Prolonged retention of tooth enhances the possibility that dentist may treat the patients with severe tooth wear without any invasive procedure. Tooth wear is generally considered as a result of natural physiological process. On average, the occlusal wear is estimated to be 29 µm per year for molars and 15 µm per year for premolars.1 Some endogenous or exogenous factors (e.g.; tobacco chewing) accelerate the normal wear rate and results in pathologic tooth wear. Tooth wear as a result of parafunctional habits is anticipated to progress approximately 3 times faster than physiological tooth wear.2,3 The etiologic factors include bruxism, gastroesophageal reflux disease and congenital anomalies such as Weyer's acrodental dysostosis and Dentinogenesis imperfecta.4,5 Predicting a suitable differential diagnosis is difficult in such cases due to the possibility of combination of these processes in developing occlusal wear.6

Although 'full-mouth rehabilitation' is the treatment of choice for generalized tooth wear, it is not always true applied to all clinical conditions. That is why a more comprehensive occlusal rehabilitation approach may be used to manage generalized tooth wear when the coronal tissues are moderately worn, and only some teeth require endodontic and restorative treatment. A prior endodontic restoration in worn dentition with an acceptable existing vertical dimension at occlusion and established occlusal relationships not only simplifies the treatment procedures but also makes it economically efficient. An overlay denture is partial or complete removable denture fabricated over retained roots or teeth that are not prepared with a coping to interfere with the denture.7 Overlay dentures has part of their components that covers the occlusal surface of the abutment teeth to restore them into a functional occlusion.8-10 The present article described an unique prosthodontic management of a pediatric patients suffering from rare hereditary disorders wherein the tooth development and morphology is severely impaired.

A 13-year-old male with a known history of Weyer's acrodental dysostosis reported to the dental clinic with the chief complaint of difficulty in eating and poor esthetics of the existing denture. History revealed that a denture had been fabricated 2.5 years ago, but no longer fitted. Intraoral examination showed extensive tooth wear extending to the cementoenamel junction in most areas of the teeth. Additionally, several findings related to the syndrome were noticed like partial ankyloglossia, widely spaced teeth, discolored malformed dentition, oligodontia, large pulp chambers, and collapsed bite (Figs. 2A and 2B). Radiographic finding includes multiple impacted teeth, multiple missing permanent tooth germs, retained teeth, short roots and enlarged and open pulp chambers (Fig. 2C). The fabrication of overlay denture was planned to restore the lost vertical dimension of occlusion and to improve the associated class III facial profile (Figs. 3-5). Most evidently, the patient's attitude, self-confidence and quality of life had enhanced (Fig. 6). As the available tooth structure is insufficient for future fixed prosthodontic treatment, relining/rebasing of existing denture or fabrication of new overlay denture is planned for long-term usage.

Complete overlay dentures are comparatively simple to fabricate and render satisfactory results as in present case report where the pediatric patient had an excellent treatment outcome. The major advantages include: low treatment cost, short chair time, reversibility, alterability, maintenance of alveolar bone and preserved proprioception, and excellent retention and stability. Most outstandingly, there is also a great deal of psychological benefit to the child patient.