Digitally Guided Rehabilitation Following Vertical Dimension Increase: A Case Report

Deep bite associated with loss of vertical dimension of occlusion (VDO) represents a significant restorative challenge requiring accurate diagnosis and careful treatment planning. This case report describes the rehabilitation of a 21-year-old male patient presenting with severe tooth wear, reduced VDO, and multiple inadequate restorations associated with endodontic complications. A digitally guided workflow combined with occlusal deprogramming using a Leaf Gauge was used to establish a reproducible mandibular position and increase the VDO. Following digital analysis and mock-up validation, the maxillary anterior teeth were restored with monolithic multilayer zirconia crowns to establish stable anterior and canine guidance. Mandibular posterior teeth were rehabilitated using CAD/CAM composite-ceramic endocrowns, onlays, and overlays, while the mandibular anterior teeth were restored using an injectable composite technique. Clinical follow-up at 6 months and 1 year demonstrated stable functional and esthetic outcomes without mechanical complications. This case highlights the effectiveness of combining digital planning, occlusal management, and a minimally invasive multimaterial restorative approach in the rehabilitation of complex worn dentition cases. Furthermore, the step-by-step digital workflow contributed to predictable and stable results, while potentially reducing the risk of future restorative failures.

Keywords: Deep bite; Vertical dimension of occlusion; Digital workflow; Zirconia crowns; Endocrowns;Injectable composite