[Nickshu]

These reconstructions on severely worn dentitions are big projects. To do them right they often require orthodontics b/c the teeth erupt as they wear.

You are correct in that your decision point is wear a nightguard or get the reconstruction (and still wear a nightguard, but look better).

There is not a cure for bruxism, so you will likely grind on the restored dentition as well. Sleep apnea may play a role, but no real evidence there, still controversial. Now grinding on a restored dentition (porcelain/zirconia) will not wear like your teeth did. Once you wear through enamel you are dentin on dentin, which wears 7x faster than enamel does, so that's why the wear gets so bad once it reaches a certain point.

One option for this is Botox injections in your masseter muscles, I have used this in several patients who are destroying expensive restorative care with success. But you have to be committed to doing it every 3-6 months.

Bottom line is you have to be committed to wanting to do this, and then maintain it and deal with the issues afterwards that are sure to come.

Opening your bite up w/ a reconstruction *could* also help your sleep apnea as well, as one other data point for you.

Hope that helps. I am not a restorative/general dentist, I am a periodontist but I am involved in a lot of these reconstructions helping build the necessary foundations.