International Journal of Dentistry

Review Article

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