Indirect Restorations for Increasing the Vertical Dimension of Occlusion.

Objective: This article presents a clinical case of erosive tooth wear, in which the vertical dimension of occlusion (VDO) has been restored using defect oriented posterior onlays and anterior veneers respecting minimal invasive treatment approaches.

Clinical consideration: A 44-year-old female with the history of bulimia nervosa and bruxism expressed the desire to improve the aesthetic appearance and reestablishment of function of her worn dentition. After a 3-month functional therapy to ease myofunctional problems using a Michigan splint, a diagnostic phase revealed the necessity for a full mouth prosthetic rehabilitation. A slight increase of the VDO of 1 mm at the incisal point was determined. Veneered lithium disilicate ceramic restorations of 0.3-0.5 mm in thickness were produced for the incisors and monolithic lithium disilicate restorations of 0.8-1.0 mm in thickness for posterior teeth.

Conclusions: Functional and aesthetic prosthodontic rehabilitation of severely worn teeth can be achieved satisfactory with minimal invasive procedures using defect oriented, indirect lithium disilicate ceramic restorations with increasing the VDO to its original state.

Clinical significance: Indirect, minimal invasive lithium disilicate ceramic restorations are suitable to restore the VDO of severe dental erosions.