Severely worn dentition seriously affects patient's esthetics and function. Its etiology is complex, differential diagnosis is difficult, treatment process involves multiple disciplines, and requires esthetic and functional rehabilitation. A "8-step sequential treatment" for the rehabilitation of severely worn dentition has been established. In recent years, digital technology has been increasingly applied to the esthetic and functional rehabilitation of severely worn dentition. This article will describe the application of digital methods in the 8-step sequential treatment of severely worn dentition.
Humans ; Tooth Wear/rehabilitation* ; Esthetics, Dental ; Dentition ; Digital Technology

Excessive wear causes many complications when untreated, so that accurate diagnosis, analysis and predictive treatment plan should be made, and through evaluation of vertical dimension and stepwise treatment, a stable inter-arch relationship can be set. For the long-term success of implant treatment, ideal position and angle of implant is important, and its importance increases especially in multiple implant cases. Therefore, thorough diagnosis and planning, accurate surgery and prosthodontic procedures are significant. In this case, a 68-year-old male patient with a loss of vertical dimension due to multiple tooth loss and overall tooth wear was planned with systematic analyses from the pre-treatment stage to rehabilitate vertical dimension. Full-mouth fixed rehabilitation with computer tomography guided implant surgery was performed to the newly set vertical dimension and attained satisfactory outcomes both functionally and esthetically.
Aged ; Dentition* ; Diagnosis ; Humans ; Male ; Rehabilitation* ; Tooth Loss ; Tooth Wear ; Tooth* ; Vertical Dimension*

Severely worn dentition is frequently multifactorial. It is crucial that the etiology of excessive wear be determined, but accurately diagnosing the factors responsible for tooth wear is often confusing. Before initiating the treatment of these cases, meticulous examination and determining vertical dimension are essential. A 69-year-old male patient had the chief complaint that he has worn dentition and functional and esthetic discomfort. Based on model analysis and diagnostic wax up, new vertical dimension had been determined. Provisional restorations were cemented and after 5 months permanent prostheses were fabricated. This case reports a satisfactory functional and esthetic clinical outcome achieved by restoring the vertical dimension.
Aged ; Dentition ; Humans ; Male ; Mouth Rehabilitation* ; Mouth* ; Prostheses and Implants ; Tooth Wear ; Tooth* ; Vertical Dimension*

The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and the permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function.
Aged ; Dental Occlusion ; Dentition ; Esthetics ; Female ; Humans ; Mouth ; Mouth Rehabilitation ; Splints ; Tooth ; Tooth Wear ; Vertical Dimension

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.
Aging ; Dental Occlusion ; Dentition* ; Diagnosis ; Humans ; Male ; Mouth Rehabilitation* ; Mouth* ; Tooth ; Tooth Wear ; Vertical Dimension*

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony and functional disorders. In this case, a patient with severely worn dentition was treated. Diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated with zirconia crown and routine clinical assessments were made. Esthetically and functionally satisfactory results were obtained.
Aging ; Crowns* ; Dental Occlusion ; Dentition* ; Humans ; Mouth Rehabilitation* ; Mouth* ; Tooth ; Tooth Wear ; Vertical Dimension

Complete denture prosthodontics includes replacement of natural teeth and associated maxillary and mandibular structures for full edentulous patients. The final objectives of prosthodontic treatment include esthetic and functional rehabilitation. Because the esthetic demand of senior patients has increased esthetic requirement should not be overlooked in denture treatment. In complete denture treatment, attempts have been made to reproduce tooth wear, arrangement, recession of cervical gingiva, staining, improved gingival shade and so on. This 61 year old female patient came to the Department of Prosthodontics with the chief complaint that dentures made 5 years ago in a local clinic were broken and did not fit well. The patient put more emphasis on fabrication of natural and esthetic dentures than recovery of masticatory function. Remake of maxillary complete denture and mandibular implant retained overdenture was planned. In order to create esthetic and natural contour, Aesthetic Color Set Easy system(R) (Candulor dental GmbH, Wangen, Germany) was used to make complete dentures reproducing various gingival shades. Patient's esthetic satisfaction was high. When complete denture prosthodontics treatment involves appropriate expression of individual characteristics in addition to proper selection of esthetic materials, treatment will give satisfaction to both dentist and patient.
Dentists ; Denture, Complete* ; Denture, Overlay ; Dentures ; Female ; Gingiva ; Humans ; Prosthodontics ; Rehabilitation ; Tooth ; Tooth Wear

With the evolution of the computer-aided design/computer-aided manufacturing (CAD/CAM) technology, the intraoral scanners are playing an increasingly important role, as they are the first step towards a completely digital workflow. The CAD/CAM double scanning technique has been used to transfer the information from provisional restorations to definitive restorations. In this case, a 67-year-old male with esthetically compromised anterior teeth, generalized severe attrition of teeth, and reduced vertical dimension was treated with full mouth rehabilitation including a re-establishment of the lost vertical dimension of occlusion assisted by the crown lengthening procedure. The provisional restorations were fabricated using an intraoral scanner and the CAD/CAM double scanning technique. After the period of adaption, the definitive monolithic zirconia restorations were delivered. The CAD/CAM double scanning technique successfully transferred the occlusal and morphological characteristics, obtained from the provisional restorations, to the definitive restorations.
Aged ; Crown Lengthening ; Dentition ; Humans ; Male ; Mouth Rehabilitation ; Mouth ; Tooth ; Tooth Wear ; Vertical Dimension

Excessive tooth wear results in unacceptable damage to the occlusal surface and can cause pulpitis, occlusal disharmony, dysfunction, and unesthetic result. Patients with severe attrition have to be classified as several types relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. The patient in this case was a 80 - year - old woman who lost support of posterior occlusion and collapsed of the occlusal plane due to confrontation of the opposing teeth, accompanied by an increase in the number of remaining bristles, resulting in a loss of intermaxillary space for prosthesis. In this case, treatment with increased vertical dimension may have stability if the increase in vertical occlusal height is minimized within the required range, and a stable occlusal contact is provided after an increased vertical occlusal height stabilization period. After the new VDO had been confirmed under interim fixed restorations, definitive fixed restorations were produced. Through these treatment processes, we obtain satisfactory results that are functional and aesthetically pleasing.
Dental Occlusion ; Dentition* ; Female ; Humans ; Prostheses and Implants ; Pulpitis ; Rehabilitation* ; Tooth ; Tooth Wear ; Vertical Dimension

Excessive tooth wear can cause irreversible damage to the occlusal surface and can alter the anterior occlusal relationship by destroying the structure of the anterior teeth needed for esthetics and proper anterior guidance. The anterior deep bite is not a morbid occlusion by itself, but it may cause problems such as soft tissue trauma, opposing tooth eruption, tooth wear, and occlusal trauma if there are no stable occlusal contacts between the lower incisal edge against its upper lingual surface. The most important goal of treatment is to form stable occlusal contact in centric relation. In this case report, patients with decrease in vertical dimension and anterior deep bite due to maxillary posterior tooth loss and excessive tooth wear were treated full mouth rehabilitation with increased vertical dimension to regain the space for restoration and improve anterior occlusal relationship and esthetics. The functional and aesthetic problems of the patient could be solved by the equal intensity contact of all the teeth in centic relation (CR), anterior guidance in harmony with the functional movement, and restoration of the wear surface beyond the enamel range.
Centric Relation ; Dental Enamel ; Esthetics ; Humans ; Mouth Rehabilitation ; Mouth ; Overbite ; Tooth Eruption ; Tooth Loss ; Tooth Wear ; Tooth ; Vertical Dimension