Equilibration of a progressive anterior open occlusal relationship: a clinical report

This clinical report described the initial phase of treatment of a progressive anterior open occlusal relationship. Trial equilibration on duplicate mounted diagnostic casts demonstrated centric contacts on all posterior teeth by reducing only the maxillary palatal cusps until the central incisors coupled. Anterior guidance and posterior teeth disclusion were confirmed with wax augmentation of maxillary canine palatal contours. Palatal surface and occlusal matrix reduction guides were used to visualize and measure the amount of planned tooth structure removal required to achieve a programmed occlusion. Intraoral composite resin augmentation of maxillary central incisor and canine palatal surfaces provided anterior guidance. Equilibration was limited to the maxillary palatal cusps and one lower molar. The initial 3 mm open dimension between the maxillary and mandibular incisors was eliminated. Accurate evaluation of the equilibrated duplicate casts resulted in a more conservative final result with less posterior tooth reduction and increased maxillary palatal contours. A comfortable and stable occlusion was established without any esthetic change prior to definitive restoration with multiple individual crowns.