Full-mouth rehabilitation of a young adult with Type-II dentinogenesis imperfecta

Abstract

Dentinogenesis imperfecta is a hereditary autosomal dominant disorder. Type-II symptoms are discoloration, tooth/root dysmorphia, and chipping of enamel. Coverage of all teeth is recommended. To restore esthetics and masticatory function of the patient with dentinogenesis imperfecta. A 24-year-old male patient had multiple caries but no occlusion on the right side. The examination revealed DMF-T 31, tulip-shaped and short/rounded radixes, shell-like chipping of enamel, which led to the diagnosis of type-II dentinogenesis imperfecta. After elimination of all decays an intraoral scanner (Trios 3, 3Shape, Copenhagen, Denmark) was used to capture the initial surface information on both arches. The 3D-mirroring technique was performed: the tooth shapes were copied from the less-damaged surfaces on the left side to the right side, and smile design (3Shape Smile Design) was performed to reconstruct the esthetics of the fronts. Reconstructed 3D tooth surfaces were generated. All teeth were prepared and digitalized. Sectioned bite registration and digital bite acquisitions were performed. Reconstructed 3D tooth surfaces were copied onto the prepared teeth data and temporaries were 3D printed (NextDent 5100, NextDent B.V., Soesterberg, Netherlands) out from resin (NextDent C&B MFH) and cemented. After 3 months of wearing, the temporaries were rescanned intraorally, master casts were printed. Metal frameworks were sintered based on the prepared teeth scans, then porcelain layering is done on printed master casts in an adjustable articulator (PROTAREvo3, KaVo, Biberach, Germany). The tooth shapes and masticatory function were restored. The digital mirroring technique, smile design, and sectional bite registration can improve the quality of complex rehabilitation.