From Volume 48, Issue 7, July 2021 | Pages 541-544
This article describes the management of a patient with generalized (primarily erosive) tooth surface loss. It specifically looks at minimally invasive techniques using improvements in material science to achieve this in an efficient and predictable manner within a general dental practice setting.
With an increasingly elderly population who are retaining teeth for longer, the prevalence of tooth surface loss is on the increase. The most recent Adult Dental Health Survey (2009) revealed that 77% of dentate adults exhibited wear into dentine.1 Tooth surface loss can be attributed to either erosion, attrition or abrasion. However, it is commonly multifactorial in aetiology.2
Preventive management of tooth surface loss is the cornerstone of care for these patients, and screening tools such as the Basic Erosive Wear Examination (BEWE) should be employed at recall examinations for all patients.3 Tooth surface loss can be classified as being physiological or pathological. However, both groups may need restorative management in cases of:4
The traditional restorative management of tooth surface loss involved full mouth reconstructions using indirect restorations, which often resulted in a high treatment burden to teeth, and accelerated their path along the restorative cycle.2 This report presents a case that demonstrates the management of generalized tooth surface loss using a combination of direct and indirect composite restorations, with almost no tooth removal required.
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