A 22 year old female with chief complaint of tenderness of the masticatory muscles and joint sound referred to Prosthodontic Department of Shiraz Dental School. The patient expressed the history of nocturnal bruxism and pain in the masticatory muscles in early morning that decreased with time. In extraoral examination, there was no facial asymmetry and masseters of both sides were tender with palpation. In intraoral examination, excessive wear of the anterior and posterior teeth and several wear fascets on the posterior teeth wear were found. Overjet was 0 mm and overbite was -1mm which was due to excessive wear of the anterior teeth. There was a single click while opening and closing the mouth in the right TMJ, but both right and left TMJs were tender during examination. There were interferences in the centric relation both in the arc of closure and line of the closure.
At first, stabilization appliance was made for the patient to relax the masticatory muscles and to reduce their pain. The patient wore the appliance for 4 months. Then occlusal equilibration was done for her in order to achieve bilateral, even and simultaneous contacts in the centric relation. After that without increasing the OVD, the upper and lower anterior teeth were reconstructed with composite resin so that in the excursive movements the anterior teeth could exclude the posterior teeth out of the occlusion. This treatment approach is affordable for patients because it minimizes the need for orthodontic and extensive prosthodontic treatments.