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

To present a structured decision-making approach to full-mouth rehabilitation in patients with generalized severe tooth wear, using functional risk classification (Green, Yellow, Red) and the Smile Design and Space (SDS) Concept for vertical dimension planning.

A 65-year-old male presented with generalized erosion and attrition, affecting esthetics and speech. A structured diagnostic protocol began with symptom-based questionnaires and clinical examination. He was categorized as "Yellow" indicating the absence of temporomandibular disorders (TMD), repeatable occlusion, but need for interdisciplinary pretreatment. The SDS Concept guided the vertical dimension of occlusion (VDO) increase, based on incisal display, smile line, and prosthetic space, using the formula A + B - C = VDO. Functional crown lengthening was performed to restore the ferrule. Restorations were done with adhesively bonded lithium disilicate crowns and layered ceramics.

A 10 mm VDO increase was well tolerated, with restored esthetics, stable occlusion, and improved phonetics. The SDS protocol provided a reproducible, esthetically driven method for VDO and prosthetic space evaluation with no complications.

Integrating functional risk classification with the SDS concept enables individualized, systematic full-mouth rehabilitation in severe tooth wear cases, improving diagnostic precision and interdisciplinary communication.