When considering a full mouth rehabilitation, the objective is to restore the worn-out teeth and at the same time, consider the proper function, muscle issues, periodontal issues, and the temporomandibular joints. These all need to work together to bring the patient to an overall state of improved oral health. Once a proper evaluation is conducted, approaching the path to restoration can begin. When determining the appropriate approach with regards to occlusion principles, it is important to identify the patient's vertical dimension of occlusion or VDO.
Patients with excessive wear usually fall within one of the following groups:
- Loss of vertical dimension usually identified by drooping at the corners of the mouth. These cases require an increase in the VDO.
- No loss of vertical dimension and space is available. May require gingivoplasty and adjustments to the opposing to make room for restorations.
- No loss of vertical dimension and space is limited. These cases usually show wear on the anterior and minimal wear on the posterior. These cases may require ortho, repositioning, or surgery to make room for restorations.
After the dental health of the patient has been evaluated, a treatment plan can be created to determine restorative options, including the teeth to be treated, the vertical dimension of occlusion, space available, and condylar position.