Case of the Month: A Functional and Cosmetic Treatment Plan


Erosion, eruption, and more feature in this month’s cosmetic case.

Case #10: Treatment Planning with Dual Functional and Cosmetic Goals

Dr. John Nosti on Cosmetic DentistryClinician: Dr. John Nosti, Mays Landing, NJ

pre-opA 23-year-old female presented with erosion on the maxillary anteriors. This led to loss of anterior guidance, centric occlusion not coinciding with maximum intercuspation, resultant wear on the posterior segments, and over eruption of the anterior segment to keep pace with the erosion present.

pre-opTreatment Planning for Restoration Purposes

A functional and cosmetic treatment plan was generated to restore the missing enamel on the anteriors, restore the anterior guidance, remove any interferences into centric occlusion, stabilize the occlusion, and laser osseous recontouring to raise the gingival levels.

The Wax Up and Determining Goals

pre-opA diagnostic wax up was completed to generate the desired cosmetic goals and communicate these goals with the patient.

Placing the Mock Up

Osseous recontouring was completed with the Versawave laser. Mock up was placed, and depth guides placed to ensure conservation of tooth structure where possible. Contacts were broken where interproximal decay was present.

Restoration Results

Eight Empress Aesthetic restorations were completed at shade 020/030. The patient is extremely happy with her results!

How would you treat a case with both functional and cosmetic end goals? Let us know your thoughts in the comments! And don’t miss the previous Case of the Month on aesthetics and full mouth rehabilitation…

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