Esthetic and function rehabilitation of severely worn dentition with prosthetic-restorative approach and VDO increase. Case report

摘要

The aim of this study is to report a case of restorative treatment of severely worn dentition. In this case report,udthe erosive/abrasive worn dentition have been reconstructed with metal ceramic crown on the posterior teeth and withudceramic veneers on the anterior teeth 1.3 - 2.3 and 3.4 - 4.3. A prosthetic treatment was proposed to a male patient of 58 years old having a clinically significant tooth wear. After clinical exam, impressions of maxillary and mandible arches were taken with alginate to obtain preliminaryudcasts for diagnostic waxing to all maxillary and mandibular teeth and fabrication of all provisional crowns in acrylic resin for posterior teeth, and from the diagnostic wax-up were fabricated a silicone guide masks for anteriorudteeth. An increase in VDO should be determined on the basis of a need to accomplish satisfactory and aesthetically pleasing restorations; it was proposed to increase the incisal lenght of the maxillary anterior incisors, together with alteration of the VDO 3 mm anteriorly. The posterior teeth 1.6 - 1.5 - 1.4 - 2.4 - 2.6 - 3.5 - 3.6 - 3.7 - 4.4 - 4.7, where the amount of tissue lost was greater, wereudrecontructed with metal ceramic crowns. Two implants (Nobel replace 4.3x10) was placed. The implant were located inudthe area 4.5 - 4.6. The anterior teeth were restored with veneers. The prosthetic challenge with restoring severely worn dentitions is to preserve as much of the alreadyuddiminished tooth structure as possible for retention while also providing enough interocclusal space for the restorative material.