Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

Clinical considerations in the application of direct composite for tooth wear

British Dental Journal volume 234, pages 400–405 (2023)Cite this article

Abstract

Various techniques are available for the application of composite to restore worn teeth. Different techniques may be chosen based on the clinical presentation or clinician preference. However, for composite to be successful, there are numerous factors which must be considered in order to optimise the outcome. Pre-treatment steps, such as isolation for optimal moisture control and adequate surface preparation of the tooth, as well as the post build-up objectives of achieving a stable occlusion, good marginal adaptation and final aesthetics, are discussed in the paper.

Key points

  • Composite can be used to restore teeth using the free-hand technique, free-hand technique with a palatal stent, or full coverage matrix techniques. Each method has advantages and disadvantages which are discussed.

  • Optimal surface preparation of the teeth for restoration, adequate isolation to ensure good moisture control, sufficient thickness of composite and a stable occlusion post restoration are key considerations to successful composite restorations.

  • Multiple appointments are generally required in the restoration of tooth wear patients when using composite. Having consecutive appointments allows the clinician sufficient time to ensure restorations are well-contoured and polished to optimise the aesthetics but also review the occlusal scheme and make necessary adjustments.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Aminian A, Leven A J, Ashley M P. Indications for the use of direct composite restorations in the management of tooth wear. Br Dent J 2023; 234: 395-399.

  2. Mehta S B, Banerji S, Millar B J, Suarez-Feito J-M. Current concepts on the management of tooth wear: part 4. An overview of the restorative techniques and dental materials commonly applied for the management of tooth wear. Br Dent J 2012; 212: 169-177.

  3. Tiwari B, Ladha K, Lalit A, Dwarakananda Naik B. Occlusal concepts in full mouth rehabilitation: an overview. J Indian Prosthodont Soc 2014; 14: 344-351.

  4. Mehta S B, Banerji S, Millar B J, Suarez-Feito J M. Current concepts on the management of tooth wear: part 3. Active restorative care 2: the management of generalised tooth wear. Br Dent J 2012; 212: 121-127.

  5. Spear F. The maxillary central incisal edge: a key to esthetic and functional treatment planning. Compend Contin Educ Dent 1999; 20: 512-516.

  6. Jafri Z, Ahmad N, Sawai M, Sultan N, Bhardwaj A. Digital Smile Design - An innovative tool in aesthetic dentistry. J Oral Biol Craniofac Res 2020; 10: 194-198.

  7. Vig R G, Brundo G C. The kinetics of anterior tooth display. J Prosthet Dent 1978; 39: 502-504.

  8. Sabri R. The eight components of a balanced smile. J Clin Orthod 2005; 39: 155-167.

  9. Lu H, Yoshinaga T, Li C, Nozaki K, Iida A, Tsubokura M. Numerical investigation of effects of incisor angle on production of sibilant /s/. Sci Rep 2021; 11: 16720.

  10. Poojary P K, Bhandary S, Srinivasan R, Nasreen F, Pramod J, Mahesh M. Influence of restorative technique, Bevelling and aging on composite bonding to sectioned incisal edges: A comparative in vitro study. J Conserv Dent 2013; 16: 28-31.

  11. Ramírez-Barrantes J C. Esthetic Anterior Resin Restorations: To Bevel Enamel or Not? Odovtos Int J Dent Sci 2019; 23: 27-31.

  12. Sinjari B, Santilli M, D'Addazio G et al. Influence of Dentine Pre-Treatment by Sandblasting with Aluminium Oxide in Adhesive Restorations. An In Vitro Study. Materials (Basel) 2020; 13: 3026.

  13. Zhang L, Yu P, Wang X-Y. Surface roughness and gloss of polished nanofilled and nanohybrid resin composites. J Dent Sci 2021; 16: 1198-1203.

  14. Poyser N, Porter R, Briggs P, Kelleher M. Demolition experts: management of the parafunctional patient: 2. Restorative management strategies. Dent Update 2007; 34: 262-268.

  15. Raskin R, Setcos J C, Vreven J, Wilson N H. Influence of the isolation method on the 10-year clinical behaviour of posterior resin composite restorations. Clin Oral Investig 2000; 4: 148-152.

  16. Robinson S, Nixon P J, Gahan M J, Chan M F W Y. Techniques for restoring worn anterior teeth with direct composite resin. Dent Update 2008; 35: 551-558.

  17. Mehta S B, Francis S, Banerji S. A Guided, Conservative Approach for the Management of Localized Mandibular Anterior Tooth Wear. Dent Update 2016; 43: 106-112.

  18. Bailey O, McGuirk C, O'Connor C. Matrix transfer techniques for direct paste composite resins. Br Dent J 2022; 233: 91-98.

  19. Dietschi D. Free-hand composite resin restorations: a key to anterior aesthetics. Pract Periodontics Aesthet Dent 1995; 7: 15-25.

  20. Panchal A C, Asthana G. Oxygen inhibition layer: A dilemma to be solved. J Conserv Dent 2020; 23: 254-258.

  21. Gulamali A B, Haemmings K W, Tredwin C J, Petrie A. Survival analysis of composite Dahl restorations provided to manage localised anterior tooth wear (ten year follow-up). Br Dent J 2011; DOI: 10.1038/sj.bdj.2011.683.

  22. Blum I R, Lynch C D, Wilson N H. Factors influencing repair of dental restorations with resin composite. Clin Cosmet Investig Dent 2014; 6: 81-87.

  23. Leven A J, Némat S M. Presentation and management of mandibular anterior tooth wear. Dent Update 2022; 49: 569-574.

  24. Poyser N J, Briggs P F A, Chana H S, Kelleher M G D, Porter R W J, Patel M M. The evaluation of direct composite restorations for the worn mandibular anterior dentition - clinical performance and patient satisfaction. J Oral Rehabil 2007; 34: 361-376.

Download references

Author information

Authors and Affiliations

  1. Private Practice, Clinic 334, Wilmslow, UK

    Amin Aminian

  2. Manchester University NHS Foundation Trust, Manchester, UK

    A. Johanna Leven & Martin P. Ashley

Authors
  1. Amin Aminian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Johanna Leven
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin P. Ashley
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Amin Aminian is the main author, with support and contribution from A. Johanna Leven and Martin Ashley. All three authors contributed to the concept, the design, the writing and the editing.

Corresponding author

Correspondence to Amin Aminian.

Ethics declarations

The authors declare that there are no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aminian, A., Leven, A. & Ashley, M. Clinical considerations in the application of direct composite for tooth wear. Br Dent J 234, 400–405 (2023). https://doi.org/10.1038/s41415-023-5675-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-023-5675-2

Search

Advanced search

Quick links