Go an extra mile for a perfect smile - A multidisciplinary approach for management of amelogenesis imperfecta

Abstract

Amelogenesis imperfecta refers to a group of rare, inherited disorders characterized by abnormal enamel formation. Patients mainly seek solution for unesthetic appearance caused by the condition. As prosthetic rehabilitation is essential for esthetics and function an interdisciplinary approach is often needed for restoration of health and its long-term maintenance. A multidisciplinary approach was mandatory for the management of this case. Short clinical crowns were present in all quadrant which made it difficult to achieve adequate retention and resistance forms for tooth replacement. In all quadrants, surgical crown lengthening was done by full thickness flap utilising a sub marginal incision with bone reduction wherever required to achieve bone level at least 3-4mm from gingival margin to facilitate supra crestal attachment (biologic width). After sufficient healing and stabilisation of gingival margins, prosthetic rehabilitation followed using fixed metal ceramic crown from molar to molar in both jaws. Depigmentation of the gingivae via conventional scalpel (upper arch) and laser (lower arch) was done to enhance the pink aesthetics. Sufficient crown length for a good resistance and retention form and adequate biologic width was established and pink white esthetic harmony was achieved.