Dentaltown April 2018 - 31

Fig. 3

With our aging
population, people are
keeping their teeth
longer. Attrition of tooth

Fig. 4

Fig. 5

Fig. 6

should be performed, including soft and hard
tissues, oral cancer screening, periodontal
pocket measurements, and impressions for
diagnostic models. Before recommending
treatment, it is incumbent on us to try our
best to find out why the incisal edges are
worn excessively. In my experience, there
are many patients who exhibit this anterior
wear pattern without severe posterior wear
and collapsed vertical dimension.
This article will deal with caring for
a patient who had minimal chipping and
severely exposed dentin on the inciso-palatals
of his upper incisors. In this case we'll
demonstrate a technique for restoring the
physiologic contours and protecting the
exposed dentin and incisal edges of the
patient's upper incisors.
The technique will show tooth preparation and bonding and restoration with Estelite
Sigma Quick (Tokuyama Dental), a universal,
supra-nano filled composite. This material
has spherical fillers that make it easy to polish
and contribute to long-lasting retention of
surface smoothness. Its chameleon property
makes it an excellent choice for blending
with surrounding tooth structure.

Fig. 7

Background
The patient reported that he felt "ridges"
near the edge of his upper front teeth a few
years ago but didn't think much of them. He
also noticed some "small chips" on his "top
front teeth." He made no comment about
his lower front teeth, which also showed
moderate wear. After studying all the data

structure accompanied
by continuous eruption,
is a normal phenomenon,
but cratering or
cupping of incisal edges
with exposed dentin
represents excessive
wear.
we gathered through our comprehensive
examination process, it was determined that
the patient's excessive upper incisal wear was
probably due to a combination of factors.
In the years before we saw him, he
discovered he had a habit of pushing his lower
teeth forward during the day and rubbing
them against his upper front teeth in what
we know is a protrusive movement. Since his
lower incisal edges showed moderate wear,
it's probable that the excessive wear on his
uppers began prior to his feeling the ridges.
Our comprehensive examination
findings showed a flattened bite without
canine guidance and disclusion (Fig. 5). A
combination of erosion, further attrition
and parafunctional movements probably
contributed to the large troughs in his upper
incisal edges.
Treatment recommendations included
dentaltown.com \\ APRIL 2018

31



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Table of Contents for the Digital Edition of Dentaltown April 2018

Dentaltown April 2018 - Intro
Dentaltown April 2018 - Cover1
Dentaltown April 2018 - Cover2
Dentaltown April 2018 - 1
Dentaltown April 2018 - 2
Dentaltown April 2018 - 3
Dentaltown April 2018 - 4
Dentaltown April 2018 - 5
Dentaltown April 2018 - 6
Dentaltown April 2018 - 7
Dentaltown April 2018 - 8
Dentaltown April 2018 - 9
Dentaltown April 2018 - 10
Dentaltown April 2018 - 11
Dentaltown April 2018 - 12
Dentaltown April 2018 - 13
Dentaltown April 2018 - 14
Dentaltown April 2018 - 15
Dentaltown April 2018 - 16
Dentaltown April 2018 - 17
Dentaltown April 2018 - 18
Dentaltown April 2018 - 19
Dentaltown April 2018 - 20
Dentaltown April 2018 - 21
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Dentaltown April 2018 - 23
Dentaltown April 2018 - 24
Dentaltown April 2018 - 25
Dentaltown April 2018 - 26
Dentaltown April 2018 - 27
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Dentaltown April 2018 - 30
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Dentaltown April 2018 - 32
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Dentaltown April 2018 - 43
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Dentaltown April 2018 - Cover3
Dentaltown April 2018 - Cover4
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