Update on the 'index technique' in worn dentition: a no-prep restorative approach with a digital workflow

Following the guidelines of the 'index technique' that were published in this journal in 2015, this article presents the 'digital index technique,' an updated no-prep restorative approach to the management of worn dentition. Patients with minimal, moderate, and severe hard tissue wear can be treated based on the application of minimally invasive or noninvasive adhesive composite restorations on posterior and anterior worn dentition. The technique allows for a purely additive treatment without sacrificing healthy hard tooth tissue. It follows the principles of biodentistry (maximum conservation of healthy tissue), and the reinforcing of residual dental structure. Depending on the severity of the enamel and dentin wear, the number of caries, and the size of the existing restorations, different treatment options can be applied to each tooth: direct and indirect partial restorations or full crowns. It is essential to diagnose and treat tooth surface loss in order to properly restore biomechanics, function, and esthetics by means of adhesive restorations. This article proposes that the update of the index technique through the digital workflow is a fast and conservative approach for the planning and management of a full-mouth adhesive restoration in all cases of light, moderate, and severe worn dentition. The technique is based on a 'copy-and-paste' guided approach, stamping composite resin directly onto the tooth surface by means of a transparent index created from a full-mouth digital restorative wax-up, following an initially planned increase in occlusal vertical dimension (OVD) through an esthetic and functional analysis.