An anterior reconstruction: increase the occlusal vertical dimension or reduce periodontal support?

Abstract

Aim The aim was to document a clinical situation which was managed at minimal biological cost and with straightforward implementation. Summary Challenges of space management may arise in prosthetic dentistry as a minimum height is needed for the supporting tissues and the restorative material. While increasing the vertical occlusal dimension allows an increase in the height of the prostheses, the option may be complex and has disadvantages, including the need to modify the entire occlusion. Crown lengthening is an alternative therapeutic option, but it results in a decrease in periodontal support. Nevertheless, it allows less extensive prostheses to be provided without impacting the rest of the arch. Managing complex clinical situations with moderate biological cost and straightforward implementation is possible, as illustrated in this clinical report. Key learning points 1. Crown lengthening is a solution to increasing the tooth surfaces necessary at prosthetic rehabilitation. 2. Increasing occlusal vertical dimension (OVD) is a solution to providing the occlusal space necessary for the restorative material without reducing the supporting tissues. 3. Crown lengthening reduces periodontal support but can be considered when the root length of the affected teeth is sufficient. 4. Increasing the OVD requires modification of the entire occlusion. 5. Crown lengthening offers the advantage of not modifying OVD or intercuspal position (ICP).