Achieving Esthetic and Functional Objectives with Additive Equilibration

In a case involving a patient with high esthetic demands who wanted to keep treatment conservative, minimal direct bonding was used to enhance anterior esthetics while creating acceptable function. Primary treatment goals in the case, in which the patient was diagnosed with a constricted chewing pattern, were to improve esthetics by lengthening the maxillary anterior teeth and to stop continued loss of anterior tooth structure. Through the use of a Kois deprogrammer, an additive equilibration with direct composite was done to provide proper occlusal function to support the esthetic outcome, and no tooth reduction was needed.

The full diagnosis, the options on the table, and the reasoning behind the final plan — walked through start to finish.