Multidisciplinary Esthetic Rehabilitation of a Traumatized Central Incisor
Abstract
Management of anterior tooth fractures has progressively shifted toward minimally invasive strategies that preserve sound dental tissues while achieving optimal esthetic outcomes. When traumatic injuries are associated with enamel defects and gingival pigmentation, successful rehabilitation requires a comprehensive multidisciplinary approach addressing both dental and soft-tissue esthetics. A 22-year-old woman presented with esthetic concerns following trauma to the maxillary anterior region. Clinical examination revealed an uncomplicated enamel–dentin fracture of the maxillary right central incisor (tooth 11), enamel hypomineralization affecting both central incisors, and physiological gingival hyperpigmentation. A staged multidisciplinary treatment protocol was implemented. The fractured tooth was initially restored with a direct composite resin as a provisional restoration. Enamel microabrasion was subsequently performed to eliminate superficial hypomineralization defects and improve color uniformity. Gingival depigmentation using a rotary diamond bur was then carried out to optimize the appearance of the gingival tissues before definitive restoration. Finally, a lithium disilicate partial ceramic veneer was fabricated using a digital workflow and adhesively bonded following conventional hydrofluoric acid etching, silanization, and adhesive cementation protocols. The sequential therapeutic approach resulted in excellent integration of the restoration with the adjacent dentition and surrounding gingival tissues while preserving maximum sound enamel. The patient expressed high satisfaction with the esthetic outcome, which included improved tooth morphology, color harmony, and gingival appearance. This case illustrates that combining enamel microabrasion, gingival depigmentation, and adhesive rehabilitation with a lithium disilicate partial ceramic veneer provides a conservative and predictable treatment option for complex anterior esthetic rehabilitation. Careful t