Hemmings KW, Darbar UR, Vaughan S. Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months. J Prosthet Dent. 2000; 83:287-293 https://doi.org/10.1016/s0022-3913(00)70130-2
Edelhoff D, Sorensen JA. Tooth structure removal associated with various preparation designs for anterior teeth. J Prosthet Dent. 2002; 87:503-509 https://doi.org/10.1067/mpr.2002.124094
Burke FJ, Lucarotti PS. Ten-year outcome of crowns placed within the General Dental Services in England and Wales. J Dent. 2009; 37:12-24 https://doi.org/10.1016/j.jdent.2008.03.017
Buonocore MG. A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces. J Dent Res. 1955; 34:849-853 https://doi.org/10.1177/00220345550340060801
What is the limit for composite restorations? James Baker Dental Update 2024 50:4, 707-709.
Authors
JamesBaker
BChD (Hons) MSc Con Dent (Dist), MFDSRC(Eng)
Specialist in fixed and removable prosthodontics, past President of the British Society for Restorative Dentistry, Honorary Associate Professor, Peninsula Dental School, University of Plymouth, Visiting Specialist and Honorary Senior Clinical Lecturer, Eastman Dental Institute, University College London
Extensive tooth tissue loss due to caries, trauma or tooth-surface loss has traditionally been treated with crowns. However, this results in further depletion of the remaining structural tooth tissue, sometimes requiring use of the root canal space for post and core restorations to retain the crown. This paper explores the use of occlusal-coverage direct composite restorations as a conservative alternative to destructive conventional indirect restorations. In combination with the use of short-fibre reinforced composite (SFRC) the author suggests that it is possible and desirable to restore extensively damaged teeth that would otherwise require a post-crown or possibly even extraction.
Article
Full disclosure, I am a prosthodontist, which means I have been trained in, and continue to train others in, the dark art of tooth preparation. But I have a confession. I believe tooth preparation to be a fundamentally bad thing. Just as GV Black's ‘Extension for Prevention’ philosophy is now rightly viewed with abject horror from our enlightened modern perspective, I believe that wilfully removing one of nature's most robust materials will be viewed with utter incredulity by generations of dentists to come. Does this mean I don't ‘do crowns’? Of course I do, but only in very specific situations: treatment of cracked tooth syndrome; replacement of failed existing crowns; and, very occasionally, as abutments for fixed or removable partial dentures. In all other situations, I believe that there are much more sensible ways of achieving our goals, whether to improve shade, shape, tooth position, occlusal function or protection of the remaining tooth structure.
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