Case Model 4
Bite Instability — System-Level Convergence
Case Summary
Generalized posterior wear
Multiple fractured restorations over 5 years
Loss of posterior support on right side
Anterior wear facets
Patient reports clenching
No acute pain
No single tooth catastrophic failure
1. Structure Assessment
Generalized enamel thinning
Dentin exposure in posterior segments
Reduced posterior occlusal table on right
Multiple large restorations
Several crack lines present
Periodontal support adequate
Structural reserve: Globally Moderate to Low
Structural compromise is cumulative rather than isolated.
2. Force Assessment
Parafunction confirmed
Asymmetrical load distribution
Posterior support loss shifting force anteriorly
Lateral interferences present
Force risk: High
Force is unevenly distributed and concentrated on compromised regions.
3. Time Projection
Progressive fracture history
Increasing restoration replacement frequency
Ongoing parafunctional activity
No prior occlusal intervention
Time risk: High
Pattern indicates accelerating fatigue across system.
4. Long-Term Stability Projection
Under Isolated Tooth Repair
Continued redistribution of force
New fracture sites likely
Progressive structural reserve decline
Increasing intervention frequency
Under Comprehensive Occlusal Intervention
Force redistribution across arch
Stabilization of load vectors
Improved durability of restorations
Slowing of structural reserve depletion
5. Threshold Position
Projected force across projected time exceeds structural tolerance at the system level.
Instability is not confined to a single tooth.
Threshold convergence present at arch level.
Decision:
System-level intervention indicated.
Isolated repair without occlusal correction will not restore projected long-term stability.