Multidisciplinary Management Of Tooth Wear, Missing Dentition And Gingival Recession

This case report outlines the interdisciplinary management of a patient presenting with localised mild to moderate tooth surface loss, missing dentition, and localised gingival recession on Class III malocclusion. The initial intervention involved localised occlusal adjustment at the retruded contact position to establish a stable occlusal relationship. Direct resin composite restorations were employed to rebuild the worn dentition, while multiple-unit fixed bridges were fabricated to restore missing teeth and improve occlusal function. Subsequently, periodontal plastic surgery was performed to correct gingival recession at the maxillary right lateral incisor (UR2), achieving root coverage and aesthetics. The aim was to restore/ improve aesthetics, function, and occlusion of dentition and replace missing teeth. The management of restoring the teeth worn with direct resin composite offers the advantages of an acceptable aesthetic outcome. It is conservative, easy to use and adjust, and serves as medium-term and definitive restorations. Evidence showed the high success rate of resin composite restorations on worn anterior teeth. Root coverage on UR2 achieved by the bilaminar technique consisted of a coronally advanced flap and connective tissue graft, successfully treating gingival recession. Treatment of gingival recession with mucogingival therapy was effective; significant recession reduction and increase in keratinised tissue were well-maintained over a 4-year observation period. The treatment resulted in a satisfactory aesthetic and functional outcome, with high patient satisfaction. This case highlighted the importance of a multidisciplinary approach for successfully rehabilitating patients with complex dental conditions involving occlusion, aesthetics, and periodontal health.