A cost-effective treatment for severe generalized erosion and loss of vertical dimension of occlusion: laboratory-fabricated composite resin restorations.

This case report describes preventive and restorative treatment planning for a 56-year-old female patient with severe, chronic, poorly controlled gastroesophageal reflux disease and resulting loss of vertical dimension of occlusion. First, the demineralization process was controlled through collaboration with the patient's physician, and measures were taken to restore adequate stimulated salivary flow. Then, for financial reasons, indirect laboratory-fabricated composite resin restorations were adhesively bonded to replace lost tooth structure and reestablish the patient's collapsed vertical dimension. Indirect-laboratory fabricated restorations can be a cost-effective alternative to direct composite resin or all-ceramic restorations for the treatment of chronic severe erosion, but there are no long-term clinical reports in the current literature to support or contraindicate the use of indirect composites for this type of clinical application. Therefore, careful, long-term follow-up evaluations are planned for this patient.

Oral diagnosis and treatment planning: part 4. Non-carious tooth surface loss and assessment of risk.

Non-carious tooth surface loss or tooth wear is becoming an increasingly significant factor affecting the long-term health of the dentition. The adverse effects of tooth wear are becoming increasingly apparent both in young persons and, as more people retain their teeth, into old age. This situation challenges the preventive and restorative skills of dental practitioners.

Attrition and erosion: assessment and diagnosis.

The management of patients with extensively worn and badly broken down dentitions presents a difficult challenge in dental practice and restorative treatments are often complex, time consuming and costly to implement, so careful case selection and treatment planning is essential. Ultimately the success of any restorative intervention is very dependent on the stability of the oral environment and the status of the remaining tooth structure. Prior to the commencement of any restorative treatment an understanding of the importance of the disease process, the risk factors in the mouth, and the intrinsic and extrinsic factors which affect the oral balance is critical. While there is a growing range of materials and techniques available for cost effective and conservative management of these cases, failure to take a systematic approach to assessment and stabilization may result in early restorative failure, rapid recurrence of the problems and a repeat restoration cycle. Therefore successful management of these patients must include an appropriate mix of preventive and restorative strategies.

Incorporating orthodontics into restorative treatment to improve long-term prognosis.

Interdisciplinary treatment that incorporated orthodontics with restorative dentistry was used in this complex case to achieve major esthetic changes for a 45-year-old female patient, whose primary concern was the worn appearance of her teeth. The planning and sequential treatment of the case was facilitated using a system of diagnosis, risk assessment, and risk management. By employing orthodontics in the treatment plan, the number of restorations was kept to a minimum, thereby reducing the biomechanical risk to the dentition.

The prevalence, etiology and management of tooth wear in the United Kingdom.

STATEMENT OF PROBLEM: Recent epidemiologic evidence suggests that tooth wear is now a significant problem in both children and adults. There is growing evidence that a major cause of severe wear in patients is regurgitation erosion due to a variety of factors including gastroesophageal reflux disease. PURPOSE: The purpose of this article is to discuss the prevalence of tooth wear in the United Kingdom. Emphasis in management should be on accurate diagnosis, and in some patients, long-term monitoring before embarking on any irreversible, interventive treatment. Even when treatment is necessary, a period of monitoring is helpful to assess the rate of progress of the wear, the effectiveness of preventive measures, and therefore the extent of the treatment necessary.

Veneering of teeth. State of the art.

Veneering of discolored, malformed, poorly restored, or broken-down teeth is now a reality in routine dental practice. Various types of veneers have been described. The most commonly used veneer has been described in detail. Properly placed veneers should provide patients with years of inexpensive, esthetic service. They are satisfying to dentists and patients, and their use should be encouraged.