Prosthodontics & Occlusion · patient case question
What additional protective measure should be part of the plan?
Patient case: Failing anterior crown in a bruxer
Patient: 49-year-old woman.
Chief complaint: My crown feels loose and it does not match my other teeth.
History: Crown placed approximately twelve years ago. Partner reports night-time grinding.
Findings: Porcelain-fused-to-metal crown on a maxillary anterior tooth with a visible metal collar at the margin and gingival recession. The crown is markedly brighter and whiter than the adjacent teeth, which are distinctly yellow. Generalized wear facets on the posterior teeth. The crown moves on digital pressure.
Show answer and explanation
Correct answer: B. An occlusal night guard
- A. Opening the vertical dimension across the whole mouth is a major irreversible undertaking, not a protective adjunct for a single crown.
- B. CORRECT. A hard occlusal splint distributes parafunctional load and protects both the new ceramic restoration and the remaining dentition. Without it, the replacement is exposed to the same forces that contributed to the first failure.
- C. Muscle relaxants have a limited, short-term role in acute myofascial pain and do not protect the restoration.
- D. Placing new ceramic in an unprotected bruxing occlusion invites the same outcome again.
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