COMPREHENSIVE ANTERIOR REHABILITATION FOR FUNCTIONAL AND ESTHETIC ENHANCEMENT: CASE BASED INSIGHTS

Authors: Dr Vaidehi Rajnikant Kesaria, Dr. Prabhakar Basappa Angadi, Dr. Lavina Hemant Punyarthi, Dr Ritesh Sanjay Gandhe

DOI: 10.18231/j.aprd.12810.1759494123

Keywords: Keywords: anterior guidance, occlusal rehabilitation, zirconia crowns, provisional restoration, CAD/CAM, esthetic dentistry

Abstract: Abstract Purpose: To present two clinical cases demonstrating comprehensive anterior rehabilitation focused on re-establishing anterior guidance for optimal esthetics and function. Background: Accurate anterior guidance is critical for protecting posterior dentition from excessive functional stresses and for achieving favorable esthetics, phonetics, and comfort. Faulty guidance can lead to premature contacts, restoration failure, and periodontal compromise. Case Descriptions: Case 1: A 55-year-old male presented with severe anterior attrition, deep bite, and generalized posterior wear. Following endodontic therapy (13–23, 45–33) and crown lengthening (43–33), tooth preparations were performed according to biomechanical principles. A diagnostic wax-up and custom incisal guide table facilitated temporization and functional evaluation. Definitive monolithic zirconia crowns were fabricated and cemented with resin cement. Case 2: A 19-year-old female with endodontically treated maxillary and mandibular anteriors sought esthetic improvement. A diagnostic wax-up and provisional phase preceded digital impressions. Layered zirconia crowns were CAD/CAM-fabricated for enhanced esthetics and cemented with resin-modified glass ionomer cement. Discussion: Both cases highlight the importance of provisional restorations in verifying esthetics, phonetics, and functional dynamics prior to definitive rehabilitation. Customized incisal guide tables allowed precise replication of functional movements. Material selection was individualized, monolithic zirconia for strength in high-load situations, layered zirconia for superior esthetic outcomes. Digital workflows enhanced precision and predictability. Conclusion: Successful anterior rehabilitation demands precise recording and transfer of anterior guidance, careful material selection, and thorough provisional evaluation. Integrating digital technology with established prosthodontic principles can deliver predictable, long-lasting functional and esthetic results.