How to Use Minimally Invasive Techniques and Smile Design Principles

Dental Team: Dr. Javier Vasquez, Oral Design Miami, South Miami, FL, who has an in-house laboratory and was the master ceramist on the case, and Dr. María Del Roció Montoya, Miami Natural Smiles, also in South Miami, who assisted on the case.

Restorative Challenge: A 24-year-old female patient presented with a great deal of aberration due to a gag reflex and other medical conditions (see Figure 1). During examination, we noticed she had lost a tremendous amount of vertical dimension as a result of breakage of the teeth. We also observed pronounced facial musculature changes and a lack of function. We took several photographs that documented the delamination of the enamel that was also affecting the lingual surfaces of the teeth.

There was a collapse between the upper and lower dentition that was creating a parafunction of...