A METHODICAL APPROACH FOR RESTORATION OF LOST VERTICAL DIMENSION BY ADVOCATING HOBO'S TWIN STAGE TECHNIQUE – A CASE REPORT

Abstract

Statement of Problem Restoration of occlusal harmony in patients with worn dentition and reduced vertical dimension is a demanding situation as every case is unique in itself. There is great apprehension involved in clinicians due to widely divergent views regarding the choice of an appropriate occlusal scheme. Rehabilitating the lost vertical dimension in a graduated and structured fashion will not only bring back the harmony of the stomatognathic system but also plod the adverse diversifications on the muscles and orthopedic instability of the temporomandibular joints.   

Purpose To restore the vertical dimension by adapting a less cumbersome and precise technique that uplifts both functionality and esthetics.

Material and Methods The case report humbly represents the rehabilitation of a 47 year old female patient with severe worn out dentition. Assessment of lost vertical clinically and adjudging the space to be distributed among both the arches through the metal fused to porcelain restorations, by advocating Hobo’s Twin stage technique to achieve disclusion and a canine guided occlusal scheme.

Results A stable occlusion was achieved, with the desired amounts of disclusion of more than 1mm on protrusive and nonworking sides, and about 0.5mm on working sides during eccentric movements with a pleasing esthetics, with more than 9 months follow up deciphering uneventful occurrences.

Conclusion The technique adapted requires very less complicated armamentarium, calculated condylar guidances, methodical method of achieving anterior guidance with sequential technique gives a very predictable outcome.