Digital-Guided Telescopic Crowns For Stage Iv Periodontitis

This case demonstrates telescopic crown rehabilitation for Stage IV periodontitis with dentition defects. Digital-guided preparation (common path of insertion) and facebow-driven tooth arrangement achieved functional-aesthetic restoration while preserving compromised teeth A patient presented with multiple missing and residual teeth exhibiting severe bone resorption (root exposure 1/3–1/2), mobility (Ⅰ–Ⅱ°), and occlusal collapse. Per 2022 EFP S3 guidelines, interdisciplinary assessments chose telescopic crowns as fixed splint. Treatment Protocol 1:Oral hygiene reinforcement and smoking cessation. 2:Periodontal therapy. 3:Full-mouth preparations: 0.3 mm chamfer margins, 2.6–3.0 mm occlusal reduction, 2–6° axial convergence. Intraoral scanning verified insertion path; CAD-guided refinements ensured precision. Polyether silicone impressions finalized. 4:Jaw relation/provisionals: 3D-printed EXOCAD provisionals reestablished vertical dimension and lip support. 5:Inner crowns: Titanium inner crowns tried in, followed by digital master modeling. 6:Final prostheses: Outer crowns/frameworks validated, bonded with resin cement. 7:3-month follow-up confirmed stable occlusion, and periodontal health. Telescopic crowns served as bioactive splint, redistributing forces to stabilize periodontally compromised teeth. Supragingival margins minimized iatrogenic trauma. Despite implant recommendations for severe bone loss, this case validates telescopic systems as alternatives when patient preferences or anatomical limitations prioritize tooth preservation. Digital workflows (intraoral scanning, CAD-guided prep, 3D-printed provisionals) enhanced precision and efficiency in telescopic crown rehabilitation for Stage IV periodontitis. This multidisciplinary approach underscores the synergy of prosthodontic innovation and periodontal stewardship in complex cases.