Personalized Bonding Approach for Full-Mouth Adhesive Rehabilitation in Dentinogenesis Imperfecta

针对牙本质发育不全患者的全口粘接修复,采用个性化粘接方法

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Abstract

Dentinogenesis imperfecta is a rare genetic disorder impacting dentin structure, with an incidence of 1 in 6000 to 1 in 8000 individuals. This condition alters the tooth's color and structure, affecting patients aesthetically, functionally, and socially. Advances in adhesive dentistry offer new therapeutic possibilities, although challenges remain. This article describes the full-mouth adhesive rehabilitation of a 24-year-old male patient diagnosed with DGI, who presented with generalized enamel fractures, shortened crowns, and chronic apical infections. Clinical and radiographic examinations revealed typical features of DGI, including bulbous crowns, short roots, cervical constrictions, and pulpal obliterations. Microscopic analysis of an extracted molar confirmed enamel and dentin structural anomalies, including a smooth dentin-enamel junction (DEJ) and obliterated dentinal tubules. Given the compromised DEJ and high risk of enamel fracture, a minimally invasive, full adhesive treatment plan was developed. The protocol involved resin infiltration (Icon, DMG) to enhance enamel bonding, followed by the placement of lithium disilicate ceramic crowns in the anterior region and monolithic zirconia bridges posteriorly. Vertical dimension of occlusion was increased using composite abutments and a digital workflow ensured accurate, tissue-preserving preparations. The treatment significantly improved the patient's quality of life, with the General Oral Health Assessment Index (GOHAI) increasing from 36/60 to 58/60. A one-year follow-up showed no prosthetic or biological complications. Further research and long-term monitoring are necessary to confirm the clinical stability and effectiveness of this approach in managing dentinogenesis imperfecta.

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