Abstract
This clinical report illustrates the oral rehabilitation of a 48 year old female patient with severely worn teeth with accompanying loss of vertical dimension of occlusion. The aim of treatment was to restore aesthetics and improve masticatory function and it was achieved by placing a tooth supported overdenture with custom made precision attachment from mandibular right and left first premolars, single crowns in relation to maxillary centrals, laterals, canines and right and left first premolars, metal-ceramic three unit fixed partial dentures for the missing maxillary and mandibular right and left first molars. Metal occlusal surfaces were preferred for strength and durability and keeping the cost factor in mind as per the patients request. This treatment option has been suggested to be efficient and cost effective,with the final outcome pleasing to the patient.
Highlights
Tooth wear is commonly found in every dentition and may have physiologic or pathologic causes
Most common problem to be faced in the reconstruction of a severely worn dentition is the lack of restorative space in which there will be a need in the alteration of the vertical dimension of occlusion (VDO), Understanding what determines the VDO and what the effects of altering it have on the temporomandibular joint (TMJ), muscle comfort, bite force, speech, and long term occlusal stability are prerequisites to rest oring the worn dentition
Assessment of the vertical dimension is important for the management, and careful comprehensive treatment plan is required for each individual case
Summary
Tooth wear is commonly found in every dentition and may have physiologic or pathologic causes. The determination of VDO can be achieved by several methods such as phonetics, interocclusal distance, swallowing & patient preferences[5,6,7,8]. A carefully monitored trial period with removable occlusal splints, followed by fixed provisional restorations should be performed whenever clinical evaluation demonstrates the necessity to restore VDO10-12. This clinical report describes the use of tooth supported over denture in relation to lower anterior with custom made precision attachment and single crowns in relation to upper anterior region and FPD in relation to upper and lower posterior teeth. Thi s treatment option is suggested to be efficient and cost effective, with the final outcome pleasing to the patient
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