Severe bruxism can destroy natural teeth within a few years. Akindra, 33 from Turkey, arrived at International Plus with advanced tooth wear, jaw pain and gum disease after years of grinding. This case study documents the full mouth reconstruction our restorative team planned to save every natural tooth and rebuild both function and aesthetics with 24 zirconia crowns. Since 2014, International Plus has treated more than 200,000 patients from over 140 countries and Akindra’s case shows how early treatment prevents extractions when grinding has already reached the nerve.
Key Takeaways
- The challenge: Severe bruxism had worn Akindra’s teeth to the pulp, fractured a lower left tooth and caused gum recession, periodontal disease and jaw joint pain.
- The solution: A staged full mouth reconstruction: root canal treatment on eight teeth, deep periodontal care, then 24 zirconia crowns in shade OM1 and a Plus 5 tooth form.
- Technical highlights: Endodontic treatment on lower teeth 43, 42, 41, 31, 32, 33, 35 and upper tooth 11, followed by high strength multilayer zirconia crowns matched with digital smile design.
- The outcome: Every natural tooth was saved with zero extractions; Akindra regained a balanced bite and a uniform smile with a specialist referral for jaw joint follow-up.
Akindra’s Story: Years of Grinding Before the Diagnosis
Bruxism is a repetitive jaw-muscle activity of grinding or clenching, often during sleep. Akindra, 33 from Turkey, lived with severe bruxism for years before the damage became visible. Grinding had flattened Akindra’s tooth surfaces, fractured a lower left tooth and worn several teeth close to the pulp. Sensitivity to hot and cold made eating painful and constant jaw tension pointed to a temporomandibular joint problem. Sleep bruxism affects roughly 8 to 12 percent of adults according to a 2022 systematic review in Japanese Dental Science Review (Minakuchi et al., 2022). When Akindra first described the symptoms, our team recognized a pattern seen in other severe bruxism and tooth loss rehabilitations: a cosmetic worry hiding deeper structural loss. Because grinding rarely stops on its own, our restorative team treated Akindra’s bruxism as one whole-mouth problem, not a set of separate broken teeth.
Diagnosis and Treatment Plan for a Full Mouth Reconstruction
A full mouth reconstruction is the rebuilding of every tooth in both jaws to restore function, bite balance and appearance. For Akindra, our Diagnostic Council reviewed panoramic and periapical radiographs before approving any treatment. The findings were clear: advanced wear across 24 teeth, periodontal disease with gum recession, a fractured lower left tooth and pulp exposure on several lower teeth. Wear had reached the pulp on teeth 43, 42, 41, 31, 32, 33 and 35, plus upper tooth 11, causing sharp sensitivity. The Diagnostic Council, the board behind our multidisciplinary rehabilitation cases, sequenced care in three phases: endodontic treatment first, periodontal healing second, zirconia crowns last. Restoring root-filled teeth with full-coverage crowns improves long term survival as confirmed in a 2021 review in the International Endodontic Journal (Bhuva et al., 2021). In our practice, we prefer the staged sequence because rushing crowns onto inflamed gums risks early failure.
| Phase | Treatment | Teeth involved |
| Phase 1 | Root canal treatment | Lower 43, 42, 41, 31, 32, 33, 35 and upper 11 |
| Phase 2 | Deep periodontal scaling and gum-level correction | Full mouth, focus on recession sites |
| Phase 3 | 24 zirconia crowns, shade OM1, Plus 5 form | Both jaws, tooth-supported |
Why Did Akindra Need Root Canals and Gum Treatment First?
Root canal treatment is a procedure to remove infected or exposed pulp and save a natural tooth from extraction. Akindra needed root canals on lower teeth 43, 42, 41, 31, 32, 33 and 35, plus upper tooth 11 because grinding had worn several teeth into the pulp chamber. Some lower teeth were double-rooted, which demanded careful instrumentation. Before any crown work, the restorative team performed deep periodontal scaling and gum-level correction to treat the gum disease and recession. Non-surgical periodontal therapy reduces pocket depth and improves attachment according to a 2020 meta-analysis in the Journal of Applied Oral Science (Baeza et al., 2020). Healthy gums give crowns a stable, sealed margin. In the Istanbul phase, our team completed all endodontic and periodontal work before a single crown was prepared, protecting eight treated roots and preventing extractions across Akindra’s whole mouth.
Building Akindra’s Smile With 24 Zirconia Crowns
Zirconia is a strong ceramic used for durable, natural looking dental crowns. After endodontic and periodontal healing, the restorative team fitted Akindra with 24 zirconia dental crowns in shade OM1 and a Plus 5 tooth form. Each crown was milled from high strength multilayer zirconia, which blends color from gum line to biting edge for a lifelike result. The restorative team rebuilt the vertical dimension lost to grinding and balanced the occlusion for comfortable chewing, an approach anchored in the 2021 Occlusal Vertical Dimension consensus in the Journal of Prosthodontics (Goldstein et al., 2021). Monolithic zirconia crowns show high survival in tooth-supported cases, confirmed by a 2022 meta-analysis in the Journal of Prosthodontic Research (Leitão et al., 2022). Full-coverage zirconia suits heavy grinders because the ceramic resists fracture better than layered porcelain though even zirconia needs a protective night guard afterward. Our team matched each crown to Akindra’s face with digital smile design before cementation.
The Result: A Rebuilt, Functional Smile
Akindra completed the full mouth reconstruction with every natural tooth saved and zero extractions. The 24 zirconia crowns restored a balanced bite, removed the sensitivity and gave Akindra a uniform, natural smile in shade OM1. Because bruxism continues after treatment, the restorative team referred Akindra to a specialist for temporomandibular joint follow-up and fitted a protective night guard. Early treatment made the difference: catching the wear before roots were lost meant crowns, not implants. Zirconia single crowns show survival comparable to metal-ceramic restorations over five years per a 2018 systematic review in Clinical Oral Implants Research (Pjetursson et al., 2018). Patients can read comparable journeys in our couple full mouth zirconia case and our crossbite correction zirconium case. As with every case International Plus publishes, individual results may vary and only a personalized consultation can determine the right plan. Akindra’s full mouth reconstruction reflects a system built on a Diagnostic Council, staged sequencing and an in-house laboratory, backed by Ministry of Health authorization and 5,504 verified Google reviews at 4.8 out of 5.
Frequently Asked Questions
What is a full mouth reconstruction for bruxism?
A full mouth reconstruction for bruxism rebuilds all worn teeth in both jaws to restore chewing function, bite height and appearance. For grinders, treatment usually combines root canals for pulp-exposed teeth, periodontal care and full-coverage crowns such as zirconia, planned in stages so the healthiest teeth are preserved.
Can severely worn teeth be saved without extraction?
Severely worn teeth can often be saved when grinding has damaged the crown but the roots remain healthy. In Akindra’s case, root canal treatment on eight teeth and full-coverage zirconia crowns preserved every natural tooth. A thorough radiographic examination determines whether each tooth can be restored or needs replacement.
Why are zirconia crowns used for teeth grinding?
Zirconia crowns are used for teeth grinding because high strength multilayer zirconia resists fracture and wear better than layered porcelain. The ceramic rebuilds lost tooth height and balances the bite in a single, durable material. A protective night guard is still recommended afterward to reduce grinding forces on the new crowns.
How many crowns are used in a full mouth reconstruction?
A full mouth reconstruction typically uses 24 to 28 crowns, covering all visible and functional teeth in both jaws. Akindra received 24 zirconia crowns in shade OM1 with a Plus 5 tooth form. The exact number depends on how many natural teeth are present and which teeth need full coverage.
Does a full mouth reconstruction stop teeth grinding?
A full mouth reconstruction restores the damage from grinding but does not stop bruxism itself, which is driven by muscle and neurological factors. Akindra was referred to a specialist for jaw joint follow-up and fitted with a night guard. Ongoing management protects the new crowns from future grinding forces.
Reviewed by Dr. Abdurrahim Ulu
References
- Minakuchi H, et al. Managements of sleep bruxism in adults: a systematic review. Jpn Dent Sci Rev. 2022. PMC8958360
- Bhuva B, et al. The restoration of root filled teeth: a review of the clinical literature. Int Endod J. 2021. PMID 33128279
- Baeza M, et al. Effect of periodontal treatment in patients with periodontitis: a meta-analysis. J Appl Oral Sci. 2020. PMC6919200
- Goldstein G, et al. Occlusal Vertical Dimension: Best Evidence Consensus Statement. J Prosthodont. 2021. PMID 33331675
- Leitão CIMB, et al. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res. 2022. PMID 34615842
- Pjetursson BE, et al. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res. 2018. PMID 30328190
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This content is written, reviewed, and approved by the International Plus Medical Review Board to ensure clinical accuracy and adherence to strict editorial standards. All medical information is regularly monitored, audited and updated in light of the latest scientific advancements.
However the information provided here is for general informational purposes only and cannot be used for self diagnosis or making individual health interpretations. Results of medical treatments depend on individual anatomy and the unique healing process of each patient. This information should not replace a personal consultation with a qualified healthcare professional. To understand the best options for your specific needs and to receive a personalized treatment plan, we invite you to book a free consultation with the expert medical team at International Plus.
Dr. Emre Çolak concentrates on advanced implant surgery and modern regenerative treatments, delivering refined solutions to patients abroad in need of complex dental restoration.
