Tooth wear is often progressive and multifactorial. When left unmanaged, it can affect not only smile aesthetics but also occlusal stability and joint comfort.

In this case, our patient presented with generalised anterior tooth wear, resulting in shortened clinical crowns and a noticeable clicking of the temporomandibular joint. She was concerned about the ageing appearance of her smile and the long-term functional implications of continued wear.

Comprehensive Diagnosis and Planning

As with all advanced restorative cases, treatment began with a thorough examination. This included assessment of:

• Wear patterns and enamel loss
• Occlusal relationships
• Vertical dimension considerations
• Temporomandibular joint function
• Periodontal health

Understanding the underlying cause of wear is critical before undertaking additive restorative treatment. Composite bonding must not only improve aesthetics, but also integrate harmoniously within the patient’s functional envelope.

High-resolution intraoral and full-face photographs were taken to analyse smile proportions, tooth display and facial dynamics.

Digital Smile Design & 3D Mock-Up

Using advanced digital planning software, we designed a proposed increase in tooth length and refinement of contour to restore lost structure while maintaining natural aesthetics.

A 3D-printed mock-up was fabricated from the approved digital design. This provisional template was transferred directly into the mouth, allowing the patient to:

• Visualise the new proportions
• Assess phonetics and occlusion
• Experience the proposed vertical changes
• Provide informed approval prior to definitive treatment

This stage is fundamental in ensuring predictability and shared understanding.

Restorative Phase

Following patient approval, six upper anterior teeth were restored over approximately three hours.

Rubber dam isolation was used to ensure optimal moisture control – essential for long-term bonding success. The enamel surface was conditioned using micro-etching, a minimally invasive technique that does not require drilling but creates microscopic surface texture to enhance adhesion.

Using the validated mock-up as a reference, each tooth was restored with layered composite resin, carefully sculpted to reproduce natural morphology, surface texture and light reflection.

Final Outcome

After two appointments, both aesthetics and function were significantly improved. The anterior teeth were restored to harmonious proportions, and the occlusion was carefully balanced to improve comfort and joint stability.

The result is a rejuvenated smile supported by improved functional control.

The next phase of treatment will address the posterior teeth to further stabilise the occlusion and protect the anterior restorations long-term.