Adhesive rehabilitation of localized anterior tooth wear in combination with the Dahl concept
Case series study
Abstract
Localized anterior maxillary tooth wear caused by erosion/attrition with loss of interocclusal space needs complex management.
This observational case-series study reports eight cases with worn anterior dentition, treated with sandwich-veneers
at an increased vertical dimension of occlusion without restoration of unaffected posterior teeth.
48 palatal direct veneers were fabricated in eight patients from nanohybrid resin composite using a wax-up based
template at an increased vertical dimension. 54 labial lithium-disilicate ceramic veneers were made after the complete
re-establishment of posterior occlusion. The sandwich veneers were evaluated after a mean service time of 35.1 months
according to the USPHS criteria. Re-establishment of posterior contacts, subjective patient satisfaction and function were
also evaluated.
The overall survival of the sandwich-veneers is 100%. The success of the labial ceramic restorations was excellent. The
quality of the palatal resin composite veneers was found to be good. The marginal discoloration (70.8%), wear (45.8%),
surface roughness (20.8%) and marginal integrity (12.5%) showed small deteriorations. Firm posterior contacts re-established
within 4 weeks. Patient satisfaction was high concerning aesthetics and function. The short-term outcome of this
non-invasive sandwich-approach combined with the Dahl-concept is favorable and promising.
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