Conservative, Functional, and Esthetic Rehabilitation of Severe Palatal Erosion (Class IV) Using Modified Dahl...

This article demonstrates the clinical application of biomechanical and occlusal principles to conservatively provide optimal clinical outcomes in restoring an eroded anterior dentition. The authors manage a challenging case involving limited palatal clearance (ie, deep bite) coupled with palatal erosion and wear by combining the centric relation (CR) and Dahl principles to create anterior interocclusal space to reduce the need for more invasive palatal reduction. The combined use of adhesive restorations-resin composites on the palatal surface and indirect porcelain veneers on the facial/incisal surfaces-through enamel and dentin bonding helped optimize esthetic and functional/biomechanical aspects. This ultraconservative approach enabled the desired esthetic and biomechanical outcomes to be achieved through the treatment of localized anterior tooth erosion and wear. In short, when treating eroded maxillary anterior teeth with deep bite, adequate restorative space should first be created by conjoining CR and Dahl principles before using adhesive dentistry to restore with bonded composites and porcelain veneers.