Morphological and Functional Parameters in Patients with Tooth Wear before and after Treatment

UNLABELLED Advanced tooth wear often results in lost vertical dimension and impacts facial aesthetics. Complex restorative treatment can replace the lost tooth structure and improve functional occlusal and facial skeleton parameters. PURPOSE The aim of the study is to assess changes in the morphological and functional occlusal parameters of the facial skeleton after prosthetic rehabilitation that increased lost occlusal vertical dimension. MATERIAL AND METHODOLOGY 50 patients with advanced tooth wear were clinically examined, to assess the degree of wear. Each subject underwent cephalometric analysis, digital occlusal analysis, and electromyographic analysis, of the anterior temporalis, superficial masetter, anterior digastric, and the sternocleidomastoid muscles. Prosthodontic treatment was performed to restore the occlusal vertical dimension of each subject's occlusion, which was followed by repeating the pretreatment analyses. Pre and post treatment parameters were statistically compared. RESULTS Pre-treatment cephalometric analysis showed that lost vertical dimension reduced anterior facial height and resulted in small angular skeletal parameters. Post treatment anterior facial height increased from the increased occlusal vertical dimension. The mean value of functional electrical activity during clenching post treatment, increased compared to pretreatment. CONCLUSION Increasing the vertical dimension of occlusion improved facial aesthetics by positively affecting facial skeletal angles. The restored occlusal surface morphology changed the pre treatment flat broad occlusal contacts into more point contacts. The increased vertical dimension of occlusion after treatment also increased muscle activity levels over the pretreatment levels after three months period of adaptation.