Minimally Invasive Prosthetic Procedure (MIPP): Up to 12-Year Survival of Full-Mouth Rehabilitations in Patients with Severely Worn Dentition (Managed with Lithium Disilicate Ceramic Restorations).

Minimally invasive prosthetic procedures (MIPPs) have been suggested and utilized for the esthetic rehabilitation of severely worn dentition. Minimizing the reduction of tooth structure and the use of additional adhesive techniques are key elements to ensure long-term results. This article presents the long-term result of this restorative technique. A total of 1,040 lithium disilicate restorations were adhesively luted, and 45 patients and 87 arches were treated. The cumulative survival rate recorded was 99.15%, with a 10-year survival probability of 96.5%. These remarkable results strongly support the use of MIPP as a restorative option for severely worn dentition.

Increasing the Vertical Dimension of Occlusion: A Multicenter Retrospective Clinical Comparative Study on 100 Patients with Fixed Tooth-Supported, Mixed, and Implant-Supported Full-Arch Rehabilitations.

This multicenter retrospective clinical study was aimed at comparing the effects of an increase in vertical dimension of occlusion (VDO) in patients with fixed rehabilitations. Expert clinicians retrospectively evaluated 100 patients treated with an increase of the VDO and fixed dental prostheses (FDPs) supported by teeth, implants, or both. The patients were divided into three study groups according to the type of support of restorations in posterior areas, as follows: partially edentulous patients with posterior teeth-supported rehabilitations and no implants in posterior segments (group A), partially edentulous patients with posterior mixed rehabilitations and at least one osseointegrated implant in posterior segments (group B), and completely edentulous patients with posterior implant-supported rehabilitations (group C). The new VDO was tested with mock-ups, temporary restorations, or removable appliances. The patients were followed up for at least 1 year after the delivery of final restorations. Clinical variables were collected retrospectively, such as presence of referred self-reported bruxism and temporomandibular joint or muscle symptoms before treatment, extension of the dental arches, increase in VDO, restorative materials, and functional complications. Descriptive statistics were analyzed; the three experimental groups were compared with one-way analysis of variance (ANOVA) followed by Tukey post hoc test for the quantitative variables and with logistic regression using the likelihood ratio test for the qualitative variables. Statistically significant differences were reported among the experimental groups for functional complications. Functional and prosthetic complications after the VDO increase were not frequent. Functional complications were mainly noticed in group C but usually were no longer evident after 2 weeks. No significant differences were found between groups in terms of prosthetic complications and self-reported bruxism.

Esthetic rehabilitation of a worn dentition with a minimally invasive prosthetic procedure (MIPP).

A minimally invasive prosthetic procedure (MIPP) for the esthetic rehabilitation of the complete arch advocates the preservation of enamel to optimize the adhesive bond of the luting agent to both the tooth surface and the etchable ceramic restoration. When esthetic rehabilitation of a worn dentition is required, a MIPP can be selected to reduce the biological cost of removing additional enamel tooth structure. The fundamental steps to achieve this goal are to: (1) increase the vertical dimension of occlusion (VDO); (2) reduce the thickness of the monolithic ceramic material; (3) preserve the enamel during tooth preparation; and (4) adhesively bond the etchable ceramic restorations. This article presents a comprehensive, minimally invasive prosthetic treatment approach for the esthetic rehabilitation of a severely worn dentition using a lithium disilicate all-ceramic material with partial and complete coverage restorations.

Esthetic rehabilitation of a severely worn dentition with minimally invasive prosthetic procedures (MIPP).

Restorative treatment of the severely worn dentition is typically indicated to replace deficient tooth structure, limit the advancement of tooth destruction, improve oral function, and enhance the appearance of the teeth. Minimizing removal of additional tooth structure while also fulfilling the desire of patients to have highly esthetic restorations can present a prosthetic challenge when the existing tooth structure is already diminished. This article presents a comprehensive minimally invasive prosthetic treatment approach using a lithium disilicate all-ceramic material for the esthetic rehabilitation of a severely worn dentition for a female patient diagnosed with Söjgren syndrome.