Prosthetic rehabilitation in a partially edentulous patient with a loss of vertical dimension

Tooth loss can cause an imbalance in the stomatognathic system and lead to a change in the occlusal vertical dimension (OVD). Loss of the OVD may significantly affect a patient's functionality, comfort, and aesthetics. Tooth wear is one of the etiologies of OVD loss, but it can usually be compensated by extrusion mechanisms from worn teeth and alveolar bone growth. Clinical elevation of the OVD may facilitate treatment in patients with complex cases, such as tooth wear. A 51-year-old patient presented with tooth loss at 14→18, 21, 24→28, and 46→48 and severely worn teeth with exposed dentin on teeth 33→43. No problems with the temporomandibular joints were observed. Frame removable partial dentures (RPDs) were fabricated to replace the missing posterior teeth with increased OVD, and the composite resin was used to restore worn anterior teeth in the lower arch, the clinical crown height, and to establish the occlusion, esthetic, and function. Increasing the OVD using frame RPDs for missing posterior teeth and composite resin restorations for worn anterior teeth improved aesthetics and function in this patient. Direct restorations using composite resin on selected teeth can provide optimal aesthetics and functionality at an affordable cost.