Correcting Occlusal Dysfunction While Addressing Patient's Esthetic Concerns

This case illustrates a method of addressing a patient's esthetic and functional concerns using additive restorative dentistry to avoid increasing biomechanical risk. Use of a Kois deprogrammer aided in the functional diagnosis and treatment to equilibrate the new additive restorations. At presentation, the patient was unhappy with the appearance of her smile, as she had bulbous, triangular-shaped crowns, a midline discrepancy due to a missing lateral incisor, and mismatched shades of porcelain-fused-to-metal crowns. Also, her bite was uncomfortable, as she found it difficult to find a repeatable bite position. Before addressing the patient's esthetic concerns, it was necessary to first evaluate her functional, periodontal, biomechanical, and dentofacial risk factors. After arriving at the functional diagnosis, and prior to preparing the patient's teeth, the clinician was able to allow the patient to preview her new smile with an intraoral mock-up. The treatment both satisfied the patient's esthetic expectations and addressed her functional concerns.