Functional And Esthetic Rehabilitation Of Worn Dentition With Malocclusion

Male 75 years old; Chief complaint: bilateral posterior teeth missing for more than 10 years, unable to chew, requiring dental prosthesis. Check: Facial symmetry, normal mouth opening, mouth opening slightly to the left. 16, 25, 27, 44, 46 missing;12 13 17 22 31 32 35 41 42 43 47 Heavy wear;14 15 24 25 Stretch and bite into the gum of the jaw. Diagnosis: upper and lower dentition defect,Tooth defect,Malocclusion Treatment: Functional aesthetic reconstruction using the eight-step wear method. After etiology analysis and risk assessment: (1) Disease control phase: Periodontal treatment; dental treatment; surgical extraction. (2) Functional restoration phase: Occlusal reduction with a guide, vertical dimension increase of 6 mm, diagnostic provisional restoration for 3.5 months. (3) Zbris measurement evaluation, prosthetic design, speech assessment, and adjustments, followed by diagnostic planning for implant placement. (4) Provisional restoration with stable and non-deviated intercuspation; CT shows symmetrical joints; provisional prosthesis worn for 3 months—improved aesthetics, function, and static-dynamic harmony. Final prosthesis replicates the provisional restoration. Vertical distance determination method; facial-guided aesthetic functional design, starting with the design of the incisal edge of the central incisors in both dynamic and static states, and meeting the minimum restoration space requirements for prosthetic design. Complex cases of wear with malocclusion, multidisciplinary treatment planning, and facial-guided design allow for intraoral adjustments based on patient subjective and objective responses, achieving a final stable aesthetic and functional restoration.