Lev, a renowned scientist, presented with a severely worn dentition resulting from decades of undiagnosed and untreated parafunctional bruxism. The dentition showed extensive structural loss, multiple fractured teeth, and existing restorations in disrepair. He had previously received disjointed care without a cohesive functional or restorative plan. This case gained widespread recognition online due to the complexity of rehabilitation and the transformative aesthetic and functional result.
Through a phased, prosthetically driven approach, Lev’s severely worn dentition was successfully rehabilitated with segmented FP1 zirconia bridges in the upper arch and conservative restorations in the lower arch.
Raising the vertical dimension and using long-term Provisionals allowed us to assess function and aesthetics before final delivery. The result: a confident smile, restored bite, and a stable, maintainable outcome—achieved without overextending surgically.
This case demonstrates how thoughtful planning and digital precision can transform even the most compromised wear cases.
Maxillary Arch
• Diagnosis: Mixed dentition with root canal-treated teeth, prior suboptimal implants, and compromised occlusion
• Plan:
o Endodontic treatment of strategic teeth (performed by Dr. Ali)
o Use of existing lower implants, despite unfavourable angulation, with prosthetic compensation
o Restoration of remaining teeth using veneers, onlays, and provisional crowns, later converted to definitive restorations after functional monitoring
This case exemplifies the complexity of managing severe bruxism in patients with a history of uncoordinated care. A key component of success was the decision to segment the maxillary FP1 prosthesis into three sections. This allowed for:
Restoring vertical dimension and guiding the occlusion into a stable, functional path was essential to long-term success. Using jaw tracking and provisionalisation allowed the team to validate the new occlusal scheme before committing to definitive restorations.
Despite pre-existing challenges—such as poorly positioned implants and a heavily restored lower arch—strategic planning and careful sequencing led to a full functional and aesthetic rehabilitation.
Lev’s case is a strong reminder of the power of phased, digitally guided, and patient-specific planning in complex wear cases, particularly those complicated by parafunction.
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Trust Dr. Arman Barfeie to transform your smile with expert dental implants, stunning cosmetic treatments, and thorough, personalized care. Enjoy a warm, patient-focused experience that guarantees your comfort and delight at his premier Forest Hill dental practice.