From Volume 47, Issue 1, January 2020 | Pages 14-21
For patients presenting with more severe forms of tooth wear, removable dentures offer an alternative means of prosthodontic rehabilitation. The use of overdentures, onlay dentures or overlay dentures to restore severely worn teeth can achieve excellent aesthetic and functional results. This article looks at the indications for treatment planning and provision of these prostheses.
The prevalence of tooth wear (TW) in the United Kingdom is increasing. The Adult Dental Health Survey of 2009 suggested that 77% of adults had anterior TW. The report also suggested that 2% of the dentate adult population were found to have severe wear exposing secondary dentine or pulp.1 This is concerning as tooth wear patients often present to the restorative dentist complaining of poor dental aesthetics and dentinal sensitivity (Figure 1). Consequently, they may request treatment. Fortunately, loss of pulpal vitality is relatively uncommon, even in patients with severe wear.2,3
Nevertheless, the oral rehabilitation of TW patients is still complicated by a number of factors, including a lack of interocclusal clearance (for prosthodontic rehabilitation) and poor gingival aesthetics (Figure 2).
A number of operative options are available to the restorative dentist to rehabilitate patients with a worn dentition. These include the placement of direct composite resin (Figure 3), indirect extra-coronal restorations (both full and partial coverage) (Figure 4), as well as removable dentures.
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