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Treatment of localized anterior toothwear with composite restorations at an increased occlusal vertical dimension Ulpee R Durbar Ken W Hemmings Dental Update 2024 50:10, 707-709.
Patients may present with localized anterior toothwear, complaining of poor appearance or sensitivity. or both. Restoration of these teeth continues to cause problems, especially if interocclusal space has been lost. Conventional treatment to satisfy the patient's aesthetic and functional demands is time consuming and requires careful maintenance. This paper describes the use of chairside composite resin restorations in the treatment of localized anterior toothwear. lnteroccusal space is provided by placing the restorations at an increased vertical dimension of occlusion. It enables the presenting complaint to be resolved while restoring structure, function and appearance.
CPD/Clinical Relevance: Localized anterior toothwear may be treated in suitable cases by placement of palatal composite restorations, with posterior tooth contact normally being re-established within 6 months.
Original article reproduced in full from: Darbar UR, Hemmings KW. Treatment of localized anterior toothwear with composite restorations at an increased occlusal vertical dimension. Dent Update 1997; 24: 72–75. (Please note that the figures have been reproduced from the original printed version.)
Article
Localized anterior toothwear is a problem increasingly being encountered by both patient and practitioner.1 It is usually caused by a combination of erosion, attrition and abrasion, and may be generalized or confined to the anterior teeth. Rapid toothwear increases the interocclusal space and causes loss in vertical face height but in a large number of patients the rate of toothwear is slow, allowing compensatory eruption of the opposing teeth. This maintains intercuspal tooth contacts and occlusal face height, thus reducing the interocclusal space available for restoration. This is a common problem in patients with localized toothwear and restoration of these teeth becomes a challenge.
The interocclusal space required for restoring the teeth may be created in a number of ways:2
It is important to identify the cause of toothwear and commence preventive care before undertaking restorative treatment.3 Restorative treatment may involve use of fixed and/or removable prostheses,4,5 although the use of crowns can be destructive in an already compromised dentition. Adhesive cast restorations6,7 have been used to overcome these problems. However, the aesthetics of these restorations remain problematic.
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