Unlike restorative dentistry where the foundation (whether it is tooth or gingival tissue) for the building blocks (restorative materials) are already present, reconstructive dentistry requires re-establishment of the foundation and sufficient understanding of the masticatory system where interplay between joint, muscle, and teeth becomes very important.
This patient presented with interproximal cavities, failing existing restorations (fillings, crowns and bridges) and history of periodontal (gum) disease which caused her to loose some of her teeth and her supporting bone level.
Healthy dental-gingival complex is achieved following periodontal therapy and placement of new restorations including porcelain crowns, bridges and veneers at an established occlusal scheme.
Maxillary right central incisor with history of trauma was necrotic. Endodontic therapy was performed followed by internal bleaching. A complete healing of the periapical area with bone fill was observed.
A limited orthodontic therapy was carried out on Maxillary dentition to reposition Maxillary right lateral incisor into it's original position to obtain right and left symmetry and to obtain more favorable tip and torque of the maxillary dentitions. A full mouth bleaching was done and gingivoplasty or gum lift was also performed on the central incisors to obtain proper gingival height and symmetry in relation to those of lateral incisors and canines. Finally, the central incisors were very conservatively prepared for veneers which were then fabricated with CEREC technology and bonded in place. This case shows the integration of various disciplines in dentistry in addressing patient's concerns and achieving a successful result.