Problems Identified at the Initial Visit
During the first examination, the following issues were detected:
- unnatural shape and color of the temporary crowns;
- vertical dimension of occlusion not consistent with physiological parameters;
- inflammation and hyperemia of the mucosa around the restorations;
- an uneven smile line;
- insufficient adaptation of the temporary crowns to the gingival margin.
In such cases, it is necessary not only to replace the restorations, but also to restore the physiological parameters of the masticatory system before final cementation.
Diagnostics and Preparatory Stage
Comprehensive diagnostics were performed, including:
- assessment of occlusion and vertical dimension of occlusion;
- evaluation of soft tissue condition;
- functional examination;
- photographic protocol and digital smile design / digital modeling.
Based on the findings, the correct vertical dimension of occlusion was restored, which is a mandatory prerequisite before placing veneers and crowns. Soft tissue correction was also performed to ensure proper gingival contours and create conditions for a predictable aesthetic outcome.
Fabrication of New Temporary Restorations
At the preparatory stage, new temporary crowns and veneers were fabricated. Their objectives were to:
- restore correct anatomical proportions;
- stabilize function;
- shape the proper gingival contour;
- allow the patient to evaluate the form and parameters of the future definitive work.
Using the temporaries, final calibration of the vertical dimension, smile line, and overall aesthetics was performed.
Definitive Veneers and Crowns: Final Reconstruction
After the stabilization stage, 28 thin-walled veneers and crowns were fabricated, precisely reproducing:
- the patient’s individual tooth anatomy;
- a natural shade;
- enamel translucency and light transmission;
- the shape of incisors, canines, and premolars.
Thin-walled restorations provide high-level aesthetics with minimal tooth preparation, preserving hard tissues and ensuring long-term durability.
Treatment Outcome
After final cementation of the definitive restorations, it was possible to:
- restore a physiological vertical dimension of occlusion;
- achieve an even, harmonious smile line;
- eliminate inflammation and achieve proper soft tissue adaptation;
- obtain a natural tooth shape and shade;
- create stable occlusal contacts.
The patient noticed visible improvement already after the new temporary restorations were placed, and the final prosthetic reconstruction delivered a predictable aesthetic outcome and correct function.
Why a Two-Stage Approach Is Used in Such Cases
Transitioning from temporary restorations to definitive ones is necessary when:
- bite rehabilitation is required;
- tooth anatomy needs to be changed;
- soft tissue inflammation is present;
- previously fabricated crowns do not match physiological parameters;
- future restorative parameters must be evaluated before final fixation.
The temporary stage allows testing of shape, color, and vertical dimension, as well as soft tissue correction — resulting in a more accurate and stable final outcome.
How This Protocol Is Implemented at DentalDate
At DentalDate, full reconstructions are performed based on:
- detailed functional diagnostics;
- planning of the future occlusion;
- precise modeling of tooth morphology;
- a sequential transition from temporary to definitive restorations.
This protocol enables a predictable aesthetic and functional result, especially in complex clinical cases requiring rehabilitation of large segments of the dental arch.
