Restoration of Worn Teeth with Ceramic Veneers & Onlays – Kathrin’s Story

Tooth wear – Restorative dentistry

How to plan and create a minimally invasive ceramic veneer and onlay preparation for worn teeth.

At her first visit, a complete anamnesis, a meticulous oral examination, a radiographic evaluation, and a functional analysis of the temporomandibular joints were made. The evaluation revealed the presence of different forms of tooth wear. The patient presented clinical signs of a combination of erosion, abrasion, and attrition (suspected bruxism). Information obtained from the anamnesis revealed that the patient was experiencing a stressful period and consuming excessive energy drinks. Study models, an arbitrary face-bow record, registration in centric relation, intra and extraoral photographs, and a video recording were also obtained to complete the patient’s dataset. 

All the collected data were used to create a DWU to determine the necessity of increasing the patient’s VDO in order to obtain adequate space for the restorative treatment. Especially for restoring proper anterior canine guidance, the VDO was minimally increased by lifting the incisal pin of the articulator by 2.5 mm. The photographic documentation and analysis provided basic information about the esthetic appearance of the patient.

Mock-ups were made to refine the planned vertical dimension of occlusion in a dynamic state using the speech method, whereby any occlusal contact is detected during speech. A mock-up try-in was performed several times to capture the patient type and energy. With the complete restorative team discussing and noting all necessary corrections, including video and photographic analysis, adjustments of function and esthetics were made.

Treatment Team: Dentist: Dr. Reza Saeidi Pour, MDT: Otto Prandtner, Prof. Daniel Edelhoff

Restoration of worn teeth - OccluShaper

Preparation tutorial with Prof. Edelhoff describes the principles of minimally invasive treatment using occlusal onlays for the reconstruction of severely worn occlusal surfaces.

There is increasing evidence of risks associated with dental hard-tissue damage because of erosion/biocorrosion, attrition, and abrasion. The defect morphology of these wear-related lesions is different from that of caries lesions; occlusal surfaces are more often affected in the posterior region. Against this background, restorative treatment concepts have become significantly more differentiated in recent decades. Predominantly subtractive concepts to provide mechanical retention for the restoration using traditional cements are now replaced by less invasive, primarily defect-oriented procedures wherever feasible. In the case of pronounced dental hard-tissue loss, additive approaches also allow restorations that restore function. In addition, there are modifications of traditional procedures, such as defining the treatment goal in the lead-up to the treatment itself with the aid of a diagnostic wax-up. The wax-up provides orientation for the subsequent tooth preparation and allows a particularly economical approach to the removal of healthy dental hard tissue. Furthermore, the introduction of new preparation designs has contributed significantly to the preservation of dental hard tissue on the teeth to be restored.

Indications for the preparation of occlusal onlays:
• therapy of carious teeth
• treatment of premolars and molars damaged by bruxism and/or biocorrosion
• to restore the occlusion
read more .. https://rezottoproduction.com/wp-content/uploads/2018/12/Onlay-Kometdental_pdf.pdf

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Restoration of worn teeth - Ceramic Veneer

Step-by-Step preparation of ceramic veneers for the restoration of worn teeth.

Ceramic veneers have developed into a serious treatment alternative  to the classic far more invasive restorative approaches.

Minimally invasive preparations, such as those for veneers, place higher demands on practitioner’s skills than far more invasive full-crown preparations. On the one hand, the preservation of tooth enamel under the veneer is an essential factor that determines the success of the treatment. On the other hand, a more invasive preparation for the veneer offers the dental technician greater freedom of design.

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