Full‐Mouth Rehabilitation of a Patient with Severely Worn Dentition and Uneven Occlusal Plane: A Clinical Report

Abstract

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.

Aşiri Di̇ş Aşinmasi Olan Bi̇r Hastanin Tam Ark Restorasyonu Ve Isirma Kuvveti̇ni̇n Değerlendi̇ri̇lmesi̇: Vaka Raporu

“…16 Hastaların artan dikey boyuta nöromusküler adaptasyonunun genellikle oklüzal splint veya geçici restorasyon (direk kompozit rezin uygulamaları veya geçici restorasyonlar) veya onlay protezler kullanımıyla yapılabileceği bildirilmektedir. 11,12,23,24 Bu yöntemler arasında, yapım ve uyumlamaları kolay olsa da, okluzal splintler, hareketli apareylerdir ve konuşmada sorun yaratabilirler. Aynı amaçla onley protezler sık kullanıl-makla beraber, yüksek maliyet zor yapım işlemleri ve uyumlama güçlüğü ve konuşma sorunları gibi dezavantajlara sahiptir.…”

“…10 Ancak, diş aşınmasının bu tolere edici mekanizmaları aştığı durumlarda OVB kaybı görülür; böyle durumlarda diş aşınması yavaş ilerler ve karşıt çenedeki dişlerin erüpsiyonu restorasyon için gerekli mesafeyi ortadan kaldırır. 11 Dolayısıyla, aşınmış dişlerin estetik ve fonksiyon amaçlı restorasyonu sırasında restoratif tedavi için yer sağlanması OVB'nin arttırılmasını gerektirebilir.…”

Full Mouth Rehabilitation of a Patient with Severely Worn Dentition and Reduced Occlusal Vertical Dimension: A Clinical Report

“…19 The distribution of wear in the dentition is not even, as is evidenced by the difference between anterior and posterior teeth. 20 Inadequate or unstable posterior support has been identified as a factor in severe anterior attrition and decreased OVD. 21 Posterior occlusal prematurities, too, may cause increased function on anterior teeth, resulting in increased wear.…”

Ultrasound Effect in the Removal of Intraradicular Posts Cemented with Different Materials

“…Moreover, there is a consensus that worn teeth can be a result from a combination of long-lasting etiological factors, which increases the teeth wear over de the years. 24,25 Thus, a correct diagnosis and treatment planning should be carefully planned to avoid further dental damage. Recently, Marques et al examined the influence of the instrumentation technique and irrigating solutions on the bond strength of the glass fiber posts to radicular dentin.…”