Conventional all ceramic crowns versus CADCAM all ceramic laminates for esthetic rehabilitation of teeth with dental fluorosis: A 5 year follow-up study

Every individual wants to look good and have a pleasing smile. In this era of social media where each and every phase of one’s life is captured in camera, having an unpleasant smile makes a huge negative psychological impact on every individual. The foremost reason of an unesthetic smile commonly is dental fluorosis. Dental Fluorosis is an abnormality that causes enamel discolouration which may result when excess fluoride is consumed during the teeth forming stage i.e. 8 years and younger. The effect remains lifelong resulting in a huge esthetic insult. Treating such patients with aesthetic all ceramic crowns and veneers will definitely improve the patient’s self-esteem. In this retrospective study we clinically evaluated the aesthetics and patient satisfaction of 2 different treatment modalities for dental fluorosis namely Conventional all ceramic crowns and CADCAM all ceramic laminates in teeth with anterior fluorosis. Patients were divided in two groups. Both the groups included 35 patients each, Group 1 received conventional all ceramic crowns (156 in anterior maxilla and 24 in anterior mandible) using IPS e max fabricated in porcelain furnace and Group 2 received CADCAM porcelain laminate veneers (144 in the anterior maxilla and 36 in the mandible) fabricated with incisal overlap technique that covered the incisal edge and part of the palatal/lingual side of the tooth with a 1 mm high palatal bevel. The Orofacial Aesthetic Scale (OES) was used to assess the overall satisfaction level and White Aesthetic Score was used to assess the overall aesthetic improvement post treatment in both the groups. On the basis of the OES, it was found that CADCAM all ceramic laminates was more satisfying treatment for the patient rather than more extensive conventional all ceramic crown preparation. WES scores suggest that conventional all ceramic crown gives more aesthetic results as compared to CADCAM all ceramic laminates in moderate fluorosis. The results of this clinical study should encourage clinicians to consider CADCAM all ceramic veneers over Conventional all ceramic crown restorations when restoring the smile of patients with moderate fluorosis.