New dental materials to restore worn teeth – Function and esthetics
When a patient has worn dentition, the treatment is a rehabilitation with the aim of recreating and restoring the lost tooth structure with a tooth-like material. In the last decade, excellent innovative materials of different kinds, such as ceramic reinforced composites and resin infiltrated ceramics, have become available for our restorations to improve everyday.
In this article a case of worn dentition is presented with its workflow and materials explained.
This young man complained about hypersensitivity upon chewing, especially in the posterior area; under examination he showed tooth erosion with alteration of smile line and tooth axis, and shortened teeth.
– the upper arch shows a shortened anterior group and a flat, crooked smile line, so only the 8 anterior teeth will be included in the treatment planning
– the lower arch eroded molars were the most sensitive area, while the 6 lower anteriors had a good structure, so only posterior teeth were included in the treatment
Functional veneers (palatal and occlusal) were fabricated with a new generation of composite blocks.
Buccal veneers were made of lithium disilicate (emax LT).
– millability of the material to reach 0,5 mm
– wear behavior of the material very enamel-like, which is essential in that case because of the nature of the antagonist and the masticatory parafunction of the patient.
You can note the mimicry of the material.
Many smart and innovative products have appeared on the market the last ten years, especially with regards to CAD CAM workflow. Of course it is of utmost importance to get a deep understanding of the features of these materials, in terms of type of material, physical properties, thickness limits. Then the dentist and the technician must build a harmonious workflow and thoroughly discuss clinical and technical parameters. Last but not least, mechanical conditions, i.e. the nature of the antagonist, and chemical conditions, i.e. acidic environment, must be analyzed to better predict the long term prognosis of the rehabilitation.
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