Maxillary teeth with porcelain and enamal fractures, super-eruption of lower incisors with incisal wear…
This patient has a reasonably esthetic smile but over time has worn and developed severe vertical and horizontal fractures on the lingual surfaces of her maxillary anterior teeth. The patient wanted to address this before it worsened any further and wanted to improve the esthetics of her central incisors.
If you look closely you can see the fractures that have extended over to the facial surfaces on the two central incisors as well as cracking of the enamal on the laterals. The lower incisors have slowly super-erupted as they have worn against the lingual surfaces of the upper anterior teeth. This is a pathway issue. The patient needs more room to function and is limited by the alignment and position of the teeth.
Diagnostic wax up correcting the function was completed. The new bite relationship was caried over to the provisionals. The lower teeth were modified in shape to correct the functional interferences and to give her more room.
Slight modifications were made to the temporaries for esthetic reasons. The patient was concerned about the temporaries being to bright and so they were stained to give warmth. Maybe a little too much but she was happy.
Seating of the final restorations.
ou can see here the modifications made to the lower teeth to improve the bite relationship. The lingual surfaces had to be prepped in this case to correct the wear and structure so the bite relationship was also corrected here to shallow out her bite and give her more freedom in movement and function.
Final restorations on front 4 incisors completed in layered lithium disilicate- emax. Completed by master ceramist Martin Vojtus of the Winters Lab.
Modified lower anteriors.
The patient was pleased with the final result and feels that the teeth have beautiful natural characterization that mimics her natural teeth and enhances her smile.
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