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Restoration of severe localized tooth wear with zirconia-reinforced lithium silicate: A case report

From Volume 47, Issue 11, December 2020 | Pages 907-911

Authors

Anurag Srinivas

DCT 2 in Restorative Dentistry, Birmingham Dental Hospital

Articles by Anurag Srinivas

Email Anurag Srinivas

Gareth Brock

Specialist Registrar in Restorative Dentistry, Liverpool Dental Hospital, The University of Queensland, Australia

Articles by Gareth Brock

Abstract

Tooth wear is becoming an increasingly common cause for referral to restorative dentistry departments in the UK. Often, these cases are treated with resin-bonded composite direct restorations in the first instance. This article presents a case of 23-year-old patient who was treated using zirconia-reinforced lithium disilicate restorations.

CPD/Clinical Relevance: In certain cases, indirect restorations can be considered a first-line treatment, based on the presentation and patient factors. Each case should be evaluated on its own merits and careful consideration should be given to the evidence base and its relevance.

Article

Non-carious tooth wear (TW) is a common reason for referral to restorative dentistry departments in UK dental hospitals. Following implementation of appropriate preventive strategies, localized anterior TW cases are commonly treated with direct composite resin restorations in the first instance.1 We present a case of a 23-year-old woman who presented with severe localized TW of the maxillary anterior sextant, treated with an alternative management strategy.

Patient SP is a 23-year-old female who was referred by her GDP regarding severe TW. SP's main concerns were increasing hypersensitivity of her maxillary anterior teeth, and poor aesthetics.

The patient had suffered from an illness in her late teens leading to daily vomiting for almost 2 years. Gastroenterological investigation indicated that certain foods were causing the vomiting. Appropriate preventive strategies were implemented and the patient's vomiting is now rare.

On presentation, teeth in the maxillary anterior sextant were severely worn, through to dentine, labially and palatally. The wear lesions appeared to be erosive in nature with a pseudo-chamfer ring of enamel present, cervically, around the teeth. Mild TW consistent with erosive ‘cupping’ lesions were noted in the premolar regions in both arches. The TW could be considered pathological as the amount of wear caused concern for the patient and the wear progressed quickly in comparison to SP's age.2 Periodontally, there were only localized areas of bleeding on probing in two of the sextants. There was no pathological pocketing and no evidence of active periodontal disease. Her basic periodontal examination (BPE) scores were:

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