Abstract
This clinical report reviews and assesses a 5-year observation of a minimal intervention approach (using the Dahl concept) for the management of severe anterior tooth wear in a 44-year-old male.
References
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A 5-year observation of the Dahl principle to manage localized anterior tooth wear
From Volume 49, Issue 9, October 2022 | Pages 732-736
Article
Tooth wear is a physiological process that occurs throughout life and its prevalence in the community increases with age.1 However, when the rate of wear exceeds the sustainability of the teeth, it may be considered pathological, which causes concern for the patient.2 The aetiology of tooth wear is multifactorial and the clinical presentations are varied.3 Management of tooth wear may vary from the conservative ‘watch and review’, to extensive prosthodontic oral rehabilitations. The decision to intervene, and the extent, is determined by the impact the problem has on the individual's aesthetic concerns, functional capacity, as well as the cost, both biological and financial.
Tooth wear often leads to a reduced occlusal vertical dimension (OVD) and the potential loss of ‘interocclusal restorative space’ (IRS). The IRS is the space required to restore proper occlusal form and anatomy to a worn dentition.4 To re-establish the IRS, the OVD is often raised. This is a critical factor to consider in the management of tooth wear. Often, a considerable removal of sound tooth structure would be required for restorative purposes with multiple crowns or occlusal veneers, increasing the biological costs to the patient. One alternative is to remove minimal sound tooth structure and follow a conservative approach, as introduced by Dahl and colleagues.5
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