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Beyth N, Tamari I et al. Spec Care Dentist 2014; 34: 295–297

This paper describes the dental reconstruction of two patients with gross tooth wear. For one patient, this was achieved using a PMMA removable prosthesis and for the other, modification of an existing metal-based prosthesis. This treatment approach was apposite as the patients' medical histories contra-indicated crown-lengthening, or tooth extractions. One patient had received radiation therapy for cancer of the tongue and the other was being treated for ischaemic heart disease. The patient who had received radiotherapy, was given advice on meticulous home oral care and following prosthetic reconstruction, the use of an adjunctive fluoride preparation using the removable prosthesis as a delivery vehicle. It was reported for this patient only, that the PMMA prosthesis survived for one year, despite the inevitable unfavourable occlusal forces. Although the authors placed emphasis on possible TMD symptoms as a consequence of increasing the occlusal vertical dimension, no such symptoms were experienced. Although not cited, the treatment of the second patient mirrored that described in the classic paper outlining the modification of an existing denture to an onlay prosthesis (J Prosthet Dent 2002; 87: 1–4).