Biermann, Jana

Manuskripteingang: 05.08.2021, Annahme: 25.08.2021 Keywords: Reparaturrestauration, Kompositreparatur, Füllungsreparatur, Kompositrestauration

Das Bleichen verfärbter Zähne stellt eine minimalinvasive Behandlungsmethode zur Verbesserung der dentalen Ästhetik dar. Da Patienten Verfärbungen der eigenen Zähne häufig als ästhetisch störend wahrnehmen1, erfreuen sich Bleaching-Methoden weiterhin großer Popularität. Im Folgenden sollen die Indikationen für eine Bleichtherapie dargestellt sowie ein kurzer Einblick in die verschiedenen Bleaching-Techniken, aber auch die potenziellen Risiken gegeben werden.

Purpose: This questionnaire survey aimed to analyse management strategies for erosive tooth wear and to identify factors influencing dentists' decision-making. Materials and Methods: A questionnaire presenting clinical cases with erosive tooth wear on anterior and posterior teeth (BEWE scores 1 to 3) was sent electronically to German dentists (n = 13.683). Statistical analysis was performed by Wilcoxon signed-rank tests, Kruskal-Wallis-tests and Fisher's exact tests (p 0.05). Results: Only 455 dentists (3.3%, mean age: 52.3 ± 9.6) participated. Suggested therapeutic measures were statistically significantly different between BEWE 1, 2 and 3 (p 0.001) and between anterior and posterior teeth with BEWE scores 1 or 2 (p ≤0.025). Initial erosive lesions (BEWE 1) were mainly treated by information about the main causes and/or preventive measures (posterior teeth: 75.6%, anterior teeth: 64.4%), only 20.0% and 31.3% considered restorative treatment for posterior and anterior teeth, respectively. For teeth presenting score 2, a very high proportion of dentists considered restorative treatment (posterior teeth: 60.6%) additionally to prevention, especially when anterior teeth (91.0%) were affected. In case of severe erosive lesions (BEWE 3), the vast majority of dentists considered restorative treatment (posterior teeth: 98.3%, anterior teeth: 99.8%). The decision-making was mainly dependent on the lesion depth, size of affected surfaces and the presence of pain. Fluoride agents and agents containing tin chloride or tin fluoride were most frequently recommended as preventive measures. If distinct defects (BEWE 2) were treated restoratively, mainly composite restorations were performed (posterior teeth: 72.0%, anterior teeth: 90.5%). Severe defects (BEWE 3) were mostly restored with ceramic restorations (posterior teeth: 66.1%, anterior teeth: 66.6%). Conclusion: Stepwise management of erosive tooth wear was observed. Dentists' decision-making was related to severity and localisation of erosive tooth wear and to various patient-related factors (e.g. depth of lesion and size of affected surface per tooth). Keywords: Basic Erosive Wear Examination, decision-making, erosive tooth wear, questionnaire, survey