Esthetic rehabilitation of tooth wear caused by nocturnal bruxism and erosion
Abstract
Introduction: In the case of a young female patient with high esthetic demands, the complete oral rehabilitation of tooth
wear caused by bruxism and acid erosion is a great chal lenge. If the tooth wear affects only the anterior teeth and the
premolars, the small interocclusal space does not provide adequate space to restore the original height of the anterior
teeth, so the vertical dimension of the occlusion also need to be restored.
Aim: Full mouth esthetic rehabilitation with increasing occlusal vertical dimension (OVD) for a patient with worn front
and premolar teeth caused by nocturnal bruxism and acidic erosion.
Methods: 40 years old woman presented, whose main concern was having esthetically unpleasant cuboid shaped
worn front teeth. First digital smile design was applied (3Shape TRIOS Smile Design), followed by gothic arch tracing
and face bow registration. The OVD was increased with 3.0 mm and diagnostic wax-up (upper front- and premolar teeth;
lower front-, premolar- and molar teeth) was made on casts mounted on articulator programmed to individual patient parameters.
A motivational mock-up was made to show the patient the expected outcome and according to this silicone
keys were made for minimal invasive preparation. During optical impression taking (TRIOS 3, 3Shape) the bite was registered
with the help of chairside temporaries. PMMA temporaries were milled.
Results: After 2 months of wearing, the functional PMMA temporaries were scanned and overlapped on virtual model
of prepared teeth using gingival, dental reference points (3Shape Dental System). Monolithic final restorations (crowns,
overlays, veneers) were milled (IPS e.max CAD, Ivoclar Vivadent) and cemented in absolute isolation using clear luting
cement.
Conclusions: To reach the satisfied esthetics in the front region a careful treatment planning was made, that includes
the analysis of the face and teeth, also creating conventional wax up and mock-up. The vertical dimension was increased
in temporary phase, then with copying functional temporaries a digital workflow was used for a predictable final result.
References
ABDUO J, LYONS K: Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J. 2012;57(1):2-10. https://doi.org/10.1111/j.1834-7819.2011.01640.x
BARTLETT D, PHILLIPS K, SMITH B: A difference in perspective--the North American and European interpretations of tooth wear. Int J Prosthodont 1999;12:401-8.
BHAGAT A, BARABDE AS, THAKARE A, OSWAL MM: Indigenous digital intraoral Gothic arch tracer. J Indian Prosthodont Soc. 2019;19(2):180-183. https://doi.org/10.4103/jips.jips_157_18
BHUVANESWARAN M: Principles of smile design. J Conserv Dent. 2010;13(4):225-232. https://doi.org/10.4103/0972-0707.73387
BRIGNARDELLO-PETERSEN R: Insufficient evidence about sleep bruxism being a risk factor for ceramic restoration failure. J Am Dent Assoc. 2018 Jan;149(1):e34. https://doi.org/10.1016/j.adaj.2017.10.015
CADDEN SW: Orofacial pain. Guidelines for assessment, diagnosis, and management, 4th edition (2008), European Journal of Orthodontics, 2009 April; 31(2):216-217. https://doi.org/10.1093/ejo/cjp007
CHAIYABUTR Y, KOIS JC, LEBEAU D, NUNOKAWA G: Effect of abutment tooth color, cement color, and ceramic thickness on the resulting optical color of a CAD/CAM glass-ceramic lithium disilicate reinforced crown. J Prosthet Dent. 2011;105:83-90 https://doi.org/10.1016/S0022-3913(11)60004-8
CHUN K, CHOI H, LEE J: Comparison of mechanical property and role between enamel and dentin in the human teeth. J Dent Biomech. 2014;5:1758736014520809. https://doi.org/10.1177/1758736014520809
COACHMAN C, BOHNER L, JREIGE CS, SESMA N, CALAMITA M: Interdisciplinary guided dentistry, digital quality control, and the "copy-paste" concepts. J Esthet Restor Dent. 2021 Oct;33(7):982-991. https://doi.org/10.1111/jerd.12736
COACHMAN C, CALAMITA MA: Virtual esthetic smile design. Journal of Cosmetic Dentistry. 2014;29(4):102-116.
COACHMAN C, PARAVINA R.D: Digitally Enhanced Esthetic Dentistry-From Treatment Planning to Quality Control. J. Esthet. Restor. Dent. 2016;28(1): S3-S4. https://doi.org/10.1111/jerd.12205
DIETSCHI D, ARGENTE A: A comprehensive and conservative approach for the restoration of abrasion and erosion. Part I: concepts and clinical rationale for early intervention using adhesive techniques. Eur J Esthet Dent. 2011 Spring;6(1):20-33.
FABBRI G, ZARONE F, DELLIFICORELLI G, CANNISTRARO G, DE LORENZI M, MOSCA A et al.: Clinical evaluation of 860 anterior and posterior lithium disilicate restorations: retrospective study with a mean follow-up of 3 years and a maximum observational period of 6 years Int J Periodontics Restorative Dent, 2014 Mar-Apr;34(2):165-77. https://doi.org/10.11607/prd.1769
GODOY DE OLIVEIRA PT, SOMACAL DC, JÚNIOR LHB, SPOHR AM: Aesthetic Rehabilitation in Teeth with Wear from Bruxism and Acid Erosion. Open Dent J. 2018 Jul 31;12:486-493. https://doi.org/10.2174/1874210601812010486
GRÜTTER L, VAILATI F: Full-mouth adhesive rehabilitation in case of severe dental erosion, a minimally invasive approach following the 3-step technique. Eur J Esthet Dent. 2013. Autumn;8(3):358-75.
GUESS P.C., ZAVANELLI R.A., SILVA N.R., .BONFANTE E.A, .COELHO P.G, THOMPSON V.P: Monolithic CAD/CAM lithium disilicate versus veneered Y-TZP crowns: comparison of failure modes and reliability after fatigue Int J Prosthodont, 2010 Sep-Oct;23(5):434-42.
GURREA J, BRUGUERA A: Wax-up and mock-up. A guide for anterior periodontal and restorative treatments. Int J Esthet Dent. 2014 Summer;9(2):146-62.
HERMANN P, SZENTPÉTERY A: Gnatológia Szemmelweis Kiadó,Budapest, 2018; 41-65. 148-150. 235-245. 261-277.
https://ivodent.hu/__docs/501_ed64f15523fd974f7e58a5ba63788430.pdf (2022.01.03)
JAEGGI T, GRÜNINGER A, LUSSI A: Restorative therapy of erosion. Monogr Oral Sci. 2006;20:200-214. https://doi.org/10.1159/000093364
JENNES ME, MEHRHOF J, STRIETZEL FP, SCHWENDICKE F, HERBST S, SPIES B: Digital treatment planning and prosthetic rehabilitation of a patient suffering from generalized tooth wear. Dtsch Zahnärztl Z Int. 2020;2:73-81.
KLINK A, HUETTIG F: The challenge of erosion and minimally invasive rehabilitation of dentitions with BEWE grade 4. Quintessence Int. 2016;47(5):365-72. DOI: 10.3290/j.qi.a35262
MAGNE P, PARANHOS MP, SCHLICHTING LH: Influence of material selection on the risk of inlay fracture during pre-cementation functional occlusal tapping. Dent Mater. 2011 Feb;27(2):109-13. https://doi.org/10.1016/j.dental.2010.09.002
MCLAREN EA, GOLDSTEIN RE: The Photoshop Smile Design Technique. Compend Contin Educ Dent. 2018 May;39(5):e17-e20
MUTS EJ, VAN PELT H, EDELHOFF D, KREJCI I, CUNE M: Tooth wear: a systematic review of treatment options. J Prosthet Dent. 2014 Oct;112(4):752-9. https://doi.org/10.1016/j.prosdent.2014.01.018
SCHULTHEIS S, STRUB JR, GERDS TA, GUESS PC: Monolithic and bi-layer CAD/CAM lithium-disilicate versus metal-ceramic fixed dental prostheses: comparison of fracture loads and failure modes after fatigue. Clin Oral Investig. 2013 Jun;17(5):1407-13. https://doi.org/10.1007/s00784-012-0830-1
SMITH BCN, ROBB ND: The prevalence of tooth wear in 1007 dental patients. J Oral Rehabil 1996;23:232-239. https://doi.org/10.1111/j.1365-2842.1996.tb00846.x
STANLEY M, PAZ AG, MIGUEL I, COACHMAN C: Fully digital workflow, integrating dental scan, smile design and CAD-CAM: case report. BMC Oral Health. 2018;18:134. https://doi.org/10.1186/s12903-018-0597-0
STRAUSZ T, AHLBERG J, LOBBEZOO F, RESTREPO CC, HUBLIN C, AHLBERG K et al.: Awareness of tooth grinding and clenching from adolescence to young adulthood: a nine-year follow-up. J Oral Rehabil. 2010 Jul;37(7):497-500. https://doi.org/10.1111/j.1365-2842.2010.02071.x
VICHI A, FERRARI M, DAVIDSON CL: Influence of ceramic and cement thickness on the masking of various types of opaque posts. J Prosthet Dent. 2000;83:412-417. https://doi.org/10.1016/S0022-3913(00)70035-7
Copyright (c) 2022 Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
.png)
1.png)
