Adhesive Rehabilitation of a Severely Worn Dentition: A Case Report

Abstract

Introduction: Tooth wear is a multifactorial progressive condition, leading to the loss of dental hard tissues. It is the result of a combination of mechanical (attrition and abrasion) and chemical (erosion) processes. As a consequence of worn dentition, patients claimed functional and esthetic problems. Case description: This case report presents a 43 years-old senior female patient with a severe dental wear. Clinical examination revealed a worn dentition, a conserved vertical dimension and functional and esthetic problems, with a healthy periodontium. An adequate increase of the vertical dimension of occlusion was necessary to harmonize dentofacial esthetics and to provide an adequate space for the restorative material. A full-mouth conservative prosthetic rehabilitation was then conducted. Tabletops were bonded in the posterior region to restore the VDO, ceramic veneers and palatal indirect resin to reestablish the maxillary anterior contact and guidance. Discussion: Rehabilitation of worn dentition still remains a challenging situation for practitioners. In fact, because of its multifactorial etiology, tooth wear can manifest in many ways, and therefore, it can be difficult to diagnose and to manage. Traditionally, a full-mouth rehabilitation based on full-crown coverage has been the recommended treatment for patients with tooth wear. Nowadays, the improvement of adhesive techniques leads to a more conservative approach for such situation. Conclusion: The innovative approach to restore worn dentition using an adhesive technique should be preferred to achieve maximum preservation of the tooth structure and the most predictable esthetic and functional outcome.