CASE REPORT


The Restoration of Severe Generalized Dental Erosive Wear using Direct Composite: A Case Report



Sara Alhammadi1, Alex Milosevic2, *
1 Department of Prosthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
2 Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE.


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Creative Commons License
© 2021 Alhammadi & Milosevic.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Former Professor and Program Director in Prosthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE; E-mail: alex.milosevic@outlook.com


Abstract

Introduction:

This case report describes a conservative restorative approach in the management of severe generalized tooth wear.

Case report:

The male, aged 57 years, was mainly concerned with the poor appearance of his teeth with short and discolored upper incisors. History revealed that he suffered from gastric reflux for 25 years, for which he was prescribed Ranitidine and was advised to self-medicate with cider vinegar. Furthermore, he divulged that he ground his teeth at night and during the day and had a high intake of carbonated cola drinks. On examination, dentine was exposed in several areas, and to a significant extent, on the incisal aspects of the lower incisors, the palatal surfaces of the upper incisors, and the occlusal surfaces of the molars. Mandibular tori were present.

The primary diagnosis was erosive tooth wear with elements of attrition and abrasion. The intervention included dietary advice and restoration with direct composite resin at an increased occlusal vertical dimension of 1.5mm on the retruded axis. The patient reported no functional problems and was pleased with the aesthetic result.

Conclusion:

Vinegar is promoted to have health benefits, especially with respect to glucose response, but the dental implications are overlooked. This paper reviews the literature on vinegar as a medicament and considers its role as a co-factor for erosion in this case. The clinical steps used to restore the eroded dentition by direct composite are described. The use of this approach is a safe, conservative and successful treatment option without recourse to complex and biologically costly conventional alternatives. The application of direct composite in tooth wear cases meets the European consensus requirements.

Keywords: Dental erosion, Multi-factorial etiology, Direct composite, Tooth wear, Molars, Incisors.