Digital Approach Provides Predictability in Increasing the VDO in Erosive Wear: Clinical Technique and 9-Year...

This clinical case describes a digital workflow using face scans and CAD/CAM technology for a full-mouth rehabilitation with increased vertical dimension of occlusion (VDO) with adhesive lithium disilicate restorations after 9 years.

A healthy, 46-year-old man displaying severe tooth wear, underwent an extensive full-mouth rehabilitation involving an increase of the VDO through laminate veneers and adhesive partial coverage lithium disilicate restorations. Anatomical landmarks of the face and reference planes were captured using a digital face scanning system. The anatomical position of the maxilla was registered with a transfer device. Digital data sets of the intraoral situation combined with a facial scan enabled precise virtual planning, guiding minimally invasive preparations. Long-term provisional restorations, milled from high-performance polycarbonate, were used to test the novel VDO before the final lithium disilicate restorations were fabricated. This approach provided a time- and cost-efficient treatment solution. No failures were observed at the 9-year follow-up.

Utilizing face scans and design software enable a virtual visualization and comprehensive quality control for patients with dental wear, resulting in significant time savings and increased predictability for the dental technician, dentist and patient.

The described digital workflow optimizes the planning and implementation of a comprehensive adhesive full-arch rehabilitation with an increase of the VDO. The clinical long-term follow up result of CAD/CAM assisted minimally invasive lithium disilicate restorations after 9 years demonstrates to clinicians a reliable treatment concept for patients with dental wear.