A Conservative Prosthodontic Approach to Full-Mouth Rehabilitation in a Patient with Severe Tooth Wear and Tetracycline Staining

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A Conservative Prosthodontic Approach to Full-Mouth Rehabilitation in a Patient with Severe Tooth Wear and Tetracycline Staining

Jimmy Londono, DDS, FACP; and Sung Bin Im, CDT

Severe tooth wear combined with intrinsic tetracycline staining presents clinicians with the dual challenge of restoring occlusal function while effectively masking a deeply discolored dentition. This CE article presents the full-mouth rehabilitation of a 40-year-old female patient using a conservative prosthodontic approach supported by comprehensive diagnosis, digital smile design, and a provisional evaluation phase to confirm adaptation to an increased vertical dimension of occlusion before definitive treatment. The authors outline key clinical and laboratory procedures, including conservative tooth preparation, digital wax-up, provisionalization, try-in verification, and an evidence-informed zirconia bonding and cementation protocol. The article also explores the role of multilayer monolithic zirconia in balancing mechanical performance with esthetic demands in challenging discoloration cases. This case report demonstrates how a minimally invasive, carefully planned treatment approach can achieve predictable functional and esthetic outcomes in patients with severe wear and tetracycline staining.