LAUSR

BACKGROUND Evaluation of a new vertical dimension of occlusion (VDO) in complex restorative treatments is considered a necessary step prior to placement of restorations. OBJECTIVES This Randomized Controlled Trial (RCT) aimed to assess the effects of using an evaluation of a VDO-increase before restorative treatment in patients with moderate to severe tooth wear, on OHRQoL, freeway space (FWS), and interventions to restorations. METHODS Forty-two patients with tooth wear were included and randomly allocated to either a test phase with a Removable Appliance (RA) or no test phase. Restorative treatment consisted of restoration of all teeth using composite restorations in an increased VDO. OHIP-score, freeway space (FWS), and clinical acceptability of restorations were assessed at baseline and at recall appointments (1 month and 1 year). Intervention to restoration was scored in case of material chipping or when the abutment tooth had increased sensitivity that could be linked to occlusal overloading. ANCOVA analyses, Univariate Cox regression, t-Tests, and descriptive analyses were performed (p<0.05). RESULTS Clinical follow-up after 1 year was completed for 41 patients. No significant effect of testing the VDO with a RA could be found on the OHIP-score (p=0.14). Reduction of FWS in the RA group, compared to the control group, was significantly lower at 1 year (p=0.01, 95%CI -1.09 to -0.15). No effect on early interventions to restorations was found (p=0.94). CONCLUSION This RCT showed that a removable appliance is not indicated to functionally test the increased VDO prior to restorative treatment in patients with tooth wear.