Worn teeth – Loss of occlusion on the vertical plane

The problems we face in patients can be separated into problems along either the vertical or the horizontal plane. On the horizontal level, for example, we find teeth migrations and malocclusion. On the vertical plane we find occlusal problems (overerupted teeth, abrasion, etc.) and problems due to loss of posterior support which causes reduced vertical dimension of the face of the patient.

A 67 year old male patient was admitted to our clinic with intense wear of the anterior teeth and loss of posterior support of the face due to the bilateral lack of lower back teeth. He wished for both aesthetic and functional restoration.

The prosthetic treatment plan needs to take into account the degree of tooth wear and the lost vertical dimension.

To begin with, crown lengthening of the worn teeth and endodontic treatment was undertaken.

The vertical dimension had to be increased by 4 mm in the anterior region.
This increase was achieved step by step by using an intraoral splint and the use of temporary restorations, which were evaluated with regards to speech and aesthetics.
The patient faced no adaptive problems with the new vertical dimension.
ΤFinally, cast dowel and core restorations were carried out as well as the final restorations.

The patient was satisfied both aesthetically and functionally. He has been using the restorations for about 15 years without any problem.