Rehabilitation Strategies and Occlusal Vertical Dimension Considerations in the Management of Worn Dentitions: Consensus Statement From SSRD, SEPES, and PROSEC Conference on Minimally Invasive Restorations.

Abstract

Objective: The Joint SSRD, SEPES, and PROSEC Consensus Conference aimed to provide clinical statements and recommendations for the rehabilitation of worn dentition and to evaluate the necessity of an evaluation phase when increasing the occlusal vertical dimension (OVD) during full-mouth rehabilitation.

Materials and methods: Two systematic reviews were conducted before the conference. The findings of the reviews were analyzed, discussed in working group 2, and debated in plenary sessions until a consensus was reached. Consensus statements were formulated based on available evidence and expert opinion.

Results: Both direct and indirect minimally invasive approaches, utilizing materials such as composite resins and lithium disilicate ceramics, were deemed viable for managing worn dentitions. The choice of approach and material should depend on the extent of tooth substance loss and the treatment goals. Evidence on the necessity of an evaluation phase was inconclusive. However, an evaluation phase can aid in managing patient expectations, refining treatment sequencing, and supporting less experienced clinicians. Emphasis was placed on non-invasive and minimally invasive techniques, adequate diagnostics, and the potential benefits of fixed interim restorations when evaluating increased OVD.

Conclusions: The consensus statements provide a framework for managing worn dentitions and decisions regarding OVD increases, emphasizing minimally invasive approaches and individualized treatment planning. However, gaps in evidence remain, particularly regarding the long-term effectiveness of materials and the evaluation phase. Future research is required to address these uncertainties, focusing on long-term outcomes, material comparisons, and patient-reported outcomes.