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When (and when not) to use the Dahl Concept

British Dental Journal volume 234, pages 155–164 (2023)Cite this article

Abstract

The Dahl Concept describes the re-establishment of occlusal contacts after the provision of a planned localised appliance or restoration in supraocclusion. Initially developed to create space for prosthetic rehabilitation of anterior teeth suffering from localised wear, the principle has later been successfully applied to a variety of situations, including the Hall technique and resin-bonded bridges cemented in supraocclusion. Despite high levels of success seen in the relevant literature and widespread adoption in specialist care, the wider profession appears to be far more cautious in its use. This article aims to provide a brief summary of the Dahl Concept and discuss the local and general factors that influence its successful implementation in the hope of promoting its increased adoption by the broader dental profession.

Key points

  • The Dahl Concept is a predictable treatment modality involving the triad of tooth intrusion, tooth extrusion and mandibular distalisation.

  • General considerations include age, occlusal adaptability, skeletal and incisal pattern, history of temporomandibular disorders, parafunctional habits and altered bone metabolism.

  • Local considerations include the presence of retainers/splints and implants/fixed prostheses, as well as periodontal status, restoration choice and restoration material and thickness.

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Authors and Affiliations

  1. Consultant in Restorative and Implant Dentistry, University Hospitals Sussex NHS Trust, United Kingdom

    Arijit Ray-Chaudhuri

  2. Speciality Dentist Restorative Dentistry, Dundee Dental Hospital and School, United Kingdom

    Timothy Brown

  3. Specialist in Paediatric Dentistry, Graystone Referral Centre, Sussex, United Kingdom

    Emma Ray-Chaudhuri

  4. Consultant in Restorative Dentistry, Great Ormond Street Hospital, United Kingdom

    Simon Critchlow

  5. Consultant in Restorative Dentistry, Bart´s Health NHS Trust, United Kingdom

    Raj Dubal

  6. Consultant and Honorary Senior Lecturer in Restorative Dentistry, Eastman Dental Hospital, United Kingdom

    Kushal Gadhia

  7. Consultant in Restorative Dentistry, Guy´s and St Thomas´ Trust, United Kingdom

    Sara Tabiat-Pour

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  1. Arijit Ray-Chaudhuri
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  4. Simon Critchlow
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  6. Kushal Gadhia
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  7. Sara Tabiat-Pour
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Contributions

Arijit Ray-Chaudhuri, Timothy Brown, Emma Ray-Chaudhuri, Raj Dubal, Simon Critchlow, Sara Tabiat-Pour and Kushal Gadhia all contributed equally.

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Correspondence to Arijit Ray-Chaudhuri.

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Ray-Chaudhuri, A., Brown, T., Ray-Chaudhuri, E. et al. When (and when not) to use the Dahl Concept. Br Dent J 234, 155–164 (2023). https://doi.org/10.1038/s41415-023-5502-9

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