Prosthodontic Approach In The Management Of Severely Worn Teeth

The abrasion, attrition and erosion are the common causes of worn teeth. It changes the location of intercuspal position (ICP). In general when the ICP is lost, it may develop reduced vertical dimension of occlusion. In regards to harmonious relation of condyle in TMJ and muscle function; it is obligatory for the clinician to reestablish it. However the generalized attrition does not always manifest the loss of vertical dimension of occlusion (VDO). Sometimes the eruption of teeth and the alveolar bone growth with adaptation compensates the loss of tooth structure and maintains the VDO. Therefore, the long term clinical success demands correct assessment of occlusal vertical dimension and inter-occlusal rest space in regards to centric relation before final prosthesis. The clinician uses removable occlusal splints in upper arch of his patient and restores teeth with composite and glass ionomer in lower arch with estimated increased vertical dimension of occlusion as interim procedure for three months to observe any symptoms in TMJ and muscle function.