Digital Workflow For Aesthetic Rehabilitation Of Irregular Fluorotic Anterior Teeth

Dental fluorosis presents aesthetic and functional challenges, particularly when previous composite veneers fail due to recurrent caries and marginal degradation. This report demonstrates a digital workflow integrating virtual patient modeling and occlusal analysis to reconstruct function and aesthetics for irregular fluorotic anterior teeth. A 56-year-old female presented with fractured resin veneers, secondary caries, and aesthetic dissatisfaction. Clinical examination revealed multiple compromised veneers, defective PFM (porcelain fused to metal) crowns (#24–25), generalized cervical abrasions, and malocclusion with mesiolingual rotations of #11 and #21. A staged protocol included: 1. Virtual-Patient-Based digital design: Intraoral/facial scans (TRIOS 4 [3Shape], Facego [XinTaiZhongYi]), T-Scan occlusal analysis, and CBCT created a 3D virtual patient for aesthetic design for anterior Teeth. 2. Treatment: Minimally invasive preparations for lithium disilicate crowns (#13–15) and veneers (#11–23, #34–44) via CAD/CAM (exocad [exocad GmbH]). Cervical staining (IPS Ivocolor) masked gingival recession. 3. Outcome: Restorations achieved optimal margins, occlusal stability, and patient satisfaction at 3 months. 1. Virtual Patient Integration: Dynamic occlusal data reduced preparation depth compared to conventional methods. 2. Customized aesthetics: The maxillary anterior teeth were restored with adjusted alignment. However, original mandibular alignment was maintained using T-Scan-guided adjustments to avoid functional risks of excessive bite force. 3. Preparation Precision: Selective removal of defective enamel and undercuts ensured precise seating of the prosthetic restorations. By prioritizing enamel preservation and customized aesthetics, this digital workflow delivers clinically viable solutions for intricate cases necessitating optimal aesthetic integration and functional rehabilitation.