A minimally invasive approach to restore function and esthetics in periodontally involved teeth

The objective of dental treatment is the elimination of the etiologic factors, the rehabilitation of function and esthetics, and, when possible, the maintenance of vitality and structure of the natural dentition. After the loss of the periodontal support, as a consequence of periodontal disease, it may be necessary to splint the residual teeth in order to improve their stability, and sometimes it is also necessary to modify the morphology to optimize the final esthetic outcome. In many periodontally treated teeth, prosthodontic treatment on the residual dentition will be required with an important loss of tooth structure as an unavoidable consequence. This procedure frequently requires endodontic treatment of the residual abutments in order to obtain the necessary space for replacement materials. Similar objectives could however be achieved through an alternative therapy where the esthetic remodeling of the teeth and the closure of the interproximal spaces is obtained with composite resin materials. The objective of this article is to present an alternative protocol to optimize the functional and esthetic result of periodontally treated cases, where the most frequent complication is the increased length of the clinical crown. This is obtained by utilizing a different conservative approach, which has as its main objective the stabilization of the residual teeth, the maintenance of their vitality, and the achievement of the best esthetic result possible.