Therapeutic particularities in the rehabilitation of the upper frontal group

Introduction: Changes caused by periodontal disease, anomalies of shape and position, partial edentulism, lead to disharmonies of the dento-gingival composition. A controversial topic in dental literature is the relationship between aesthetic and occlusal parameters in the context of the existence of a habitual occlusion of convenience. At the same time, the tendency to incorporate factors describing the patient’s personality, age and gender into the dental composition may bring the practitioner closer to achieving therapeutic success. Purpose: To develop an algorithm for planning and applying treatments with bioaesthetic therapeutic goals. Material and methods: 8 subjects (3 males and 5 females) aged 28 to 62 years were examined, with the assessment of dentofacial, dental and gingival components of the smile, followed by conventional imaging and chromatic analysis methods. Results and Discussion: The subjects included in the study group showed signs and/or symptoms characteristic of aesthetic disharmony of the upper frontal dento-gingival compositions as well as chronic occlusal disorders. The evaluation and quantification of dento-gingival aesthetic parameters was materialized by means of the „guide-schema” developed by us, with the demarcation of transition areas in „critical aesthetic areas”. Through complex therapeutic procedures of occlusal balancing, recontouring of compositional elements and guided layering, occlusal and esthetic curative objectives could be addressed simultaneously. Conclusion: In the algorithm of stepwise planning of cosmetic treatment sequences, the compromise of quantifying aesthetic parameters and preserving occlusal parameters was achieved.