Achieving optimal esthetics in a patient with severe trauma: using a multidisciplinary approach and an all-ceramic fixed partial denture.

UNLABELLED: The treatment of traumatic injuries can be difficult, especially when the patient's expectations are too high or unreasonable. Such cases require extremely clear communication with the patient before beginning the case, including an explanation of the final results, based on the patient's goals. Taking over a case from another colleague adds more complications and requires that close attention is paid to the reason for the original dissatisfaction between the former dentist and patient to avoid repeating the same mistakes. Clinically, patients with thin, fragile gingiva are extremely challenging if they require a fixed partial denture in the esthetic zone since the most common material, a ceramometal bridge, requires infragingival margins; if any recession occurs, a catastrophic esthetic failure will result. The case presented here underscores all these special issues. Proper multidisciplinary management, good patient communication, and the use of an all-ceramic fixed partial denture system can provide an excellent final result.

CLINICAL SIGNIFICANCE: Replacing teeth in the esthetic zone is complicated, especially when trauma has caused severe damage to the surrounding bone and gingiva. Satisfying a demanding patient requires a multidisciplinary approach and psychological management, as are exemplified in this article.