Tooth wear is caused by 3 distinct processes

  1. Erosion = loss of tooth structure due to chemicals
  2. Attrition = tooth against tooth wear
  3. Abrasion = tooth against foreign object (toothbrush)

Tooth surface loss will typically result in compensatory tooth eruption and alveolar bone growth resulting in no change in vertical dimension of occlusion VDO.  Will likely require “gaining” vertical height through ortho or surgery.

Tooth surface loss can exceed compensatory mechanisms resulting in loss of VDO.  Result will be a collapse of the anterior lower facial height.  Vertical height can simply be added to the occlusal surface of teeth or increasing vertical.

Regaining lost vertical or increasing vertical is determined by esthetics, phonetics, and interocclusal rest space.

A protrusive, lateral bite, and an anterior custom guide table are all helpful prior to any change.

Case of overlay partial to increase vertical.

Better case of crowns and new partial Jahangiri 2002 JPD

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