J Korean Acad Prosthodont.  2016 Apr;54(2):132-139. 10.4047/jkap.2016.54.2.132.

Full mouth rehabilitation in a severe worn dentition with vertical dimension gaining: A case report

• Kim JS
• Lee JH
• Jhin MJ

• KMID: 2162389
• DOI: http://doi.org/10.4047/jkap.2016.54.2.132

Abstract

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.

Keyword

Worn down dentition, Vertical dimension of occlusion; Full mouth rehabilitation; Zirconia

MeSH Terms

Aging
Dental Occlusion
Dentition*
Diagnosis
Humans
Male
Mouth Rehabilitation*
Mouth*
Tooth
Tooth Wear
Vertical Dimension*

Figure

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  Fig. 1. Pretreatment condition. (A) Centric movement, (B) Protrosive movement, (C) Maxillary occlusal, (D) Right movement, (E) Left movement, (F) Mandibular occlusal.

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  Fig. 2. Pretreatment condition. Panoramic view.

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  Fig. 3. Model analysis. Diagnostic wax-up model with new occlusal vertical dimension.

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  Fig. 4. Provisional stage (AlikeTM, GC America inc., Alsip, IL, USA) (A) Centric movement, (B) Protrosive movement, (C) Maxillary occlusal view, (D) Right movement, (E) Left movement, (F) Mandibular occlusal view.

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  Fig. 5. Tooth preparation.

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  Fig. 6. Definitive cast (PROTAR®evo., Kavo Dental GmbH, Biberach, Germany).

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  Fig. 7. Full contour wax-up.

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  Fig. 8. Post-treatment condition. (A) Centric movement, (B) Protrosive movement, (C) Maxillary occlusal view, (D) Right movement, (E) Left movement, (F) Mandibular occlusal view.

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  Fig. 9. Post-treatment condition. Panoramic view.

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