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Aesthetic rehabilitation of discoloured maxillary incisors in a patient with a Class III malocclusion: a case report Michael Chan Aesthetic Update 2025 2:2, 67-72.
This case report presents the aesthetic rehabilitation of a 23-year-old female patient with discoloured maxillary central and lateral incisors following trauma and endodontic therapy. The patient exhibited a Class III malocclusion with a reverse overjet. A conservative treatment plan was formulated to preserve tooth structure while improving colour consistency, tooth morphology and overall smile aesthetics. Management included non-vital bleaching using an inside/outside open technique, vital tooth whitening and placement of lithium disilicate veneers from UR2 to UL2. Composite bonding was performed on the upper canines to enhance tooth form. Mock-up driven, minimally invasive preparations were used, with a digital CAD/CAM approach with bonding protocols designed to optimize adhesion and aesthetics. At the 6-month follow-up, restorations remained stable with no evidence of complications. This case illustrates the importance of conservative strategies, precise planning, and patient cooperation in achieving successful aesthetic outcomes for previously treated, discoloured anterior teeth.
CPD/Clinical Relevance: A thorough aesthetic assessment and meticulous planning prior to treatment execution are essential.
Article
A 23-year-old female patient of Asian descent presented seeking an improvement in her smile. She had been self-conscious of her smile for many years owing to the poor aesthetics of her front teeth. She felt that this had negatively affected her socially, professionally, and at times had an impact on her mental wellbeing.
Historically, the patient had a fall during her teenage years that resulted in pulpal necrosis of UL1 and UL2. These teeth were subsequently endodontically treated but were otherwise sound with some small interproximal composite restorations. Following endodontic treatment, the teeth developed intrinsic dyschromia, which became a cosmetic concern for the patient. Internal bleaching of both teeth had been attempted several years previously. The patient reported that this gave minor improvement, although a significant colour discrepancy still remained compared to the remaining dentition. The results were short lived, with regression occurring a few months later. Additionally, the patient believed the teeth had progressively darkened over recent years.
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