I'll try to make this short... ish

My patient present for comprehensive exam in Oct 2019. Light generalized wear with the exception of plunging wear facets on #18 and #31. #18 had a failing MO and #31 a fracture in the MMR that I could fit an explorer in. Each was treatment planned for a crown.

The crowns were complete in November 2019. CEREC. E.max. Omni Cam. Same day. The occlusion extended to the canines on each side. (indicated by contact points on the virtual models) I scanned and complete them separately instead of the entire arch. Treatment complete. Patient happy. I also recommend a night guard at the comprehensive exam.

Pt was seen for hygiene March 2020, July 2020 and November 2020 - 4 month recall. An occlusal guard was recommended at each appointment. There was no documentation of her bite feeling "off" or "different". No discussion of hyper occlusion, anything.

I asked my hygienist about the Nov 2020 appointment is remembered me noticing a change in her occlusion immediately upon sitting down for her POE at her Nov 2020 appointment.

She present again Feb 2021 indicating that her bite felt "off" since the fabrication of the crowns a year ago. You guessed it.... anterior open bite.

She is a night time clencher with a history of non-compliant occlusal guard use. She is asymptomatic - no joint or muscle pain.

So... Spear training has made me aware that following modification of second molars patients can develop an open bite and loose their ability to find MI. Which brings me to my questions.

1. How, in 2 hours, from preparation to cementation, would a patient loose that muscle memory and their ability to find MI.

2. Is there a way to train them back to that position?

3. If not... what are the options to regain contact in MI?

Thanks in advance for any feedback!