Fig.1
A 35-year-old male presented in 2020 with moderate enamel and dentin wear affecting the anterior teeth. The patient had already noticed esthetic changes. Given his young age and the unclear etiology, the tooth wear was classified as severe. His chief complaint was to address the wear in the lower anterior teeth and to improve the overall esthetics, without a specific request for whiter teeth.

Fig.2
The maximal intercuspidation position shows already a tendency to deep bite, because of the dental wear. It was decided to use aligners to obtain the missing restorative space in the frontal area.

Fig.3
The maximal intercuspidation position after aligner therapy (18 weeks). The overbite was not increased.

Fig.4
Prosthetic space was obtained in maximal intercuspidation position in the frontal area using aligner therapy.

Fig.5
Digital wax-up.

Fig.6
Feldspathic ceramic chip for restoring the tip of the lower left canine. The dry try-in. All incisors both upper and lower jaw received such a ceramic chip.

Fig.7
Adhesive cementation protocol: rubber dam isolation, sandblasting, orthophosphoric acid etching, adhesive application and protection of the neighboring teeth with teflon tape, placement of the ceramic chips with the resin cement on the lower left canine.

Fig.8
Frontal view of the maxilla: after the aligner therapy, the mock-up, the rounded incisal edges, the ceramic chips in place.

Fig.9
Frontal view of the mandible: after the aligner therapy, the mock-up, the rounded incisal edges, the ceramic chips in place.

Fig.10
Static occlusal contacts. Comparison of the digitally planned contacts and the final occlusal contacts after adhesive cementation.

Fig.11
Palatal view of the maxilla after the adhesive cementation of the ceramic chips.

Fig.12
Smile close-up after the aligner therapy.

Fig.13
Smile close-up with the final outcome.

Fig.14
Frontal view at 3 years recall.

Conclusions

Advances in ceramic materials and interdisciplinary collaboration now support conservative treatment of worn dentitions. The orthodontic-assisted no-preparation technique is predictable, efficient, well tolerated by patients, and preserves natural tooth structure.

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