Posterior Bite Collapse: Guidelines for Treatment Based on Form and Function

The clinical syndrome known as posterior bite collapse (PBC) consists of multiple, often pathognomonic factors that deviate from normal, or an occlusion wherein the posterior occlusion is compromised and may ultimately destroy the functional protective capacity of the entire dentition. Secondary clinical sequelae may include accelerated periodontitis progression, temporomandibular disorders (TMD), increasing mobility/fremitus, additional tooth loss, anterior flaring, and loss of occlusal vertical dimension. Etiologic factors may include tooth loss without replacement, orthodontic malocclusions and dentoskeletal disharmonies, periodontitis, accelerated retrograde occlusal/interproximal wear, severe caries, or iatrogenic and conformative dentistry. Not all PBC cases require treatment, but treatment is dependent upon the periodontium's stability and its ability to maintain its form and function. Treatment decisions can also be dependent upon periodontal health, caries, function, occlusion, TMD, esthetics, and phonetics. The purpose of this article is to provide general treatment guidelines based on form and function of the masticatory system for restoring a PBC case when treatment is necessary. This article does not discuss specific mechanics for restoring PBC cases.