BSRD - Toothwear Guidelines

Question 1

Indications for fixed management of toothwear?

Answer 1

Generalised or localised toothwear in pts with associated
- pain / discomfort
- aesthetic concern
- functional disturbance
- compromised structural integrity of teeth
- alveolar compensation with resulting lack of interocclusal space for restoration

Question 2

Contraindications for fixed management of toothwear?

Answer 2

• Worn teeth compromising periodontal disease
• extensive caries
• unrestorable teeth - DPI / vertical root fractures, crestal bone caries, failed endo
• soft tissue defects compromising aesthetics
• time and cost not applicable to pt
• extensive edentulous spans or insufficient posterior support and implants not considered

Question 3

Advantages of an occlusal splint in toothwear?

Answer 3

Protect teeth from further wear

Disrupt habitual path of closure into ICP

Protection of new restorations in bruxists while tx is occurring

Management of TMD

Question 4

How can inter-occlusal space be created for increasing OVD in toothwear spaces?

Answer 4

• localised minor axial tooth movement - DAHL approach
• crown lengthening surgery
• increase OVD with a denture in cases with no posterior support
• Tooth reduction - opposing or tooth itself
• orthodontic movement