Multidisciplinary Collaborative Treatment for Bilateral Posterior Tooth Loss Based on Occlusal Reconstruction: A Case Report

Abstract

Objective To evaluate the value of occlusal reconstruction in multidisciplinary treatment for patients with long-standing bilateral posterior tooth loss, providing precise treatment references for complex dental arch defects with severe abrasion. Methods: A 66-year-old patient with long-standing bilateral maxillary posterior tooth loss, combined with severe full-mouth abrasion, deep overbite, and chronic apical periodontitis underwent imaging to assess alveolar bone conditions and temporomandibular joint status. The Gilbach splint precisely determined the vertical dimension of occlusion (elevated by 5 mm). Using impressions andCAD/CAM technology to fabricate a splint for occlusal elevation, establishing the correct vertical dimension. This restored the patient's lower third facial height, chewing function, and aesthetic appearance. Treatment was implemented in four phases: basic therapy, occlusal adjustment, final restoration, and long-term maintenance. Outcomes were evaluated during a 3-year postoperative follow-up. Results: Occlusal reconstruction restored normal lower third facial height with significantly improved masticatory function. Implant osseointegration remained stable throughout follow-up, with no ceramic fractures or prosthetic loosening. Temporomandibular joint function was normal, and patient satisfaction was high. Conclusion Occlusal reconstruction effectively restores masticatory function in patients with long-standing bilateral posterior tooth loss, improves occlusal relationships, and maintains long-term stability.