A Mixed Vertical Preparation Approach for Crown Replacement: A Concept-Driven Clinical Report

Full circumferential application of biologically oriented preparation concepts in prosthetic retreatment remains highly technique sensitive and may compromise prosthetic margin control. This concept-driven clinical report describes a mixed vertical preparation strategy that differentiates cervical objectives by tooth surface to balance periodontal tissue conditioning with prosthetic predictability. Based on a selective literature review and one illustrative clinical case, a vertical preparation performed according to Biologically Oriented Preparation Technique (BOPT) principles, combined with provisional-driven biologically oriented tissue conditioning, is confined to the vestibular surface where esthetic integration is most critical. A VertiPrep-type preparation is applied on proximal and palatal surfaces to preserve epithelial attachment and ensure a controlled prosthetic margin. The provisional restoration is central to the therapeutic mechanism, guiding soft tissue maturation over a 6 to 8-week healing period. Vestibular tissue conditioning allowed localized modulation of marginal tissue thickness. Proximal and palatal VertiPrep facilitated precise margin positioning and improved communication with the dental laboratory. This mixed vertical preparation approach represents a pragmatic option for selected crown retreatment scenarios, particularly when attempting to balance vestibular soft tissue conditioning with proximal/palatal margin control. Further prospective controlled studies are required to confirm its clinical predictability and long-term outcomes.