A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: A clinical report

Bruxism is a parafunctional activity related to clenching or grinding the teeth and tooth wear can be a consequence of sleep bruxism (SB). Management of severe tooth wear due to SB is a challenging situation because of the common reduced amount of remaining dental structure and loss of vertical dimension of occlusion. Rationale for the planning of oral rehabilitation of patients with SB presenting severe tooth wear should rely on evidence-based approaches; however, few studies have discussed properties of dental materials for SB rehabilitation and how to cosmetically manage severe tooth wear. This review aimed to provide an overview into bruxism cosmetic rehabilitation and how this can be implemented with good outcomes for the patient.

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“… 29 A more difficult condition is when there is an occlusal plane discrepancy, because an uneven amount of restoration is required. 30 …”

Section: The Management Of Sb Oral Complicationsmentioning

confidence: 99%

Sleep bruxism: challenges and restorative solutions

Mengatto

Coelho-de-Souza

Souza

2016

CCIDE

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“…Numerous case reports have demonstrated successful treatment of patients with severely worn dentitions, 38,[56][57][58][59][60][61][62][63] all with the caveat that there needs to be a compelling reason to do so. Patients are often given an intra-oral "occlusal device" post treatment to minimize damage from parafunctional habits.…”

Section: Systematic Reviewsmentioning

confidence: 99%

Occlusal Vertical Dimension: Best Evidence Consensus Statement

Goldstein

Goodacre

MacGregor³

2021

Journal of Prosthodontics

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Purpose Patients in need of extensive prosthodontic treatment may need restoration of their occlusal vertical dimension (OVD) due to tooth wear, tooth loss, or changes that have occurred to existing prostheses over time. Prosthodontic treatment is based on the clinical application of the available evidence regarding interocclusal distance (IOD), the positional stability of rest vertical dimension (RVD), and the effect of altering the OVD. Hence, the purpose of this consensus document is to examine available data related to IOD, RVD, and alteration of the OVD. Materials and Methods The search was limited to Clinical trials, Randomized Controlled Trials, Systematic Reviews and Meta‐analyses. Key words were healthy patient, mean, range, interocclusal rest distance; healthy patient, mean, range, freeway space; and dentistry, interocclusal gap, and no citations appeared. Dentistry, interocclusal distance, revealed 5 not relevant citations. Dentistry, inter occlusal rest space, and dentistry, interocclusal rest distance, both had the same single not relevant citation. Dentistry, freeway space revealed over 7,000 citations. Dentistry, occlusal vertical dimension, revealed 253 citations, 7 of which were related to the search question but only 1 which was different from the previous search. Mandible, rest vertical dimension, age changes, found 7 citations, none relative to the question. Expanding the search to include journal article found 260 citations with only one relevant to the question. Mandible, rest vertical dimension, alteration, harm revealed no citations; mandible, occlusal vertical dimension, alteration, revealed 15 citations, 1 of which was relevant; mandible, occlusal vertical dimension, changes, revealed 75 citations, none of which were relevant; mandible, occlusal vertical dimension, rehabilitation revealed 10 citations, none of which were relevant. Expanding the search strategy to include Journal article, mandible, occlusal vertical dimension, alteration, received 159 citations, 4 of which were relevant; mandible, occlusal vertical dimension, restoration revealed 208 citations, 1 of which was relevant. Numerous other articles were culled by going through the reference lists of the aforementioned articles. Results For IOD, 27 articles were found relevant to the search question, which confirmed a mean of 3.0 mm with ranges from 1 to 9 mm. Five articles revealed little evidence as to whether the RVD changes during life. For OVD, 20 articles, including 4 systematic reviews, revealed some evidence that skeletal growth continues from mid adolescence into mid adulthood; strong anecdotal evidence that some unopposed teeth will continue to erupt; no clinical evidence to support the concept that abraded teeth in occlusion in a patient with bruxism will undergo continuous eruption; and some evidence from clinical case reports that restoring OVD in patients with severe abrasion is a successful treatment. Conclusions There is a range of dimensions for the interocclusal distance (IOD) with many normal dental p...

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“…3 A atrição desencadeia o desgaste em facetas coincidentes nos dentes antagonistas. 5 O desgaste dos dentes é, de forma geral, uniforme, porém existem casos em que podemos identificar a discrepância de resistência ao desgaste em áreas de um mesmo elemento, denotando a variação da composição interna do dente. Ou seja, as áreas de maior mineralização resistem mais ao desgaste.…”

Section: N T R O D U çãOunclassified

Reabilitação funcional e estética de paciente com dentição desgastada: uma abordagem minimamente invasiva

Guanaes

2020

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Introdução: O desgaste generalizado dos dentes pode levar à deterioração do plano oclusal levando a um comprometimento estético-funcional dos dentes e a quadros complexos de reabilitação oral. Caso Clínico: Paciente SSS, homem, 62 anos, saúde sistêmica estável, dentado total, com sinais clínicos de desgaste dental generalizado por atrição. Foi confeccionada uma placa (overlay) estabilizadora para aumentar a DVO do paciente, gerando o espaço necessário para a reconstrução das estruturas perdidas. Posteriormente foram restaurados com resina composta direta todos os elementos do arco inferior, bem como os elementos 11; 12; 13; 14; 21; 22; 23 e 24 no arco superior. Desta forma se reestabeleceu, forma, função e estética dos elementos restaurados com uma abordagem conservadora e de baixo custo. Um dispositivo interoclusal foi confeccionado a fim de evitar a degradação dos dentes restaurados. Conclusão: Esse caso demonstrou um tratamento restaurador minimamente invasivo com a utilização de restaurações diretas em resina composta, o qual pode ser considerado como uma alternativa para a reconstrução de dentição desgastada por atrição, apresentando excelente resultado em curto prazo

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A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: A clinical report

Cited by 11 publications

References 15 publications

Sleep bruxism: challenges and restorative solutions

Sleep bruxism: challenges and restorative solutions

Occlusal Vertical Dimension: Best Evidence Consensus Statement

Reabilitação funcional e estética de paciente com dentição desgastada: uma abordagem minimamente invasiva

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