A Digital Workflow for Aesthetic Rehabilitation of Severe Fluorosis: Combined Laser Gingival Recontouring and Ceramic Veneers

Abstract

Aim and Background: Dental fluorosis is a prevalent condition resulting from high fluoride consumption during tooth development. The cosmetic impact of dental fluorosis can harm an individual's oral health-related quality of life and lead to long-term psychological and social effects. In extreme cases, where the fluorosed enamel is susceptible to chipping, flaking, and tooth decay, minimally invasive treatments are insufficient, and more extensive restorative measures are needed to regain proper function and appearance. Case description: A 26-year-old female patient presented with a chief complaint of discoloured anterior teeth and an unesthetic smile. Clinical examination revealed severe brown staining and pitted enamel surfaces consistent with moderate to severe dental fluorosis, as well as an uneven gingival contour with occlusal cant. A TFI score of 7 was given. Treatment: To correct the uneven occlusal cant, laser gingivectomy was performed following which the veneer preparations were refined and digitally scanned. The fluorotic lesions on the maxillary arch were rehabilitated using eight lithium disilicate veneers. The mandibular teeth were restored using direct composite veneers. A 3-month follow-up exhibited good aesthetics and patient satisfaction. Conclusion: The use of ceramic veneers in conjunction with laser gingival recontouring offers a predictable, minimally invasive solution for managing severe fluorosis stains, especially when aesthetic demands are high. Careful case selection, treatment planning, and adherence to adhesive protocols are critical to achieving long-term success. Clinical Significance: This case underscores the importance of a multidisciplinary approach combining soft tissue management and ceramic restoration in the aesthetic rehabilitation of fluorosed dentition. Ceramic veneers provide a durable and highly aesthetic option for patients with intrinsic discoloration and enamel defects, restoring both function and confidence.