The Use of Zirconium and Feldspathic Porcelain in the Management of the Severely Worn Dentition: A Case Report

The management of the interim phase of a complete oral rehabilitation in patients with severely worn dentition is often challenging due to the loss of occlusal vertical dimension, loss of tooth structure, uneven wear of teeth creating an uneven plane of occlusion, and parafunctional habits. This case report describes the management of excessive tooth tissue loss in a 45 year old woman with a history of bruxism, esthetical complaints in anterior teeth, and impaired dental function due to reduced tooth height. The patient used occlusal splint for a month and than resection of the alveolar bone was performed on the vestibular sides of the maxillary anterior teeth, except the interdental alveolar crest. Maxillary anterior teeth were restored with zirconia porcelain. Feldspathic porcelain was chosen to restore remaining teeth in both jaws; the patient also was given an occlusion guard to protect the restoration against future bruxism. Regardless of the cause of occlusal instability, it is important that the restorative dentist should be able to recognize its signs such as tooth hypermobility, tooth wear, periodontal breakdown, occlusal dimpling, stress fractures, exostosis, muscle enlargement, and loss of posterior disclusion. When restoring the worn dentition, the clinician should bear in mind the five P's: proper planning prevents poor performance.