Severely worn teeth can create a complex combination of functional, restorative, and aesthetic problems. As tooth structure is progressively lost, patients may experience changes in occlusion, reduced posterior support, sensitivity, fractured restorations, altered aesthetics, and difficulty chewing.
One of the most important steps is identifying the underlying cause of tooth wear before beginning extensive restorative treatment. Bruxism, erosion, abrasion, missing teeth, dietary factors, and previous restorative treatment can all contribute to progressive deterioration. Addressing these risk factors is essential for improving the long-term prognosis.
Treatment planning for full-mouth restoration should consider the patient's existing occlusion, vertical dimension, periodontal condition, remaining tooth structure, aesthetic expectations, and functional requirements. Diagnostic photographs, radiographs, digital scans, mounted models, and diagnostic wax-ups can help clinicians evaluate the case before definitive treatment begins.
A provisional phase can also be valuable in complex rehabilitation. Temporary restorations may allow the clinician to assess the proposed occlusal scheme, phonetics, aesthetics, function, and patient adaptation before proceeding with definitive restorations.
Another important consideration is preserving healthy tooth structure. Depending on the clinical situation, additive techniques using composite, onlays, or other conservative restorative approaches may provide alternatives to aggressive preparation. Material selection should be based on factors such as remaining tooth structure, occlusal forces, aesthetics, available space, and expected maintenance.
Long-term success also depends on maintenance. Patients with significant tooth wear may require occlusal protection, periodontal monitoring, dietary advice, improved oral hygiene, and regular follow-up.
I recently came across a detailed article discussing full-mouth restoration, worn teeth, bite collapse, treatment planning, and the different factors clinicians should consider when approaching complex rehabilitation cases.
For clinicians working with advanced tooth wear, what factors do you consider most important when deciding between conservative rehabilitation and comprehensive full-mouth restoration?
Further reading:
andent.al/blog/full-mouth-restoration-albania-worn-teeth-bite-collapse