In Full Mouth Restoration in generalised attrision cases. What do we do first obtain the incisal guidance first or increase the posterior height, why?

definitely posteriors first! You have to increase the OVD otherwise you'll break the anteriors; see"3 steps technique" from F.Vailati(Switzerland)

oh, if you don't care how long ihe definitives are gonna last, you can start with the anteriors for the beauty (and do a DSD for the show too)

highly depends on patients condition .... based on tmj joint, vdo and vdr , easthetics and patients mastication ability... dawsons prefers incisal and hobo prefers posterior guidance .... bt my opinion considering above factors we should cme to an conclusion...

 

The teeth typically have a specific anatomical relief that allows physiological mandibular movements (food incision, trituration by lateral movements, etc.). As a result of this, the teeth will present some obtuse, perfectly flat and circumscribed surfaces that will no longer allow a normal masticatory dynamics, forcing the muscles and joints to act abnormally to cope with these disorders, resulting in a serious imbalance of the entire Dento-maxillary device.

  For these reasons, the dental atrium should be regarded as an edentation, finding the best way to restore the anatomic-functional restoration of the tooth mastication surfaces, in harmony with the entire muscular and articular complex, obviously following the guidelines of dento-facial aesthetics.   Today, dentistry generally has to offer aesthetic treatment, whatever the work done, without forgetting that aesthetics can not exist in the absence of functionality. So  in  my  opinon  we should  start to  create a  good  DVD dimension  from The lateral zone to protect The frontal  zone from brakeing  or mobilizing  frontal teeth, and after web obtain  an stabile  oclussion  web când reconstruct  frontal area .

In cases showing generalized attrition, requiring full mouth rehabilitation first incisal guidance is established to cause posterior disclusion. Temporaries are used to establish the plane of occlusion.  

IN FULL MOUTH REHAB CASES WITH GENERALIZED ATTRITION FIRST GOAL IS TO ESTABLISH FAVORABLE INCISAL GUIDANCE  WITH TEMPORARY RESTORATIONS THAT DISOCCLUDE THE POSTERIOR TEETH FUNCTIONALLY AND ESTHETICALLY ACCEPTABLE, THEN ESTABLISH THE POSTERIOR OCCLUSAL PLANE.   

In full mouth restoration in generlized attrision case we do ist incisal guidance because to maintain occlusal vertical dimensions

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In many cases, the vertical dimension of occlusion (VDO) is ... As teeth are worn, the alveolar bone undergoes an adaptive process and ... As there was clinical evaluation of reduced VDO, full mouth rehabilitation with increasing VDO was ... The anterior guidance disoccluded the posterior teeth in all jaw ...

We can prevent generalized attrision more or less to obtain the incisal guidance first or increase the posterior heigth. Of course, the treatment of attrision would be done in the way of wearing the night-guard and/or adjusting the occlusion precisely.

Depending on the level of attrition first establish the OVD to restore TMJ balance forces.

Temporary restorations give the final adjustments which will be minimized by incorporating the incisal guidance adjustment. Patients feed back of comfort when temporaries are fixed checking its adaptation is most expertise judgement in using technical measures with patients expectations.