PMC3399352_01
Frontal view of teeth in occlusion (a) and panoramic radiograph (b) before treatment.
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Clinical and radiographic examinations and diagnostic casts revealed severe attrition, especially on anterior teeth and an uneven occlusal plane (Figure 1).
Removable provisional prostheses in place.
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This removable prosthesis was used to evaluate the OVD and patient tolerance (Figure 2).
Cast posts and cores.
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Root canal therapy (RCT) of anterior worn teeth and retreatment of teeth with unacceptable RCTs were performed, and casted posts and cores were fabricated (Figure 3).
Diagnostic waxup (a); fixed and removable provisional restorations in place (b).
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These restorations were fabricated according to the diagnostic waxup (Figure 4), for which the Broadrick flag analyzer was used to determine the curve of occlusal plane.
Occlusal view of the maxillary (a) and mandibular (b) arch after treatment.
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A Kennedy class II mode 1 maxillary RPD was fabricated and delivered (Figure 5).
Frontal view of teeth in occlusion after treatment (a); smile view after treatment (b).
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Finally, the occlusion of restorations was adjusted so that equal-intensity centric contacts were established on all teeth (Figure 6(a)), and anterior guidance discluded all posterior teeth in eccentric jaw movements. The smile view of patient after treatment is shown in Figure 6.
Panoramic view of 1-year-followup.
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One-year followup showed no problem in teeth, restorations and temporomandibular joints and Figure 7 show the panoramic image after this period.