Esthetic rehabilitation of a patient with moderate fluorosis: a digital workflow

Abstract

Dental fluorosis is considered as a worldwide dental health problem. Its prevalence is increasing in different parts of the world. It is described as a disorder of enamel development caused by chronic and excessive exposure to high concentrations of fluoride during the formation of enamel, which could be responsible for the hypermineralization of enamel increasing its porosity. It is clinically identified as white lines covering all or a part of the enamel surface. Posteruptively, these subsurface porosities may attract various extrinsic stains and /or bacteria and change the color of the affected enamel. In some cases, occlusal trauma may cause its detachment. The therapeutic management of dental fluorosis includes bleaching, microabrasion, veneering and crowning. The choice of the appropriate alternatives is closely linked to damages within the enamel matrix. Thylstrup-Fejerskov categorized these damages with severity scores based on their histological features. Mild-to-moderate fluorosis are often managed with bleaching and/or microabrasion, while severe fluorosis, is generally treated by veneering and crowning. The clinical case describes the treatment of discolored teeth with veneers using lithium disilicate-reinforced glass-ceramic material and highlights the different guidelines to optimize veneer bonding on fluorosis teeth.