Restabelecimento da dimensão vertical de oclusão através da confecção de Overlay: Relato de caso clínico

Abstract

The reduction of occlusal vertical occlusion (OVD) has been associated with loss of posterior occlusal stability, acid erosion and / or the presence of parafunctional habits, which result in dysfunction of stomatognatic system. In clinical situations in which the OVD is reduded, it is necessary to reestablish this position before the restorative phase. The restoration of the OVD should be done in a provisional way,using temporary prosthesis, named overlay removable partial denture, which restore the physiological function of the patient and guide the definitive rehabilitation. The overlay consists of a modified removable partial denture that covers the occlusal and/or incisal surfaces of the posterior and anterior teeth for support and stabilization, enabling occlusal stabilization and neuromuscular conditioning previously the definitive restorative treatment. In this context, the patient of this clinical case attended to the dental clinic of Dentistry Faculty of Federal University of Uberlândia for the resolution of functional and aesthetic problems. During the intra- and extra-buccal exams, it was noticed reduction of the lower third of the face, severe tooth wear, lack of some posterior dental elements, and consequently reduced OVD although no painful symptomatology. Thus, it was decided to make an overlay prosthesis prior to definitive rehabilitation, in order to allow physiological accommodation of the components of the stomatognathic system (neuromuscular system, occlusion and temporomandibular joint) throught the reestablishment of OVD. For this, the clinical phases involving impressions, determination of OVD using combination of methods (phonetic, aesthetic, and physiological), assembly of models in semi-adjustable articulator, overlay waxing, inclusion, acrylization and prostheses placement were performed. After the control period of three months, it was noticed great adaptation and confort of the patient with the overlay, so that the definitive prosthodontic treatment at the DVO instituted through the overlay could be performed.