Therapeutic Approaches in Adult Orthodontic-Restorative Patients with Dental Anomalies: A Narrative Review

Abstract

This narrative review (2023–2025) summarizes the treatment of adult orthodontic-restorative patients with different
dental anomalies, such as hypodontia, microdontia, or enamel anomaly. It is, therefore, extremely important to
have an interdisciplinary and digitally guided approach while managing adult dental anomalies. Digital dentistry,
supported by cone beam computed tomography, computer-aided design/computer-aided manufacturing, and
Digital Smile Design, enables diagnosis, treatment planning, as well as the interdisciplinary approach to be more
effectively realized. Research comparing clear aligners and fixed appliances revealed that although the results
regarding alignment are similar between the two systems, clear aligners are more comfortable to wear, easier
to maintain, and cleaner, as well as esthetically pleasing. Fixed appliances are still critical for mainly severe
malocclusions that need to be treated. In restoring teeth using ceramic veneer bonding to crowns on enamel, the
survival rate is above 90%, whereas composite bonded crowns fail readily. The existing technique is thereby
shifted by present restorative techniques toward the preservation of enamel and minimally invasive techniques
using bioactive materials. Orthodontic alignment in combination with restorative excellence offers digital control
over the predicted function and esthetics of a case. It is, therefore, extremely important to have an interdisciplinary
and digitally guided approach while managing adult dental anomalies.