Three Patient Reports Illustrating the Use of Dentin Adhesives to Cement Crowns to Severely Worn Teeth

Purpose: Severely worn and broken down teeth present clinical treatment planning dilemmas. Extreme examples of worn teeth present in patients suffering from bulimia nervosa and dentinogenesis imperfecta. Bulimia nervosa typically presents early in adult life with a myriad of clinical features and a most important dental sign of eroded palatal surfaces on the maxillary teeth. Dentinogenesis imperfecta is a relatively uncommon disorder that presents with varying severity of unsupported enamel and results in teeth more susceptible to wear. Materials and Methods: Dental treatment for both conditions when wear has resulted in the complete loss of the tooth can either be directed toward restoring remaining tooth tissue or extraction and replacement with implants or dentures. This article presents the clinical management of three case histories, each with one or more severely broken down teeth, which were restored with adhesively retained crowns. Results: Treatment lasted nearly 10 years in one patient and failed after 6 years in another. The third patient was treated more recently. Conclusion: All three case histories serve as examples of using adhesive cements to retain indirect restorations as a possible prosthodontic management strategy.