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Direct versus indirect restorations in the treatment of tooth wear: a report of two cases Farima Mehrabi Shihab Romeed Dental Update 2024 49:2, 707-709.
The process of tooth wear is multifactorial in aetiology, and when the progression has been considered excessive enough to be associated with aesthetic and functional concerns, appropriate assessment of each case and its treatment selection must be made, using evidence-based practice to treat such patients. Composite and ceramics are dental materials that have long been used for the restoration of patients with tooth wear. This article will explore the comparisons and rationale between direct and indirect methods and materials, using two rehabilitation cases as examples to show the impact of management of such patients. Although some cases may require a removable treatment option, this article will focus on non-removable options only.
CPD/Clinical Relevance: This article provides readers with an understanding of the selection criteria and utility values when deciding whether to restore a patient's dentition with indirect or direct materials.
Article
Tooth wear has increasingly posed challenges within the realms of primary care dentistry. Pathological tooth wear is defined as one ‘which is atypical for the age of the patient, causing pain or discomfort, functional problems, or deterioration of aesthetic appearance, which, if it progresses, may give rise to undesirable complications of increasing complexity’.1 The results of Van't Spijker's review indicate that the predicted percentage of adults presenting with severe tooth wear increased significantly from 3% at the age of 20 years to 17% at the age of 70 years.2 Increasing levels of tooth wear are directly associated with age, and as the percentage rise in the number of elderly people is estimated to increase by 16.4% by 2030,3 there will inevitably be an upsurge of such cases within the primary dental care sector.
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