Orthodontics and veneers to restore the anterior guidance. A minimally invasive approach

Tooth wear is defined as the progressive loss of a tooth’s surface due to actions other than those which cause tooth decay or dental trauma. It is a pathological condition with an increasing prevalence among young people. The aim of this article is to describe an alternative treatment modality to rehabilitate the anterior guidance by a minimally invasive interdisciplinary ortho-restorative treatment. Two patients came to the dental clinic for restorative treatment in order to rehabilitate the worn anterior dentition. Clinical analysis showed tooth surface loss located at the incisal edges by attrition due to an inadequate anterior guidance. In both cases the occlusal vertical dimension was reduced. First, following Dahl’s principle, resin attachments were placed in the upper canines. These attachments allowed the extrusion of posterior teeth in order to increase the occlusal vertical dimension. Furthermore, anterior teeth were intruded in order to create space for the restorative material. In the second phase, the restorative treatment was completed. Due to the characteristics of the case, feldspathic ceramic veneers were indicated. A diagnostic wax-up was performed to assist the treatment planning and a mock-up was prepared. Then, maxillary incisors were prepared through the mock-up to ensure a minimally invasive technique. Afterwards, silicone impressions were taken. Finally, veneers were cemented with a light-cured cement. In the present case, the functional and aesthetic parameters required by the patients were achieved, thus satisfying their needs. Key words:Tooth wear, anterior guidance, feldspathic veneers, Dahl’s principle, minimally invasive.