A Comprehensive and Conservative Approach for the Restoration of Abrasion and Erosion. Part II: Clinical Procedures and Case Report

This article proposes a comprehensive and conservative approach to the treatment of tooth wear, based on the application of minimally invasive composite restorations to treat both anterior and posterior decay. Three treatment options were considered, in relation to the severity of tissue loss and size of existing posterior restorations. Posterior tooth status actually will guide the clinician toward the most appropriate restorative option. In the presence of limited tissue loss and small fillings, only direct restorations are considered. With moderate tissue loss and medium size existing restorations, a mix of direct and indirect composite restorations is preferred, and with extensive tissue loss and large restorations, mainly indirect restorations will be chosen. The restoration of anterior guidance and a proper smile line are reestablished using adhesive restorations, including primarily direct composite buildups; in the presence of more severe tissue destruction, loss of facial morphology or discoloration, veneers and possibly crowns can be considered. The driving force behind the concept presented in this article is to intercept tissue destruction and restore proper tooth biomechanics, function, and esthetics using adhesive restorations which do not further invade hard tissues.