Abstract :
[en] Objectives: To introduce a minimally invasive and simple ortho-pros approach for
localized tooth wear treatment.
Clinical considerations: Four patients with localized anterior and/or posterior tooth
wear were treated. Occlusal analyses were performed, and localized wax-up or digital
setup were designed based on estimated tissue loss. No-prep anterior and posterior
partial-coverage polymer-infiltrated ceramic network (PICN, Vita Enamic) restorations (eg, palatal and occlusal veneers) were computer-aided designed and manufactured (CAD-CAM), tried in, and bonded in supraocclusion, creating a posterior
open bite. Then, brief partial (three patients) or global (one patient, for anterior teeth
alignment request) orthodontic treatment was performed to extrude the posterior
teeth and re-establish posterior occlusal contacts. The orthodontic treatment duration was ~2 months for extrusion. Direct composites were performed to mask the
labial finish line of palatal veneers. Clinical results were successful after a follow-up
of 15, 21, 23, and 47 months, with 100% success rate of PICN anterior restorations
and some minor chippings of borders of thin (0.2 mm) posterior occlusal veneers.
Patient-reported outcomes were positive.
Conclusion: Orthodontic-assisted one step-no prep technique is an advantageous
and straightforward evolution of the Dahl concept. PICNs exhibit several advantages
in this interdisciplinary approach.
Clinical significance: New hybrid-ceramic CAD-CAM materials and a collaborative
interdisciplinary approach support the evolution of the Dahl concept for conservative
treatment of worn dentitions. The orthodontic-assisted one step-no prep technique
is predictable, efficient, and well tolerated by patients and conserves tooth structure.
Scopus citations®
without self-citations
7
