Tooth wear Continued »
result of slow hard tissue loss and the periodontal ligament mechano-receptors program- ming the neuro-musculature around the mandible to move the teeth forward more to an edge to edge relationship in order to improve function. However, once one opens
the anterior vertical dimension with direct resin, or other resto- rations, the lower teeth usually move back quite soon in to class one as the condyles move upwards and backwards quite quickly, and then other tooth movements occur to establish a new intercuspal position over time5,6,7. Localised increase in anterior vertical dimension is sometimes described as being a ‘Dahl principle’6, but adaptation by dentate patients to increasing vertical dimen- sion with restorations, was described by Anderson as long ago as ı9629.
In our opinion, given
the now well documented evidence for these scientifically proven minimally destructive approaches, it is very worrying for the profession at large and the patients in general to see this sort of old fashioned iatrogenic damage still being published under the guise of using articulators to optimise the subsequent crown restora- tions. This sort of destructive
preparation for crowns in wear cases was common in the ı970s8 and ı980s when that was all that was available for us to treat this sort of problem. The sort of treatment shown
in these articles pre-dated predictable adhesive dentistry, or our understanding of differential diagnosis of causes of tooth surface loss, and when treating various sorts of prob- lems without further damaging the teeth was rather less well developed than it is nowıı.
REFERENCES :
1. Burke FJ, Kelleher MGD. The ‘Daughter Test’ in elective esthetic dentistry. J Esthet Restor Dent. 2009; 21(3) : 143-6
2. Felton D, Madison S, Kanoy E et al. Long term effects of crown prepara- tions on pulp vitality. J Dent Res 1989; 681009: Abstract 1139. 3. Edelhoff D, Sorensen
JA.Tooth structure removal associated with various preparation designs for anterior teeth. J Prosthet. Dent. 2002 May;87(5):503-9.
4. Kelleher M. Porcelain pornography. Fac. Dent. J 2011; 2: 134-141 5. Poyser NJ, Briggs PF, Chana HS, et al. The evaluation of direct composite restorations for the worn mandibular anterior dentition – clinical performance and patient satisfaction. J Oral Rehabil. 2007 May;34(5):361-76.
6. Gulamali AB, Hemmings KW,Tredwin CJ, Petrie A. Survival analysis of composite Dahl restorations provided to manage localised anterior tooth wear (10-year follow-up). Brit. Dent. J. 2011 Aug 26;211(4):E9. Doi: 10.1038/
sj.bdj.2011.683.
7. Al-Khayatt AS, Ray-Chaudhuri A, Poyser et al. J Oral Rehab. 2013 May;40(5):389-401. Doi: 10.1111/joor.12042. Epub 2013 Mar 15. Direct composite restorations for the worn mandibular anterior dentition: a seven-year follow-up of a prospective randomised controlled split-mouth clinical trial.
8. Shillingburg HT, Hobo S, Whitsett. Fundamentals of Fixed Prosthodon- tics Quintessence Publishing Co. 1978, pages 67, 111. 9. Anderson DJ Tooth movement in experimental malocclusion Archs. Oral Biol 1962. p.7-16.
10. Burke FJT, Kelleher MGD, Wilson N, Bishop KB (2011). Introducing the concept of pragmatic esthetics with special reference to the treatment of tooth wear
J.Esthet
.Restor.Dent.23 (5) 1-17.
11. Kelleher MGD, Bomfin D, Austin RS (2012). Biologically-based restora- tive management of tooth wear. Int. J. Dent. ID 742509.
If you would like to comment on any of the issues raised in this article, email
bruce@connectcommunications.co.uk
Scottish Dental magazine 51
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