PDF: Stepwise approach for full mouth rehabilitation of worn dentition: A case report

This case report describes treatment protocol for a 62-year-old female with severely worn-out dentition, partial edentulism and lost anterior guidance. A fixed permanent restoration of the occlusion was planned with appropriate planning and analysis.

Depending on cause tooth, wearing can be classified as abrasion, erosion and attrition. Excessive wearing of dentition can however result in mutilated aesthetics, pulpal pathology, occlusal disfigurements and impaired function over time. 

Wearing out of teeth causes loss of anterior guidance and loss of vertical dimension. Rehabilitation of such cases need utmost care and comprehensive planning employing various diagnostic, therapeutic and restorative play of action. 

Prosthodontic considerations like analysis of the existing occlusion and occlusal plane, availability of freeway space, size and location of edentulous areas, number, position and condition of the existing teeth in each arch, the need for altering the vertical dimensions are needed to achieve favourable results. 

Management of worn dentition with partial edentulism using fixed or removable prostheses is complex but articulated diagnostic casts and diagnostic wax-up can provide important information. 

Provisional prosthesis and meticulous clinical evaluation can help gain an indepth knowledge of reaction of stomatognathic system to altered vertical dimension in such cases. 

This clinical report describes the treatment protocol followed to rehabilitate occlusion of a 62 years old female patient who reported to the clinic with a chief complaint of difficulty in chewing due to worn-out dentition. 

Complete rehabilitation was done using fixed prosthesis with restoration of anterior guidance and rehabilitation of occlusal plane. 

Pankey Mann philosophy was used wherein occlusal rehabilitation is completed into 4 stages. 

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