null / Toothwear/ Occlusion/ Restorative

In this workshop, Dr. Dietschi will cover the management of tooth surface loss cases. He will cover how to conservatively manage these cases in various situations of mild, moderate and severe toothwear. He will cover the practical tips and which materials to use in which situations.

Tooth wear represents a frequent pathology with multifactorial origins. Behavioural changes, unbalanced diet, various medical conditions and medications inducing acid regurgitation or influencing saliva composition and flow rate, trigger tooth erosion. Awake and sleep bruxism, which nowadays are widespread functional disorders, induce attrition. It then becomes increasingly important to diagnose early signs of tooth wear so that proper preventive, and if needed, interceptive-restorative measures are taken. Such disorders have biological, functional and also aesthetic consequences.

Following a comprehensive clinical evaluation, treatment objectives, such as a proper occlusal and anatomical scheme as well as a pleasing smile line, are usually set on models with only anterior teeth or full mouth waxup, depending on the severity of tissue loss. Based on the new Vertical Dimension of Occlusion (VDO) set on the articulator, combinations of direct, semi-direct and indirect restorations (using composite resins or monolithic high-strength ceramics) can help to re-establish anatomy and function. The use of adhesive and ultra-conservative techniques has proven its potential, in particular for the treatment of moderate to advanced tooth wear. A modern approach to treat tooth wear shall involve a specific and detailed treatment planning involving its aetiology, risk factors control and the biomechanical status of each tooth to be treated.

This program will review recent knowledge and clinical concepts related to various forms of early restorative interventions (using adhesive techniques) and their potential to restrict on-going tissue destruction and restore an attractive smile.

Aims and objectives:

  • To gain an overview of conservation rehabilitation of tooth surface loss via case-based discussions

Learning outcomes:

  • Identification of key factors in tooth surface loss cases that can enable conservative rehabilitation and management
  • Occlusion and functional factors identification
  • Lab or direct techniques and how to choose which option
  • Tips on management and bonding
Didier Dietschi
Specialist Prosthodontist