Four-quadrant rehabilitation after periodontal functional and erosive damage

A case report is presented about a patient with multiple advanced periodontal recessions and an Angle Class II/1 dentition with an open bite, whereby a combined periodontal/prosthetic concept was applied based on the existing dentition. An interdisciplinary approach using orthodontic procedures as a treatment option was considered but not accepted by the patient16. Therefore, the jaw position was first stabilized by means of direct composite restorations based on the existing Angle Class II in centric jaw relation and increased vertical dimension. After a 6-month adaptation period, the successive transfer of the jaw position held in this way to indirectly produce restorations took place. In the posterior region, minimally invasively prepared partial crowns (occlusal onlays) made of pressed ceramics were used, and in the anterior region veneers were made using the sandwich technique with pressed ceramic and feldspar ceramics. After 3 years of function, the hard and soft tissue ratios are non-inflammatory and stable. No discomfort is experienced in the temporomandibular joint (TMJ) area. The patient is completely satisfied with the result. Keywords: Angle Class II/1, implants, sinus lift, tunneling, multiple recessions, bite elevation, erosion, disc displacement, vertical dimension of occlusion (VDO)