An alternative view

Professor Burke is overgenerous in his assessment of the success of traditional composite techniques in the treatment of tooth wear in his recent comments.¹

Regarding the study in question, if we consider the most aesthetically demanding area, the anterior maxilla, the study results are not encouraging. If the less significant smaller Level 3 failures are excluded, then the combined Level 1 and 2 failures (those that required restoration, repair or replacement) are actually high, at 26.9% and 32.5% for one- and two-session composite veneer placements, over a relatively short study period. In addition, polishing due to extrinsic staining or roughness was not registered as failure.²

Advocates of this style of traditional style of composite rehabilitation describe the initial aesthetic outcome as ‘good enough.’³ However, the clinical experience of many of us who previously undertook this of this type of rehabilitation in private practice (where the majority of tooth wear is treated) is that many patients were not overwhelmed with the initial aesthetic outcome, and disappointed with the rapid deterioration in aesthetics due to staining, chipping or delamination, and constant replacement/repairs.