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- Remote pathological anamnesis: bulimia during youth<\/li>\n
- Recent pathological anamnesis: gastro-esophageal reflux disease (GERD)<\/li>\n
- Non smoker<\/li>\n
- Dental anamnesis: the patient complained about severe sensitivity on all teeth and wanted to improve the esthetics of her smile; the teeth were short and abraded<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
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![\"dental](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Articolo_blog_zerodonto_new.001.jpg\")
<\/a><\/h3>\n<\/h3>\n
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Reference lines of facial analysis<\/h3>\n
![\"dental](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/2.jpg\")
<\/a><\/p>\nThe horizontal line is used as the ideal reference line to set the facebow, independently from the parallelism with the bipupillary and commissural lines. In fact, it is worth remembering that the condyles of the articulator are always positioned according to the horizontal plane.<\/p>\n
![\"reference](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/31.jpg\")
<\/a><\/p>\n![\"4\"](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/42.jpg\")
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Smile progression<\/h3>\n
The progression of the smile shows that the incisal plane had a straight trend, with an evident reduction of the length of the anterior teeth.<\/p>\n
![\"smile](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/5.jpg\")
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Display at rest<\/h3>\n
The picture at rest position allows to notice the visibility mostly of the mandibular front teeth, resulting in an aged appearance. No upper incisors are shown.<\/p>\n
![\"display](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.00.47.jpg\")
<\/a><\/p>\n<\/p>\n
Dental analysis evaluation<\/h3>\n
The front view of the anterior teeth shows the shortening of the elements of the anterior maxillary area, due to severe wear, particularly at the level of the incisal margins; this was directly related to the serious wear evident at the palatal arch, secondary to the chemical erosion emerged during youth.<\/p>\n
![\"dental](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.00.59.jpg\")
<\/a><\/p>\nThe patient presented with the absence of the occlusal contacts in the posterior regions, due to the loss of retention of the previous temporary restorations. It is worth noticing how the shortening of the anterior teeth caused a marked reduction of the overbite.<\/p>\n
![\"dental](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.01.11.jpg\")
<\/a><\/p>\nThe occlusal view of the maxillary arch shows the evidences of recent surgical procedures at level of the premolars performed in another dental office, as well as the interim characteristics of the prosthetic restorations. Moreover, the severe wear of the palatal surfaces of the maxillary incisors is evident.<\/p>\n
![\"Schermata](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.01.31.jpg\")
<\/a><\/p>\n![\"Schermata](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.01.46.jpg\")
<\/a><\/p>\n<\/p>\n
Enamel preservation<\/h3>\n
A careful examination points out the severe wear of the palatal surfaces of the maxillary incisors, due to the chemical erosion caused by bulimia during youth. These specific areas are particularly subjected to wear phenomena because of the stagnation of acid remnants on the surface of the tongue, acting as \u201creservoir\u201d after GERD events.<\/p>\n
![\"enamel](\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2014\/11\/Schermata-2014-11-13-alle-16.01.58.jpg\")
<\/a><\/p>\nHowever, it is possible to highlight the presence of peripheral marginal enamel similar to that resulting from a chamfer tooth preparation, naturally determined by the above mentioned acid action. Furthermore, enamel \u201cislands\u201d are present, and keeping them would be paramount to achieve a better adhesion of the final restorations.<\/p>\n