Digital Workflow for the Restoration of the Vertical Dimension of Occlusion Evaluated by 3D Stereophotogrammetry

To present a digital workflow approach for the full-mouth rehabilitation of severely worn dentition and to evaluate the impact of vertical dimension of occlusion (VDO) rehabilitation on facial parameters assessed by 3D stereophotogrammetry throughout all treatment steps.

Extensive tooth wear frequently demands the determination of a new VDO for the prosthodontic treatment. While digital tools have been used to establish hybrid or fully digital workflows in prosthodontics, a validation of accuracy between the planification stage and final VDO, as well as resulting linear and volumetric changes in the soft tissues after treatment, has not been reported utilizing tridimensional facial reconstruction systems. The clinical report describes the case of a 34-year-old patient with generalized erosive tooth wear and severe tooth sensitivity. After diagnosis, the patient was treated with a minimally invasive digitally driven full-mouth rehabilitation using lithium-disilicate bonded restorations, and stereophotogrammetry was used for the evaluation of facial changes before, at the planning stage, and after VDO rehabilitation.

The fully digital workflow allowed for a predictable rehabilitation of the VDO, where similar stereophotogrammetric measurements were observed during the mock-up and at the end of the treatment. 3D stereophotogrammetry imaging allowed to quantitatively assess differences in facial appearance after VDO rehabilitation.

The conscious application of fully digital workflows enables predictable achievement of both functional and esthetic parameters in the rehabilitation of VDO. 3D stereophotogrammetry confirmed similar facial measurements between the initial condition, mock-up stage, and treatment outcome.