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Precision of In Vivo Quantitative Tooth Wear Measurement Using Intra-Oral Scans
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A guide to managing tooth wear: the Radboud philosophy
1Radboud University Medical Center, Dentistry, Ph. van Leydenlaan 25, Nijmegen, 6525 EX, The Netherlands.
British Dental Journal
|March 2, 2018
Summary
For severe tooth wear, conservative management is often best, even without patient complaints. Minimally invasive treatments are preferred for rehabilitation in increased vertical dimension, especially for younger patients.
Area of Science:
- Dentistry
- Restorative Dentistry
- Dental Biomaterials
Background:
- Severe tooth wear presents complex management challenges.
- The Radboud Tooth Wear Project offers a framework for patient care.
- Increased vertical dimension of occlusion (VDO) is a common rehabilitation approach.
Purpose of the Study:
- To present a conservative, pragmatic, and minimally invasive intervention concept for severe tooth wear.
- To provide guidelines and flowcharts for managing severe tooth wear and rehabilitation in increased VDO.
- To evaluate the suitability of restorative materials for long-term rehabilitation.
Main Methods:
- Development of a conservative intervention concept based on clinical experience.
- Creation of management guidelines and flowcharts for severe tooth wear.
- Review of clinical evidence for restorative materials, focusing on direct composites.
Main Results:
- Restorative treatment is not universally indicated for severe tooth wear.
- Counselling and monitoring are suitable options for asymptomatic patients.
- Minimally invasive, adhesive strategies are preferred for increased VDO rehabilitation, particularly in young patients.
- Direct composites show suitability for medium-term rehabilitation in increased VDO, with five-year follow-up data.
- Limited long-term clinical data exists for indirect restorative techniques.
Conclusions:
- A conservative, minimally invasive approach is recommended for severe tooth wear.
- Patient complaints and age are key factors in treatment decisions.
- Direct composite restorations demonstrate potential for medium-term rehabilitation in increased VDO.
- Long-term survival of restorations can be compromised by bruxism and erosion.
- Informed consent must detail treatment options and potential complications.
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