Three-year evaluation of posterior vertical bite reconstruction using direct resin composite--a case series.

The use of resin composite materials to restore the complete occlusion of worn teeth is controversial and data are scarce. In this case series, the authors report on seven cases of progressive mixed erosive/abrasive worn dentition (85 posterior teeth) that have been reconstructed with direct resin composite restorations. In all patients, either one or both tooth arches was completely restored using direct resin composite restorations. All patients were treated with standardized materials and protocols. In five patients, a wax-up-based template was used to avoid freehand build-up techniques and to ensure optimal anatomy and function. All patients were re-assessed after a mean service time of three years (mean 35 +/- 5 months) using USPHS criteria. Subjective patient satisfaction was measured using visual analogue scales (VAS). The overall quality of the restorations was good, with predominantly determined "Alpha"-scores. Only the marginal quality showed small deteriorations, with "Beta" scores of 37% and 45% for marginal discoloration and integrity, respectively. In general, the composite showed signs of wear facets that resulted in 46% "Beta" scores within the anatomy scores. Small restoration fractures were only seen in two restorations, which were reparable. Two teeth were excluded from the evaluation, as they have been previously repaired due to fracture after biting on a nut. The results were very favorable, and the patients were satisfied with this non-invasive and economic treatment option, which still has the characteristic of a medium-term rehabilitation. The outcomes were comparable to other direct composite restorations successfully applied in adhesive dentistry.

[Technique of direct vertical bite reconstruction with composite and a splint as template]. / Technik der direkten Bisshöhenrekonstruktion mit Komposit und einer Schiene als Formhilfe.

Excessive loss of dental hard tissues caused by mechanical, chemical or traumatic influences--or a combination of these factors--poses difficulties for subsequent prosthetic tooth restorations. Traditionally reconstructive treatment to restore affected teeth has been provided using rather invasive methods like porcelain-fused-to-metal crowns or ceramic overlays. For patients with a tooth substance loss caused by an acidic diet, where a payment of the costs by the social insurance cannot be expected, a less expensive treatment modality would be of interest. The presented case report describes an alternative treatment modality of vertical tooth substance loss by using direct adhesive composite restorations. To establish a simple and controlled build-up, a mini-plast splint based on an ideal wax-up was used.