Reconstruction of crunching/abrasive dentition - Bite elevation - Total rehabilitation
The reconstruction of severely eroded or eroded teeth by grinding or strong acid exposure poses special challenges for the dentist. Often a bite elevation is indicated if the bite has sunk too much. In case of advanced loss of vertical dimension, not only the aesthetics in the anterior region suffer, but also the loss of cusps of the posterior teeth and enamel causes problems such as hypersensitive teeth, deterioration of chewing function or irreversible damage to the dental nerves. Once the tooth enamel is gone, the destruction progresses much faster. The exposed dentin (dentine) is about 10 times less resistant than enamel to abrasion and the effects of acids.
A bite elevation is an extensive intervention in the masticatory system and requires good planning and the recording and transmission of many important, patient-specific parameters. An electronic measurement of the temporomandibular joint is a matter of course for us. We use the most modern optoelectronic methods (Freecorder Bluefox).
When carrying out a bite survey, we follow the guidelines and recommendations of our professional associations DGZMK and DGFDT:
In many cases, a change in the vertical should be reversibly tested after careful analysis using appropriate rails. In this way, problems with a change can be detected and treated at an early stage.
After successful and painless wearing of the test splint, the bite is now raised in the sense of a testoclusion. For this purpose, long-term temporaries or tabletops (occlusal veneers) made of PMMA or composite are used. These tooth-coloured "copings" can be glued directly onto the teeth or existing crowns or bridges. They enable normal chewing and speaking, and restore the original anatomy of the teeth. These "copings" can be used as a base for problems during the test phase, and in case of doubt they can be removed completely.
After sufficient wearing time of the test occlusion, the "test bite", definitive crowns, partial crowns or bridges made of ceramic can now be placed in the tested bite position.