Restoration of Severe Tooth Wear: Converting the Splint Jaw Position Into Definitive Restorations.

Abstract

Objective: Loss of the vertical dimension of occlusion is observed in patients with severe tooth wear and often requires comprehensive prosthodontic treatment. A critical challenge is ensuring the precise transfer of the initially established jaw relationships to the definitive restorations. This study aimed to describe several approaches for simplifying the implementation of pretherapy into final restorations.

Clinical considerations: In the initial phase, structured treatment planning is essential to minimize potential sources of error. Prior to the placement of definitive dentures, a preliminary test phase using occlusal splints or long-term provisional restorations is crucial for achieving optimal predictability of treatment outcomes. Noninvasive therapy with splints is generally employed as the first step following a diagnostic mock-up. Subsequently, a test phase involving long-term temporaries may be implemented to comprehensively evaluate functional, esthetic, and phonetic parameters. Consequently, the application of long-term temporaries facilitates the accurate clinical transfer of the validated bite position to the definitive restorations.

Conclusions: Multiple treatment approaches can be viewed as module components that can be combined to tailor therapy according to the complexity and needs of the patient. This strategy enables the most predictable outcome in terms of function and esthetics, while ensuring safe transfer of vertical and horizontal bite relationships and preserving tooth structure.

Clinical significance: Implementing the newly developed and tested occlusal relationship into definitive restorations requires thorough diagnostics, a structured and preferably noninvasive pretreatment approach, and a reliable method for transferring the tested bite relationship.