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Article: Volume 43 Number 2 Page 106 - March 2016

  Dent Update 2016; 43: 106-112  Read article

Restorative dentistry:  A Guided, Conservative Approach for the Management of Localized Mandibular Anterior Tooth Wear

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Abstract: The successful management of the worn mandibular anterior dentition may present an awkward challenge to the dental operator. The purpose of this article is to describe a case report illustrating the use of a guided, three-dimensional protocol for the ultra-conservative and predictable restoration of the worn lower anterior dentition using direct resin composite. This technique utilizes information based on established biomechanical and occlusal principles to fabricate a diagnostic wax-up, which is duplicated in dental stone. This is used to prepare a vacuum-formed modified stent, assisting the clinician to place directly bonded resin composite restorations to restore the worn lower anterior dentition. The technique, described in 2012 and referred to as ‘injection moulding’ has the potential to offer optimal form, function and an aesthetic outcome in an efficient manner.

Clinical relevance: This article aims to describe an alternative technique to simplify the processes involved with restoration of worn lower anterior teeth.

Author notes: Shamir B Mehta, BDS, BSc, MClinDent(Prosth) MFGDP (UK), Senior Clinical Teacher, Deputy Programme Director MSc Aesthetic Dentistry, Selar Francis, DDS FAGD, Postgraduate Student King’s College Dental Institute and Subir Banerji, BDS, MClinDent(Prosth) MFGDP(UK), Programme Director MSc Aesthetic Dentistry, Senior Clinical Teacher, Department of Conservative and MI Dentistry, Unit of Distance Learning, Floor 18, Tower Wing, Guy’s Campus, St Thomas’s Street, London SE1 9RT, UK.

Objective: To increase awareness of the additional challenges involved with the restoration of worn lower anterior teeth with resin composite and understand alternative treatment techniques from those traditionally applied which may facilitate material placement and finishing.

ADG