2010 RWISO Journal - Roth Williams International Society of ...

Subtractive coronaplasty 15 was done on the posterior
teeth to achieve equal stops and maximum intercuspation in
SCP, and to preserve the natural tooth forms (Figure 16).
Figure 16 Before and after coronaplasty.
Figure 16-a The maxillary arch after coronaplasty shows
that coronaplasty does not necessarily flatten the occlusal
surfaces. Rather, it can redefine the anatomy.
Figure 16-b The mandibular arch after coronaplasty also
shows redefined anatomic form of the posterior teeth.
Anterior maxillary and mandibular teeth were built up
with wax on the diagnostic casts to relegate all eccentric
tooth contacts to the anterior teeth (Figure 17).
The additive coronaplasty was done by duplicating the
wax-up of the casts on the anterior teeth with composite
resin (Figure 18). 16
Figure 17 Wax-up on the mounted model to achieve 3 mm to 4
mm of vertical overbite and 2 mm to 3 mm of horizontal overjet.
Figure 18 Additive coronaplasty was done with a hybrid-type
composite resin on each anterior tooth according to the
wax-up in Figure 12.
66 Linton, Jung | The Effect of Tooth Wear on Postorthodontic Pain Patients: Part 2
The average unworn maxillary central incisor is approx-
imately 12 mm and the mandibular central incisors are 10
mm according to the American Academy of Cosmetic Dentistry
(AACD). In the patient’s case, they were 12 mm and
7.7 mm and were restored to 12.3 mm and 9.8 mm respectively
(Figure 19). 17
Figure 19 Measurements of the teeth before and after positive
coronaplasty. The upper central incisors were 12.0 mm long
and became 12.3 mm long. The lower central incisor was
7.7 mm long and became 9.8 mm long.
According to Lee, adequate anterior guidance can be obtained
with incisor vertical overlap of 3 mm to 4 mm and
horizontal overlap of 2 mm to 3 mm. 18 Initially in April 2008
the patient’s MIP and SCP did not coincide and his overjet
was 2 mm. In SCP the overjet increased to 3.5 mm, which was
corrected to 2 mm with additive coronaplasty (Figure 20).
Figure 20 Overjet change after coronaplasty. When MIP
and SCP did not coincide, the overjet was 2 mm. In SCP,
the overjet increased to 3.5 mm, which was corrected
to 2 mm with additive coronaplasty.
Only after additive coronaplasty could a complete elimination
of eccentric occlusal interferences be achieved with
excursive movements of the mandible (Figure 21).