Digital Multidisciplinary Rehabilitation Of Hereditary Dentinogenesis Imperfecta: A Case Report

This report presents a digital protocol integrating functional-esthetic design and dual guides for hereditary dentinogenesis imperfecta (DI) rehabilitation, prioritizing anterior guidance optimization. A 34-year-old DI female exhibited severe anterior wear (#11-44), enamel fractures, and occlusal dysfunction. Diagnostic features included reverse incisal plane, compensatory alveolar hyperplasia, and inconsistent anterior guidance. The staged protocol comprised: 1. Digital workflow: 4D virtual patient construction (Exocad) integrating CBCT and intraoral scans (Trios 4, 3Shape) established anterior guidance parameters and crown contours. 2. Guided surgery: Dual 3D-printed templates aachieved precision osteotomy and gingivectomy, followed by 6-month periodontal stabilization. 3. Provisional validation: CAD/CAM interim crowns facilitated 5-month dynamic occlusal adjustment using electronic facebow-derived anterior guidance. 4. Definitive restoration: Full-contour zirconia crowns restored functional occlusion and aesthetic harmony, maintained through 8-month follow-up. The protocol demonstrated clinical efficacy in DI rehabilitation through synergistic integration of digital masticatory simulation and periodontal biological principles. Anterior guidance reconstruction required simultaneous optimization of incisal edge positions, lingual contours, incisal and condylar inclinations. While jaw tracking systems provided foundational data for virtual articulation, clinical validation through interim restoration was mandatory to reconcile digital predictions with intraoral realities. The dual-template surgical approach (two 3D-printed guides for osteotomy and gingivectomy) following digital functional-esthetic design enhanced positional accuracy of crown lengthening, critically preserving periodontal stable. This approach demonstrates how digital tools can reconcile structural rehabilitation with functional demands in genetic dentinal disorders, though long-term monitoring remains essential given inherent material limitations.