47 YOWF wishes to replace her existing veneers #6-11 that are broken due to bruxing/clenching during wake and sleep. Additionally she required restoration of #5, 12, & 13 due to fractured cusps. She chose to close the spaces that had developed between her upper incisors as well as her lower incisors with aligners prior to new restorations due to the concerns that they would be unnaturally wide. She is currently in provisional restorations from #4-#13 and has acclimated well to the increased of 1.2mm to her VDO. I am concerned about a relapse in spacing/flaring following new restorations. I am also concerned about using zirconia restorations for their resistance to fracture due to the risk of further damage to her opposing teeth.

Her bruxing was reduced with Botox injections in her masseters for a period of time but she has developed compensatory activation of her pterygoids allowing her clenching to persist. I have concerns about using Botox in her pterygoid muscles and diminishing her ability to advance her mandible while sleeping given that her sleep study results show an AHI consistent with a mild to moderate SRBD that is largely central in origin.
Should we consider the addition of zirconia inlays/onlays/crowns on her lower canines or premolars to limit the interocclusal contact of the upper and lower incisors? Would restoring the upper with feldspathic porcelain be a better choice if she can tolerate an additional .8mm in VDO?
Following her preparations with a reduction of >1mm on the upper lingual surfaces, she is still able to achieve contact of her upper and lower incisors evidence to the prediction that spreading and flaring will recur.
Are splinted crowns an option to prevent this? My understanding is that splinting crowns is contraindicated in bruxism cases. Without room for an orthodontic lingual fixed bar. How can we stabilize her bite, preserve her restorations, and the teeth they oppose?