Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Aug 20:2019:1640563.
doi: 10.1155/2019/1640563. eCollection 2019.

Aesthetic Rehabilitation of a Patient with Bruxism Using Ceramic Veneers and Overlays Combined with Four-Point Monolithic Zirconia Crowns for Occlusal Stabilization: A 4-Year Follow-Up

André Moreira  1 , Filipe Freitas  1   2 , Duarte Marques  1   3 , João Caramês  1   4
Affiliations
Case Reports

Aesthetic Rehabilitation of a Patient with Bruxism Using Ceramic Veneers and Overlays Combined with Four-Point Monolithic Zirconia Crowns for Occlusal Stabilization: A 4-Year Follow-Up

André Moreira et al. Case Rep Dent. .

Abstract

Management of severe worn dentition in patients with bruxism is challenging as a result of the loss of tooth structure and occlusal vertical dimension, temporomandibular implications, tooth hypersensitivity, and masticatory or aesthetic impairment. This case describes the 4-year follow-up clinical evaluation of a full mouth tooth-supported rehabilitation made on a 66-year-old man with bruxism and tooth wear, with aesthetic complaints and compromised masticatory function. The prosthetic treatment was planned with a digital smile design and a mock-up technique for an aesthetic and minimally invasive approach using lithium disilicate pressed and layered veneers on anterior teeth, posterior CAD/CAM lithium disilicate overlays with facial coverage, and CAD/CAM monolithic zirconia crowns with facial feldspathic ceramic on maxillary and mandibular canines and first molars in order to ensure the occlusal stability at the increased occlusal vertical dimension. After 4 years of function, no complications were registered. The choice of an appropriate material for the rehabilitation of these patients is essential to improve treatment prognosis and should be guided by mechanical and aesthetical properties. The use of four-point occlusal stabilization with CAD/CAM high strength monolithic zirconia crowns combined with ceramic veneers and overlays appears to be a reliable treatment option that enhances aesthetics and minimizes the occurrence of ceramic fractures, ensuring the treatment prognosis and predictability.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Smile (frontal view).
Figure 2
Figure 2
Intraoral frontal view.
Figure 3
Figure 3
Maxillary occlusal view.
Figure 4
Figure 4
Mandibular occlusal view.
Figure 5
Figure 5
Initial panoramic view.
Figure 6
Figure 6
Maxillary occlusal view after initial cementation.
Figure 7
Figure 7
Mandibular occlusal view after initial cementation.
Figure 8
Figure 8
Digital scan.
Figure 9
Figure 9
Maxillary and mandibular computer-aided design of lithium disilicate restorations.
Figure 10
Figure 10
Maxillary left occlusal view after cementation of lithium disilicate restorations.
Figure 11
Figure 11
Final intraoral frontal view.
Figure 12
Figure 12
Final intraoral maxillary frontal view.
Figure 13
Figure 13
Final panoramic view.
Figure 14
Figure 14
Intraoral frontal view after 48 months.
Figure 15
Figure 15
Intraoral maxillary view after 48 months.
See this image and copyright information in PMC

References

    1. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd. Westchester, Darien, IL, USA: American Academy of Sleep Medicine; 2014. Sleep related bruxism.
    1. Bartlett D. W. The role of erosion in tooth wear: aetiology, prevention and management. International Dental Journal. 2005;55(S4):277–284. doi: 10.1111/j.1875-595X.2005.tb00065.x. - DOI - PubMed
    1. Lobbezoo F., Ahlberg J., Glaros A. G., et al. Bruxism defined and graded: an international consensus. Journal of Oral Rehabilitation. 2013;40(1):2–4. doi: 10.1111/joor.12011. - DOI - PubMed
    1. Hurst D. What is the best way to restore the worn dentition? Evidence-Based Dentistry. 2011;12(2):55–56. doi: 10.1038/sj.ebd.6400798. - DOI - PubMed
    1. Manicone P. F., Rossi Iommetti P., Raffaelli L. An overview of zirconia ceramics: basic properties and clinical applications. Journal of Dentistry. 2007;35(11):819–826. doi: 10.1016/j.jdent.2007.07.008. - DOI - PubMed

Publication types

LinkOut - more resources