Diagnosis of tooth wear – from erosion to overload

Among all the factors responsible for pathologic tooth wear, erosion and mechanical overload are the most important. Clinicians should be capable of making a correct differential diagnosis, especially in the case of damage to the incisal edges. The present article provides pragmatic guidelines to evaluate the detrimental role of erosion and overload on the anterior teeth in order to better discuss with patients when to start the therapy and what to expect about the longevity of the restorations delivered. Anterior functional conflicts and the evolution of the affected dentition in the case of excessive masticatory muscle activation are also illustrated. Keywords: anterior functional conflicts, bruxism, erosion, explosive evolution, gnathology, implosive evolution, overload, prosthodontics, restorative dentistry, tooth wear