Severe occlusal destruction, whether it results from attrition, abrasion, or erosion, must be met with definitive diagnosis and treatment. This case report illustrates the step-by-step diagnosis and treatment of a patient with severe occlusal wear. Restoration of a functional occlusion and esthetics involved endodontic treatment, reestablishment of the vertical dimension of occlusion, osseous periodontal surgery, and placement of single-tooth cast glass-ceramic crowns.