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A contemporary approach for the management of generalized tooth wear

From Volume 45, Issue 6, June 2018 | Pages 569-577

Authors

Mohammad Habib Aldashti

BDS, MFD RCSI

MClindent in Prosthodontics, Membership in Prosthodontics, RCS(Ed), Fellow, Implant Department, Loma Linda Dental School, 11092 Anderson St, Loma Linda, CA 92350, USA

Articles by Mohammad Habib Aldashti

Abstract

Abstract: This paper describes the treatment of a 39-year-old female patient with generalized tooth wear. The causes of the tooth wear were identified and controlled. Following diagnostic planning, a full mouth reconstruction at an increased vertical dimension utilizing a reorganized approach was carried out. Crown lengthening surgery was performed on the maxillary anterior teeth prior to the restorative phase. The restorative treatment included a combination of indirect and direct composite resin restorations and adhesive cast restorations. Very satisfactory functional and aesthetic outcomes were achieved.

CPD/Clinical Relevance: This paper demonstrates a practicable approach that can be applied for patients with tooth wear. The approach is conservative which eliminates the need for full coverage crowns to restore aesthetics and function.

Article

Sensitivity tests: All teeth excluding (UR1) tested positive to Endo-lce and electrical pulp testing.

Percussion test: None of the teeth was tender to percussion.

The maxillary anterior teeth (UR3 to UL3) were restored with a combination of indirect palatal composite resin veneers and direct labial composite resin build-up restorations (Figure 12). The mandibular anterior teeth (LR3 to LL3) were restored with direct composite resin with the aid of a clear silicone index (based on the diagnostic wax-up) (Figures 16-20).

Following restoration of the anterior dentition, the posteriors were stabilized with resin-modified glass ionomer occlusal stops (Figure 21).

An impression was taken and wax-up was completed to proceed with the posterior reconstruction. All 1st and 2nd molars were restored to the established OVD with adhesive gold onlays (Figure 22).

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