The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of the normal occlusal plane and the reduction of the vertical dimension. This case report describes a 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function. The gradual wear of the occlusal surfaces of teeth is a normal process during the lifetime of a patient. However, excessive occlusal wear can result in pulpal pathology, occlusal disharmony, impaired function, and esthetic disfigurement. Tooth wear can be classified as attrition, abrasion, and erosion depending on its cause. A differential diagnosis is not always possible because, in many situations, there exists a combination of these processes. Therefore, it is important to identify the factors that contribute to excessive wear and to evaluate the alteration of the VDO caused by the worn dentition.
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