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Restoration of localised erosive wear using a combination of dental materials: a conservative approach

British Dental Journal volume 230, pages 294–300 (2021)Cite this article

Abstract

Objectives To present the treatment approach for the restoration of localised anterior erosive wear using a combination of dental materials.

Clinical considerations A patient presented in a private dental practice concerned about the aesthetics of his anterior teeth. The patient's history and clinical examination revealed erosive wear on the labial and palatal aspects of his maxillary central incisors and right lateral incisor. The formulated treatment plan was to restore the teeth in a conservative way. A diagnostic wax-up was performed and confirmed with the patient with chairside mock-up. The treatment provided included direct composite restorations, replacement of a porcelain-fused-to-metal crown on his left lateral incisor with a porcelain-fused-to-zirconia crown, and lithium disilicate ceramic veneers on the worn labial surfaces of the central incisors and the right lateral incisor. The preparations for the ceramic veneers were carried out with the aid of the diagnostic mock-up, thus minimising the need for tooth removal of the worn teeth.

Conclusions Pre-operative planning for tooth surface loss cases can help to ensure that little or no remaining tooth structure is removed during the restorative procedures. A strict bonding protocol is crucial to ensure longevity of the restorations.

Key points

  • Appreciate the importance of treatment planning in bonded restorations.

  • Understand the usefulness of a diagnostic mock-up for communication and also for more conservative preparation.

  • Understand the use of different materials and visualise the process step by step.

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Acknowledgements

The authors would like to thank Mr Cuong Luong for his laboratory support.

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Authors and Affiliations

  1. Clinical Lecturer in Prosthodontics, Barts and The London Institute of Dentistry, Queen Mary University of London, London, UK; Specialist Prosthodontist, Dental Beauty Dulwich, London, UK

    Ioannis Papadopoulos

  2. Specialist Registrar in Restorative Dentistry, Barts NHS Trust, Royal London Dental Hospital, London, UK

    Jennifer Fuller

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Correspondence to Ioannis Papadopoulos.

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Papadopoulos, I., Fuller, J. Restoration of localised erosive wear using a combination of dental materials: a conservative approach. Br Dent J 230, 294–300 (2021). https://doi.org/10.1038/s41415-021-2697-5

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