Journal List > J Korean Acad Prosthodont > v.54(2) > 1034863

Kim, Lee, and Jhin: Full mouth rehabilitation in a severe worn dentition with vertical dimension gaining: A case report

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. (J Korean Acad Prosthodont 2016;54:132-9)

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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.
jkap-54-132f1.tif
Fig. 2.
Pretreatment condition. Panoramic view.
jkap-54-132f2.tif
Fig. 3.
Model analysis. Diagnostic wax-up model with new occlusal vertical dimension.
jkap-54-132f3.tif
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.
jkap-54-132f4.tif
Fig. 5.
Tooth preparation.
jkap-54-132f5.tif
Fig. 6.
Definitive cast (PROTAR®evo., Kavo Dental GmbH, Biberach, Germany).
jkap-54-132f6.tif
Fig. 7.
Full contour wax-up.
jkap-54-132f7.tif
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.
jkap-54-132f8.tif
Fig. 9.
Post-treatment condition. Panoramic view.
jkap-54-132f9.tif
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