A Clinical Algorithm for Full-Mouth Rehabilitation in Patients With Generalized Severe Tooth Wear: A Case Report

Area of Science:

• Dentistry
• Prosthodontics
• Restorative Dentistry

Background:

• Generalized severe tooth wear presents complex challenges in full-mouth rehabilitation.
• Esthetic and phonetic deficits often accompany significant tooth structure loss.

Purpose of the Study:

• To introduce a structured decision-making framework for full-mouth rehabilitation in severe tooth wear.
• To integrate functional risk classification (Green, Yellow, Red) with the Smile Design and Space (SDS) Concept for vertical dimension planning.

Main Methods:

• A diagnostic protocol including questionnaires and clinical examination was employed.
• The patient was classified as 'Yellow' risk, indicating the need for interdisciplinary treatment.
• The SDS Concept guided vertical dimension of occlusion (VDO) increase, utilizing incisal display, smile line, and prosthetic space.
• Functional crown lengthening and adhesively bonded restorations were performed.

Main Results:

• A 10 mm increase in VDO was well-tolerated, leading to improved esthetics and phonetics.
• Stable occlusion was achieved post-rehabilitation.
• The SDS protocol proved to be a reproducible, esthetically driven method for VDO and prosthetic space evaluation without complications.

Conclusions:

• Integrating functional risk classification with the SDS concept offers an individualized and systematic approach to full-mouth rehabilitation.
• This combined strategy enhances diagnostic accuracy and interdisciplinary communication in managing severe tooth wear.
• The presented method facilitates predictable outcomes in complex restorative cases.