Predictable Esthetics through Functional Design: The Role of Harmonious Disclusion

The goal of this clinical report is to describe and illustrate the principles for achieving a predictable esthetic result for patients with worn incisal edges by creating a harmonious angle of disclusion. Patients can create an esthetic problem from altered tooth form and tooth migration, caused by worn incisal edges resulting from parafunctional activity. This presents substantial challenges to the restorative dentist, paramount among them, achieving longevity of porcelain or composite bonded restorations used in an esthetic reconstruction. Although a number of therapies are available to provide esthetic improvement, the predictability in the continuing presence of the parafunction that caused the esthetic problem is in doubt. Altering the incisal edge position for esthetics and achieving a harmonious angle of disclusion, though, is a clinical approach that may substantially reduce this risk. CLINICAL SIGNIFICANCE An angle of disclusion in harmony with a patient’s envelope of parafunction reduces load on the anterior teeth and therefore may help reduce failure on the restored anterior teeth.