Long-Term Esthetic and Functional Success Following an Initial Treatment Complication

This case describes the successful long-term outcome of a patient's treatment after a restorative failure occurred soon after delivery. The esthetic and restorative treatment has been successful for nearly a decade due largely to a careful, objective evaluation of all possible causes of the restorative failure. The treatment plan for the patient, who was assessed as high risk biomechanically and functionally, was carried out in the following phases: (1) an implant placement that required an osteotome sinus lift; (2) placement of feldspathic bonded veneers for the maxillary anterior teeth to minimize removal of tooth structure; (3) numerous core-supported restorations, with fixed partial dentures placed for teeth Nos. 19 through 21 and 28 through 30; and (4) the use of a Kois deprogrammer™ to determine condylar position/centric relation reference. Finally, the maxillary teeth were lengthened to create a pleasing smile and the vertical dimension increased and restored in centric relation.