Dental literature supports the concept that vertical dimension of occlusion is normally not lost in severely worn d entition, and the bite should generally not be opened to facilitate dental reconstruction. However, restoration of a periodontally sound but severely worn dentition, at existing vertical dimension, frequently presents unique challenges in patient management, diagnosis, treatment planning, and restorative methodology. This report reviews and demonstrates an integrated and planned approach to this complex treatment situation that can lead to a favorable and predictable prognosis. The approach also allows a practitioner free use of various techniques if certain goals of occlusion are followed.