In order to increase the bite in the original Dahl technique, a partial
metal appliance is placed on the palatal surfaces of the upper anterior
teeth to create an inter-occlusal space of 1.8-4.7 mm. Thus, a
combination of interior intrusion (40%) and posterior eruption (60%)
will be achieved. In this technique, the average time of achieving an
ideal occlusion is six months for most people, and the chief reason for
treatment failure is the non-cooperation of the patients in using the
appliance which is why we altered the anterior guidance to act as fixed
anterior bite plan and to have stable anterior contacts(13).
Alternatively, this technique allows for cingulum restoration, providing
sufficient space for the posterior teeth eruption and anterior guidance
correction by creating composite stops on the anterior teeth without the
need to use an appliance. This, in turn, will increase the possibility
of the patient’s cooperation and improve the treatment effectiveness.
The objective of this treatment was to provide the lost space due to
tooth wear in anterior, remove the posterior teeth from contact, and
provide space for vertical movement (eruption) of teeth.
Both mandibular and maxillary anterior teeth were restored in this
patient, and the composite stops were created on the anterior dentition
of both jaws. After this restoration, the patient’s bite was opened, and
by creating enough space in the posterior between the teeth of both
jaws, the restoration of worn posterior teeth also became possible
(figure 6).