This case report presents the case of a 33-year-old male who reported the chief complaint of unpleasing aesthetics. This was due to fracture and discoloration of the previously done fillings for the front teeth. In addition to this, there was a fracture of silver fillings done a long time ago for the posterior teeth resulting in pain and discomfort while chewing food.

To worsen the condition further the previously untreated teeth had decayed ultimately resulting in sensitivity, pain, and discomfort. Also, the patient was not very happy with the alignment and the yellowish color of the teeth and was willing to get it corrected permanently without the involvement of the braces (i.e. orthodontic treatment).

The most important part to be considered before any treatment is started is proper discussion and discovery of the patient’s chief complaint and concerns. In this case, the patient was willing for a fixed, long term solution that would help him resolve all of these problems at once and that too in a specific frame of time as he had traveled to India just for getting treated for all of his dental issues and wanted to travel back to his home town at the earliest.

Understanding the patient's needs, a detailed treatment plan was advised for him which included rehabilitation of his full mouth with zirconia crowns. The treatment plan was addressed and executed in a phase-wise manner.

What Is Full Mouth Rehabilitation (FMR)?

A Full Mouth Rehabilitation/Reconstruction is needed when your oral health deteriorates completely due to multiple dental problems.
The procedure has the power to turn back the clock by taking away at least 10-20 years of facial aging.
Along with looking and feeling younger, you will also be able to enjoy all your favorite foods again.
It might sound like a complicated procedure, but FMR is a very simple procedure merely combining restorative dental treatments to fix or rebuild your smile and strengthen oral tissue and tooth structures as well with proper planning and involvement of intellectually and technically demanding procedures.

Advantages of Full Mouth Rehabilitation:

• Correction of teeth affected by chips and cracks.

• Correction of teeth misalignment and gaps/spaces.

• Correction of discoloration and teeth affected by deep stains.

• Correction of teeth affected by damage or decay.

• Treatment of periodontal (gum) disease.

• Improvement of worn-down teeth.

• Replacement of missing teeth.

• Improvement of conditions associated with TMJ disorders.

The first step in the FMR process is the initial evaluation. After a thorough review of the patient’s medical and dental history, a comprehensive dental examination is completed, including a proper radiographic assessment. The following is the preoperative OPG of the patient showing multiple fractured fillings and deep cavities.

Restorative dentistry involves the significant dental treatment, including proper documentation of the patient’s smile with the help of photographs, which is of utmost importance as it helps further for improving the communication with the laboratory technician.

The facially generated aesthetic treatment plan is developed which involves the aesthetic analysis of the case. The smile must complement the facial features, both vertically and horizontally. This helps in developing tooth positions aligned with parameters specific to the particular face thus complementing the full facial aesthetics.
 

Tooth proportions and proper length to width ratios are evaluated carefully and are designed digitally. All the designed digital simulations are verified by the patients and the approved design is used for the treatment further.
 

After overall assessment and proper evaluation of the recorded measurements including the facial features, the treatment was continued further with the required tooth preparation or shaping following the biomechanical principles. The final form of the teeth, as designed by the treatment plan, is used as a guide for planning tooth reduction.

The prepared teeth are recorded with the help of elastomeric impression materials. Following this immediate computer-aided design/computer-aided manufacture(CAD/CAM) fabricated temporary crowns having a superior fit and better strength were delivered to the patient.

The impressions are scanned further and the digital mock-up replicating the size, shape, and bite of the final restoration is designed and approved by the patient. This step of digital workflow fastens the procedure allowing the lab technician and the clinician to cover a range of applications and maximize the productivity of the final restoration.

Following approval of the designs, the Face-Bow Record was done for the patient with the purpose of transferring the corrected bite to the final restoration thus helping to restore the functional and aesthetic components into the patient's mouth.
Also the face–bow records permits the technician to a more accurate and efficient replication and arrangement of the teeth.

The approved designs are then copied further and the final zirconia restoration was fabricated following a few of the laboratory steps.

Brief About Zirconia Crowns:

• One of the biggest advantages of zirconia is its strength and durability.

• As Zirconia is strong it does not require much tooth preparation/cutting thus preserving the natural tooth structure. 

• Also, Zirconia is the material of choice because of its good longevity and biocompatibility, which means it is less likely to provoke any inflammation

• The product is 100% metal-free, thus preventing gingival darkening and removing the possibility of exposing metallic margins if gum recession begins.

• Layered zirconia is more translucent, naturally esthetic, and can easily match the shade of the adjacent teeth.

The intermediate step of the bisque trial/trial smile was performed, ensuring the functional stability and shade for the final prosthesis with the patient.
Preserving the continuity in the form, function, and position the final, polished zirconia crowns were placed in-situ intraorally. Required bite adjustment was made maintaining proper overjet-overbite providing balanced occlusion.

Required bite adjustment was made maintaining proper overjet-overbite along with providing bilateral balanced occlusion. The shade of the final restoration is also very much stable aesthetically enhancing the natural look of the final zirconia crowns.

After following all the sequential steps for the procedure of full mouth reconstruction the patient was very much pleased and happy with the favorable treatment outcomes. The following are the right and the left lateral profile showing correction of bite and improvement in the facial profile.

When asked for feedback post-treatment the patient quoted “The entire treatment has relieved me from all my initial complaints of pain, sensitivity, and discomfort. Now I feel like I have more natural and healthy-looking teeth giving a genuine beaming smile and a younger look”.