Diastema and Morphology Management in the Esthetic Area. Clinical Multidisciplinary Case Report with 3-Year Follow-Up

Abstract

Introduction. Ceramic laminates are restorations that are bonded using adhesive techniques, which provide for the treatment of the prepared dental elements according to well-defined steps. Adhesive cementation guarantees high predictability and esthetics. Orthodontic treatment is the first choice in patients with a dental misalignment. Patients who have dental element color and shape issues will undergo restorative treatment following orthodontics. Case Report. This clinical report describes a case treated with an interdisciplinary approach (orthodontic and prosthetic) of a patient who presented with diastemas, inversion of dental axes, small clinical crowns, and chromatic imperfections in the anterior maxillary teeth. The esthetic expectations of the patient for the anterior portion of the maxillary anterior teeth have been successfully achieved through orthodontic treatment and the realization of ceramic veneers. An accurate interdisciplinary evaluation of the treatment was necessary for a satisfactory result in the anterior maxillary teeth esthetically compromised in several aspects. Discussion. The modern materials used with the strict protocol of the adhesive procedures allow a minimally invasive, highly esthetic approach with an excellent long-term prognosis. The restorations must reproduce the physiological characteristics of the natural teeth aiming at an excellent biological, biomechanical, functional, and esthetic integration. Many adult patients come to visit with a combination of problems; the esthetic rehabilitation of these cases requires the evaluation of the quantity of gingival exposure, of the gingival architecture, of the size of the clinical crowns, and of the dental position. The ideal treatment of these cases involves an interdisciplinary approach. Prosthodontists, periodontists, orthodontists, and dental technicians must work together because the understanding of the various phases of treatment is fundamental to achieve the desired clinical result. Conclusion. The coordinated treatment of the orthodontist, periodontist, and prosthodontist, with careful consideration of the expectations and requests of patients, was fundamental for the success and satisfaction of the patient.