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    Functional and esthetic outcomes of full-mouth rehabilitation following vertical dimension reestablishment using posterior composite build-ups: A case report
    (Dennis Barber Journals, 2025) Papatya, Zeynep; Güler, Edanur; Karabulut, Dicle; Özdal, Umut
    Introduction: Loss of vertical dimension of occlusion (VDO) is a clinical condition that can significantly impact both function and esthetics. It may lead to impaired mastication, temporomandibular joint (TMJ) discomfort, facial disharmony, and reduced quality of life. Restoring VDO requires a systematic approach involving proper evaluation, neuromuscular adaptation, and establishment of a stable occlusal and TMJ relationship. This case report presents the functional and esthetic outcomes of full-mouth rehabilitation following VDO reestablishment using posterior composite build-ups and a gradual increase in occlusal height to promote TMJ stabilization. Case Description: A patient with reduced VDO was treated with posterior composite resin build-ups. The vertical dimension was increased by 1 mm per week over five weeks, allowing neuromuscular adaptation and TMJ repositioning. After successful adaptation, definitive restorations were completed. Pressable ceramic (e.max) laminate veneers were placed from first premolar to first premolar (5–5) in both arches. Zirconia crowns were used on the first and second molars (6 and 7). Throughout the procedure, esthetic, functional, and occlusal parameters were carefully monitored to ensure optimal outcomes. The patient adapted well to the new VDO, showing marked improvement in facial esthetics and occlusal function. High patient satisfaction was reported at the conclusion of treatment. Discussion: This case highlights the effectiveness of a controlled, stepwise approach to VDO restoration. Using composite build-ups allowed reversible testing of neuromuscular tolerance before final restorations. The combination of e.max veneers and zirconia crowns restored function and esthetics while preserving TMJ stability. No complications were observed during the one-month follow up, supporting the short-term success of the approach. Long term monitoring is essential to confirm the durability of results.