Reabilitação da dimensão vertical de oclusal em paciente com desgaste severo generalizado: Um relato de caso

Abstract

Severe tooth wear is a multifactorial condition that can significantly compromise aesthetics, masticatory function, and vertical dimension of occlusion (VDO), often associated with bruxism and erosive factors. This study aims to report the clinical case of a 47-year-old male patient with generalized tooth wear associated with bruxism and loss of VDO, rehabilitated through a conservative approach. After clinical and functional evaluation, treatment was conducted progressively, with initial reestablishment of VDO using a removable partial denture (overlay type), used for eight months for neuromuscular and occlusal adaptation. Subsequently, direct restorations in nano-hybrid composite resin with zirconia incorporation were fabricated in the anterior and posterior teeth, associated with finishing and polishing in multiple sessions for aesthetic and functional optimization. After completion of the rehabilitation, a rigid acrylic resin interocclusal splint was fabricated for nighttime use, with the aim of protecting the restorations and minimizing the effects of bruxism. The treatment provided restoration of vertical dimension, masticatory function and smile aesthetics, with predictable and satisfactory results. It is concluded that the combination of direct adhesive techniques and the use of overlay-type prostheses represents a predictable, aesthetic and economically viable alternative for highly complex rehabilitations. Keywords: Tooth wear, Bruxism, Temporary partial denture, Permanent dental restoration.