Mandibular Incisor Intrusion: An Adjunct to Restoring Short, Abraded Anterior Teeth

common challenge for dentists is to restore the dentition of an adult who has a history of bruxism and anterior tooth wear. Some individuals have a lateral bruxing habit, which results primarily in posterior tooth wear. Other individuals may have a circumferential or circular bruxing pattern, which produces wear on both the anterior and posterior teeth. However, there are some patients who only brux in an anteroposterior direction. These individuals cause attrition of the maxillary anterior teeth, the mandibular anterior teeth, or both. When anterior teeth abrade gradually over a long period of time, they continue to erupt to maintain occlusal contact. So after years of protrusive bruxing, when your patient wants their short, stubby teeth to look more esthetic, how do you manage this perplexing situation? Do you restore all of the teeth in order to open the bite? Do you recommend endodontics and crown lengthening of both the maxillary and mandibular incisors to permit preparation and restoration? Or are there other solutions for this anterior restorative dilemma? In many of these cases, orthodontic intrusion of the worn and abraded teeth can provide the key to the conservative management of these types of patients. This article will describe and discuss the steps involved in the orthodontic-restorative management of patients with significant wear and overeruption of their anterior teeth.