Ceramic Veneers and Occlusal Onlays for Worn Teeth

How to plan and create a minimally invasive ceramic veneer and onlay preparation for worn teeth.

At her first visit, a complete anamnesis, a meticulous oral examination, a radiographic evaluation, and a functional analysis of the temporomandibular joints were made. The evaluation revealed the presence of different forms of tooth wear. The patient presented clinical signs of a combination of erosion, abrasion, and attrition (suspected bruxism). Information obtained from the anamnesis revealed that the patient was experiencing a stressful period and consuming excessive energy drinks. Study models, an arbitrary face-bow record, registration in centric relation, intra and extraoral photographs, and a video recording were also obtained to complete the patient’s dataset.

Be sure to also check out the accompanying video tutorial about a new method of face analysis – to provide a creative, type-specific treatment space.

All the collected data were used to create a DWU to determine the necessity of increasing the patient’s vertical dimension of occlusion (VDO) in order to obtain adequate space for the restorative treatment. Especially for restoring proper anterior canine guidance, the VDO was minimally increased by lifting the incisal pin of the articulator by 2.5 mm. The photographic documentation and analysis provided basic information about the aesthetic appearance of the patient.

Mock-ups were made to refine the planned vertical dimension of occlusion in a dynamic state using the speech method, whereby any occlusal contact is detected during speech. A mock-up try-in was performed several times to capture the patient type and energy. With the complete restorative team discussing and noting all necessary corrections, including video and photographic analysis, adjustments of function and aesthetics were made.

Treatment Team: Dentist: Dr. Reza Saeidi Pour, MDT: Otto Prandtner, Prof. Daniel Edelhoff