Full-Arch Maxillary Rehabilitation Using Zirconia Fixed Prostheses: Investigating the Vertical Dimension of Occlusion (VDO)

Smigiel, Corey M.
Faculty / Advisor: Deakins, Nicole
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences


Rehabilitation of an esthetically-driven patient with worn dentition and anterior deep bite is a complex procedure, and assessment of the vertical dimension of occlusion (VDO) is an important aspect. This clinical case report describes the full maxillary rehabilitation of a patient who presented with multiple failing restorations and an unstable occlusion. A lab-processed acrylic splinted provisional was fabricated with a 2 mm VDO increase at the incisal guidance pin, and the patient was clinically observed on a weekly basis for 1 month while wearing the restoration. It is critical to confirm that the patient is tolerant to the change in VDO. A diagnostic wax-up and articulated study casts can provide important information for the evaluation and determination of a bilaterally balanced occlusion. Modifications to the VDO should be conservative and should not be changed without careful consideration. Proper oral hygiene instruction must be emphasized to the patient, as failure to maintain a healthy oral complex will result in decreased periodontal support and a poor long-term prognosis of the final restorations. Zirconia was chosen as the definitive restorative material due to its superior strength and esthetic capabilities.


Pending as of now, as the case is still on-going and will be altered. However, this section will contain my pre-treatment work up (ie. clinical evaluation of the VDO + diagnostic wax-up), provisionalization stage, and the final restorations.