The esthetically guided and occlusally protected (EGOP) technique. Case report of fully digital adhesive rehabilitation in patients with dental structure loss

Aim: To describe a technique for performing an adhesive oral rehabilitation based on a digital workflow and focused on the integration between esthetic and occlusal aspects in a young patient with a worn dentition.

Materials and methods: An adhesive oral rehabilitation with severe loss of dental structure in a 40-year-old male patient is described. The treatment was based on a fully digital workflow (including facial scanning), esthetic and occlusal virtual planning, guided implant surgeries, an adhesive resin prototype, and ceramic restorations. The technique integrates both esthetic and occlusal factors, splitting the dental arches into four sectors and following a stepped sequence with specific objectives for each one. The loss of dental structure was initially rebuilt by an adhesive composite resin full-mouth prototype rehabilitation. This step also helped to confirm the esthetic and occlusal digital planning. After 4 months, lithium disilicate restorations were delivered following the same order, sector by sector, to reduce possible errors when transferring the previously approved anatomy to the final ceramic oral rehabilitation. Lastly, an acrylic nightguard was installed and a 6-month recall program established.

Results: An accurate integration between esthetic and occlusal aspects was achieved during digital planning, which was also corroborated by the adhesive resin prototype. The final ceramic restorations fulfilled the patient's esthetic expectations and recovered the occlusal anatomy.

Conclusions: The proposed esthetically guided and occlusally protected (EGOP) technique seems to be a reliable approach to treat patients with worn dentition. Further clinical research and additional proposals are necessary to assess the possible benefits associated with these procedures.