Full Mouth Reconstruction in Turkey: Staged, Tested and Functional

Key facts - Full mouth reconstruction rebuilds the teeth in both jaws because of severe wear, erosion, multiple failing restorations or missing teeth, often at a new bite height. - European consensus advises delaying restorative treatment of tooth wear as long as possible and, when needed, using the most conservative approach. - Increasing bite height is generally considered safe, with symptoms usually temporary; patients with jaw joint disorders should test the new bite with removable appliances first. - Expect a 6–12 week provisional phase between trips; one-trip reconstructions skip the bite test. - Indicative pricing is £8,000–£20,000 or more in Turkey, against £25,000–£50,000 or more in the UK.

Functional Rebuilding, Not a Bigger Makeover

Full mouth reconstruction in Turkey is sometimes presented as a larger version of a Hollywood smile: more crowns, more teeth, one trip. The comparison is misleading. Patients who genuinely need it usually have functional problems:

• severe attrition, teeth ground flat by clenching or grinding;
• acid erosion, from reflux, an eating disorder or an acidic diet;
• multiple failing restorations, with fractures, recurrent decay or broken crowns;
• missing teeth that have allowed the rest to drift and the bite to change.

The European consensus statement on severe tooth wear sets the tone for treatment: diagnose the cause, prevent further damage, counsel and monitor, and delay restorative treatment as long as possible.¹ When treatment is needed, it recommends a conservative, minimally invasive, often adhesive approach, supported by prevention. Full crowns on every tooth are not the default.

Reconstruction often involves changing the vertical dimension of occlusion (VDO), the height of the bite when the back teeth meet. Raising it can create space for restorations without cutting teeth down, and restore lost facial height. Reviews of the evidence suggest that, when indicated, increasing the VDO is generally safe and predictable, and that any symptoms are usually temporary.³ The important exception is patients with temporomandibular disorders (TMD), where the new bite should first be tested with removable appliances before anything irreversible is done.²

That is why careful clinics plan with several specialists, control the cause first, and test the new bite in provisionals before copying it into permanent restorations. Cementing a new bite directly in ceramics leaves no room to correct it without remaking the work.

Wear, Bite Height and Jaw Position

The first step is identifying and controlling the cause. Severe attrition usually reflects bruxism, sometimes linked to sleep disorders, stress or medication. Acid erosion points to reflux, bulimia, frequent acidic drinks or occupational exposure. A reconstruction placed while erosion or grinding continues will fail the same way the natural teeth did, so medical referral, dietary change and a night guard are part of treatment.

Worn teeth do not always mean a collapsed VDO. As teeth wear, they tend to keep erupting and the bone follows, so facial height is often preserved despite very short teeth. Techniques for measuring "lost" vertical dimension are inconsistent, which is why reviews recommend deciding any increase on restorative needs and aesthetics. Generally, the smallest increase that does the job is preferred; up to about 5 mm at the front can be justified to create space for restorations and improve the appearance of the front teeth.²

The temporomandibular joint (TMJ) position provides the reference. Clinicians use centric relation (CR), a reproducible jaw position with the condyles seated in their sockets, which remains reliable even when teeth are worn or missing. Tight chewing muscles often pull the jaw into a habitual position, so CR deprogramming comes first, with an anterior jig, a leaf gauge or a short period wearing a splint. A reliable CR bite record can then be taken. Patients with active jaw joint pain, locking or limited opening are stabilised with a splint before any restorative work.

Staged full-arch provisionalisation then tests the plan:

1. Models are mounted on an articulator in CR, and a diagnostic wax-up is made at the proposed VDO with planned guidance.
2. Where there is any doubt, or a history of TMD, a removable overlay appliance at the new height is worn for several weeks first.
3. Teeth are prepared and fitted with fixed PMMA provisionals reproducing the wax-up, worn for 6–12 weeks.
4. Muscle comfort, joint symptoms, speech, chewing and appearance are monitored and the provisionals adjusted.
5. Only then are they scanned and copied into the final restorations.

Materials and Staged Provisionals

Materials follow the bite forces and wear risk in each area:

• back teeth in bruxists usually receive monolithic zirconia or, where space is very limited, cast gold, both fracture-resistant and kind to opposing teeth when polished;
• front teeth often receive lithium disilicate crowns or veneers where the bite allows, with tougher materials for severe wear;
• minimally invasive onlays and "tabletops" in lithium disilicate or composite restore worn chewing surfaces with little further reduction, particularly in erosion;
• direct or indirect composite can be a conservative first stage, or the definitive treatment in younger patients, building worn teeth back up additively, in line with the European consensus.

Provisionals are usually CAD/CAM-milled PMMA, strong and colour-stable enough for months and easy to adjust; our guide to temporary crowns explains why.

The laboratory relies on facebow-mounted or digitally articulated models, a CR bite record and the approved provisional scans. Complex cases are often restored in segments, typically front teeth first to establish guidance, then back segments, with the bite height maintained by provisional stops. Planning starts from a digital smile design, and may involve a periodontist, endodontist, orthodontist, oral surgeon for implants, and the patient's doctor for reflux, sleep or eating disorders.

A Staged Treatment Across Trips

Before travel: records. Medical history, photographs, video, scans and X-rays are sent, the cause of wear or erosion identified, and medical management of reflux or bruxism started at home.

Trip one (7–10 days).

1. Full examination, TMJ and muscle screening, and CBCT if implants are planned.
2. CR deprogramming, CR bite and facebow records.
3. Articulated models and a diagnostic wax-up at the proposed VDO.
4. A mock-up confirming appearance and speech.
5. Any extractions, implant placement and root canal treatment.
6. Preparation and fitting of fixed PMMA provisionals at the new height, or a removable overlay first if TMD is present.

At home (6–12 weeks). You wear the provisionals while keeping a symptom diary: muscle ache, clicking, headaches, speech and chewing. Minor adjustments can be made by a local dentist in coordination with the clinic.

Trip two (10–14 days). Comfort and stability are confirmed, the provisionals scanned and cross-mounted, and the laboratory makes the final restorations to match. They are tried in and fitted segment by segment, with a night guard.

Trip three, if needed. Six-month review, bite refinement and hygiene assessment.

Signs a Plan Is Being Rushed

A five-day reconstruction. Preparing and rebuilding both arches at a new bite height in one short trip leaves no time to test the bite. Problems may only appear at home, when ceramics are already cemented. Insist on a staged provisional phase.

No occlusal records or prevention. A plan based only on photos and scans, with no CR records, articulated models, diagnostic wax-up or assessment of the cause of wear, is cosmetic planning, not functional rehabilitation. Ask how your bite height and jaw position will be determined and tested, and how further wear will be prevented.

Incomplete scope. Headline quotes often exclude the provisional phase, periodontal and root canal treatment, implants and grafting, the night guard and review visits. Indicative pricing is £8,000–£20,000 or more in Turkey, against £25,000–£50,000 or more in the UK, depending on the number of teeth, implants and specialist procedures.

Candidacy

Ideal candidates

• Generalised severe wear or erosion, multiple failing restorations, or missing teeth affecting function.
• Patients whose cause of wear has been identified and controlled.
• Patients willing to complete a staged provisional phase and wear a night guard for life.

Contraindications & complications

• Active untreated TMD (until stabilised), uncontrolled reflux or eating disorders, untreated periodontitis, and unrealistic timelines.
• Heavy bruxism without commitment to a night guard.
• Complications include muscle discomfort and jaw symptoms during adaptation (usually temporary), restoration fracture, sensitivity or pulp damage, speech changes, and recurrence of wear if the cause persists.

Full Mouth Reconstruction vs Hollywood Smile

A Hollywood smile is primarily aesthetic, improving the shape, colour and alignment of visible teeth, usually without changing bite height or jaw position.

Full mouth reconstruction is functional, rebuilding worn or failing teeth in both arches, often at a new vertical dimension, guided by the jaw joints, the muscles and a tested occlusal scheme. The two are sometimes combined, but a patient with severe wear needs the functional planning and provisional testing of reconstruction.

Frequently Asked Questions

References

1. Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19(2):111–119. doi:10.3290/j.jad.a38102
2. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J. 2012;57(1):2–10. PubMed
3. Abduo J. Safety of increasing vertical dimension of occlusion: a systematic review. Quintessence Int. 2012;43(5):369–380. PubMed