Biologically Based Restorative Management of Tooth Wear
Figure 8
Patient showing moderate-to-severe wear treated by night guard vital bleaching followed by direct resin composite bonding. No destruction of any of the residual sound tooth tissue was involved.
(a) Presenting appearance of the worn, dark teeth
(b) Worn lower incisors mainly due to erosion, but with some attrition
(c) Class 2 div 2 incisor arrangement with crowding and erosion but with some attrition
(d) Appearance following 6 weeks of night guard vital bleaching with 10% carbamide peroxide
(e) Metal serration strips preventing etching of adjacent crowded enamel surfaces
(f) Palatal view of serration strips preventing inadvertent bonding of adjacent tooth surfaces
(g) Palatal surfaces are built up first, and labial bonding is then added
(h) Composite resin being added from the labial
(i) Conventional discs used for initial finishing
(j) Multibladed Tungsten carbide used for initial finishing interproximally
(k) Worn teeth covered by protective, expendable direct composite resin. No damage was inflicted on the already eroded teeth
(l) Result of treatment of moderate-to-severe wear treated by night guard vital bleaching followed by direct resin composite bonding. No destruction of any of the residual sound tooth tissue was involved