Beyond Conventional Dentures: A Metal Occlusal Strategy for Functional and Neuromuscular Rehabilitation — A Case Series
TL;DR
These cases support cast metal occlusal surfaces as a durable, low-maintenance option across a broader range of high-wear clinical scenarios than commonly recognized, extending beyond their traditional association with bruxism.
Abstract
Acrylic resin denture teeth remain the standard for removable prosthodontic rehabilitation but are vulnerable to accelerated occlusal wear under two distinct clinical circumstances: neuromuscular impairment that produces unpredictable, repetitive occlusal loading, and opposition against rigid fixed restorations such as metal-ceramic crowns. Progressive wear compromises vertical dimension of occlusion (VDO), masticatory efficiency, and longterm prosthesis stability, often necessitating frequent remakes. This case series presents two patients treated with complete dentures incorporating cast cobalt-chromium occlusal surfaces to address these wear mechanisms: an 81- year-old edentulous male with idiopathic Parkinson's disease, and a 55-yearold male with an edentulous maxilla opposing a mandibular metal-ceramic fixed partial denture. In both cases, posterior denture teeth were reduced to accommodate cast metal occlusal surfaces onlays in the first case and fullcoverage copings in the second incorporated following conventional insertion protocols. Both patients demonstrated stable occlusion, preserved VDO, and satisfactory masticatory function at follow-up, with no evidence of significant wear. These cases support cast metal occlusal surfaces as a durable, low-maintenance option across a broader range of high-wear clinical scenarios than commonly recognized, extending beyond their traditional association with bruxism.