The PGO concept: Prosthetically guided orthodontics concept.

OBJECTIVE: The aim of this case report is to present a novel digital approach of guiding orthodontics and periodontal surgery by creating interim restorations that represent the final shape of the teeth before starting the treatment. CLINICAL CONSIDERATIONS: The patient presented with worn dentition, super-erupted maxillary and mandibular anterior teeth, and altered passive eruption, all this creating a gummy smile. Following a digital wax-up design, a digital orthodontic set-up, and the digital bracket bonding, temporary restorations, and bracket indirect bonding trays were fabricated. Restorations' cementation, bracket bonding, and periodontal surgery were performed the same day. After 14 months of orthodontic treatment, teeth were restored with final ceramic restorations. One year and 6 months was the total treatment duration. CONCLUSION: Prosthetically guided orthodontic concept allows the use of digital technology to simulate the final outcome of the patient treatment before starting dental therapy. This technique not only improves the communication between specialists, it also reduces treatment time and increases precision and predictability. CLINICAL SIGNIFICANCE: The prosthetically guided orthodontics (PGO) concept has the goal to start interdisciplinary therapy with a simulation of the final outcome. Giving the worn teeth their proper size through interim restorations prior to orthodontic therapy will guide the orthodontist from the beginning of the treatment and will improve communications between all the specialists. Through a digital approach, a digital wax-up and an orthodontic digital set-up the objectives of treatment can be established early on.