Treatment completed by Dr Pooneh Shahab
Conservative Full-Mouth Rehabilitation for Severe Tooth Wear — Two-Year Follow-Up
Pre-treatment — Initial presentation
Post-treatment — Two-year follow-up
Pre-treatment — Initial intraoral view
Conservative preparation stage
Post-treatment — Following completionPre-treatment:
Smile and intraoral photographs taken before treatment.
Conservative preparation stage:
The clinical photograph documents the conservative preparation design used to preserve natural tooth structure wherever clinically appropriate.
Post-treatment:
Intraoral photograph taken following completion of the restorative treatment and smile photograph taken at the two-year follow-up.
This complex full-mouth rehabilitation addressed severe tooth wear and the loss of restorative space through a combination of layered IPS e.max restorations and a dental implant used to replace one tooth.
One tooth was extracted because it had insufficient remaining coronal tooth structure for predictable restoration and was subsequently replaced with a dental implant. No other teeth were extracted as part of this treatment, and all other remaining natural teeth were retained.
A conservative, tooth-preserving restorative approach was used. Tooth preparation was tailored to the patient’s bite and restorative requirements, with healthy natural tooth structure preserved wherever clinically appropriate.
No previously vital teeth required root canal treatment during the rehabilitation. At the two-year follow-up, none of the retained teeth had required root canal treatment.
Following a detailed assessment of the patient’s bite and available restorative space, the vertical dimension was carefully increased by approximately 3 mm anteriorly and 1.5 mm posteriorly. The bite was reorganised at a stable and reproducible jaw position.
The duration of the provisional phase varies according to the clinical requirements of each case. In this case, the planned changes were assessed with provisional restorations for more than one month. During this phase, the patient’s comfort, function, adaptation and bite stability were reviewed before proceeding with definitive treatment.
The restorative component of this full-mouth rehabilitation was planned and completed by Dr Pooneh Shahab.
Important Information
Full-mouth rehabilitation is individually planned. Whether an increase in vertical dimension and a conservative preparation design are suitable and achievable depends on individual clinical findings, including the existing bite, available restorative space, the amount and condition of the remaining tooth structure, the supporting tissues and the patient’s adaptation during the provisional phase.
Depending on the treatment required, potential risks may include sensitivity or pulpal complications that may require root canal treatment, adaptation to changes in the bite, postoperative pain or swelling, infection, delayed healing or failure of an implant to integrate, chipping or fracture of restorations, and the need for ongoing maintenance, repair or replacement.
The outcomes shown are only relevant to this patient and do not necessarily reflect the results other patients may experience.
