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).