Retratamento integrado de reabilitação estética anterior: relato de caso

Abstract

The integration between occlusal planning and esthetic rehabilitation is determinant for the longevity of anterior prosthetic treatments. This study reports a clinical case of esthetic-functional retreatment in an adult patient, following early failure of ceramic restorations associated with an edge-to-edge occlusal relationship in the anterior region and the absence of posterior dental elements. The patient presented with an urgent complaint due to loss of cementation of the crowns, in addition to dissatisfaction with the reverse smile curve and the grayish appearance of the implant-supported crown on tooth 21. Diagnosis revealed that the lack of posterior occlusal support favored overload and contacts in the anterior region, compromising the longevity of the restorations. Treatment was carried out in stages: fabrication of provisional resin crowns, temporarily modifying the edge-to-edge relationship; orthodontic treatment for lingualization of the lower incisors; rehabilitation of the posterior elements with implants, restoring occlusal stability; and replacement of the prosthetic abutment of tooth 21 with one of smaller diameter, allowing greater ceramic thickness and masking the underlying grayish hue. It is concluded that multidisciplinary retreatment was effective in resolving the patient's esthetic and functional demands, reinforcing the importance of proper occlusal assessment in the planning of long-lasting anterior esthetic rehabilitations.