A retrospective audit of the outcome of composites used to restore worn teeth

Key Points

• Highlights that restoration of the severely worn teeth are challenging.

• Notes that the long term survival of composites appear to suggest they are successful.

• Suggests that fractures, chips or bulk loss are common outcomes when using composites for worn teeth.

• Proposes that patients should be warned of the possibility of fractures before restorations are commenced.

Abstract

Objectives The aim of this audit was to monitor the outcome of composite restorations placed at an increased vertical dimension in patients with severe tooth wear.

Methods This convenience sample of patients were treated by 11 specialist trainees in prosthodontics, and restored with direct composites. Exclusion criteria included bruxism, poor medical health and a preference for monitoring rather than intervention. The restorations were placed between 2012 and 2016 and were placed over more than one appointment and the outcome monitored for up to 14 months. Failure was assessed at a binary level, either success or failure (minor or major).

Results A total of 35 patients with a mean age of 45 years (range 24–86), 27 of whom were male, received 251 restorations placed from November 2012 to November 2016. The patients had a mean of 11.51 (range 4 to 16) occluding pairs of teeth. There was a total of 40 restoration failures (17%) which was an 83% success rate based on the total number of restorations. For the patient-based data, 14 patients (39%) had no chips or bulk factures while 22 (61%) patients had failures, of which 60% were chips and 40% bulk fractures.

Conclusion Restoration of worn teeth with composites is associated with a high incidence of fractures.

Clinical significance The restoration of worn teeth with composite can involve regular maintenance following fractures and patients need to be aware of this when giving consent.