A composite approach to the management of worn maxillary first molar teeth

A lady with extrinsic acid erosion was referred to the restorative department at Bristol Dental Hospital by her General Dental Practitioner (GDP) for restoration of worn maxillary first molar teeth. These teeth were both causing symptoms of dentinal sensitivity and two attempts had been made to restore them with composite by her GDP. The restorations failed because there was insufficient space to bond the composite in place, which was due to dento-alveolar compensation of the first molars into the space created by the wear. Following relevant preventive advice, the maxillary first molar teeth were restored with 'high' direct composite resin, which allowed for adequate strength in bulk for retention while acting as fixed intrusion devices. These cured the patient's sensitivity and within four months her occlusion compensated for the composites and had re-established.