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International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 14 (2012), No. 1     15. Mar. 2012

Int Poster J Dent Oral Med 2012, Vol 14 No 1, Poster 575

Restoring the occlusal vertical dimension in severe tooth wear case

Language: English

Dr. Alexandru-Titus Farcasiu, Dr. Oana-Cella Andrei,
University of Medicine and Pharmacy "Carol Davila", Faculty of Dentistry, Removable Prosthetic Department, Bucharest, Romania

22-25 April 2010
Balkan Stomatological Society (BaSS) 15th Congress
Thessaloniki, Greece


The 62 years old partially edentulous male patient presented advanced tooth wear and a lowered occlusal vertical dimension.
He wanted to obtain esthetic results, a better chewing ability and to improve phonation. The patient hid his dental condition for many years by never smiling.
The clinical examination indicated that the etiology of teeth wear and occlusal trauma was bruxism.

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Case report

Full-arch impressions, maxillary and mandibular, were taken and the study models were mounted. Both arches were Kennedy class I. The posterior contact interferences and the dysfunctional chewing habit leaded to protrusive and laterotrusive movements which overloaded the anterior teeth. As a result the patient presented an excessive anterior wear, mobility and a decreased vertical dimension.
The anterior upper teeth length was restored using casted posts and acrylic temporary crowns, on a period of six weeks with every seven days recalls, to test and obtain a new, proper and comfortable vertical dimension.
The patient agreed with a full mouth rehabilitation using the porcelain fused to metal crowns and two removable partial dentures attached with snap systems.
After the prosthetic treatment was completed a full arch impression was taken to fabricate an occlusal nightguard and the patient was instructed to wear it in order to protect the restorations from the excessive occlusal forces.

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Conclussions. Bruxism can severely damage teeth, dramatically erode the biting surfaces and seriously affect the facial appearance. After the prosthetic treatment is completed, bruxism continues to cause excessive occlusal load of the remaining teeth and underlying tissues and ultimately results in teeth mobility and bone loss. In order to improve the long term prognostic of the treatment it is recommended to take the biggest number of abutment teeth possible, to maximally extend the saddles and to instruct the patient to wear the nightguard and the dentures every night.

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This Poster was submitted by Dr. Alexandru-Titus Farcasiu.

Correspondence address:
Dr. Alexandru-Titus Farcasiu
University of Medicine and Pharmacy "Carol Davila" Bucharest
Faculty of Dentistry, Removable Prosthetic Department
Str. Serghei Rahmaninov nr. 76-80
020199 Bucharest