Sequentially Functional And Asthetic Restoration Of Severe Dentin Dysplasia

This case report introduced sequentially functional and aesthetic restoration on a patient with dentin dysplasia type II (DD-II) accompanied by severe tooth wear. An eight-year-old girl with severe tooth wear presented for restoration. The patient had mixed dentition, and the teeth were all translucent amber, with stripped enamel and exposed dentin. The teeth wore severely, with short vertical distance to the face. Radiographically, the pulp chambers and root canals of 11, 12, 21, 22, 31, 32, 36, 41, 42 and 46 were significantly narrowed with short roots. Gross root resorption of primary teeth was observed. The canines and premature molars were at Nolla’s Stages 6-7. At the first visit, the root stumps were extracted. Next, an occlusal splint was designed and worn for 3 months to restore the vertical distance. Then, preformed stainless steel crowns were used for first molar protection and occlusal reconstruction. Finally, composite resin was used for premolar tooth wear prevention and anterior teeth aesthetic restoration. During the follow-up, no abnormality was observed and favorable outcomes were achieved. DD-II is an autosomal dominant inherited disease with opalescent dentin and severe tooth wear. The vertical distance should be firstly restored without damage to the temporomandibular joint. Moreover, the teeth should be restored functionally and aesthetically. For teeth affected by dentinogenesis imperfecta with severe tooth wear, the treatment should prioritize the reestablishment of occlusal relationships and functional masticatory rehabilitation, and ultimately address aesthetic enhancement.