Conservative Management Of         Tooth Surface Loss –        The Unconventional WayExtensive tooth surface loss has been...
Pre-operativeSlide No. 2   Dr. Abhijit Lele Poster No. 27
Pre operative                                             •Severe wear on Buccal surfaces of                              ...
Diagnosis and Treatment plan•   The cause of TSL was not entirely clear.    Gastric reflux combined with wrong brushing   ...
Post-operative Direct Composite           Protrusive Contacts         Post-op     Build-upsPosterior Disclusion           ...
Conclusion                                    Management of TSL with direct                                    composite r...
Conclusion                                    Management of TSL with direct                                    composite r...
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Dr. Abhijit Lele

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IIDC 2013

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Dr. Abhijit Lele

  1. 1. Conservative Management Of Tooth Surface Loss – The Unconventional WayExtensive tooth surface loss has been traditionally managedby extensive indirect restorations in the form of crowns oronlays. These procedures may not be deemed ‘conservative’in the true sense of the word.Due to improved composite materials and bondingtechniques a possibility to manage such situations withdirect restorations has emerged. Slide No. 1 Dr. Abhijit Lele Poster No. 27
  2. 2. Pre-operativeSlide No. 2 Dr. Abhijit Lele Poster No. 27
  3. 3. Pre operative •Severe wear on Buccal surfaces of Right side posteriors. Almost negligible wear on left side posteriors Restoring the left side posteriors was uncalled for since there was negligible wear on those teeth. Therefore it was decided to use the ‘DAHL’S Concept’ where in we planned to restore the anteriors and the right side posteriors and leave the left side posteriors out of occlusion. With time, they will supra-erupt and will start meeting.Slide No. 3 Dr. Abhijit Lele Poster No:27
  4. 4. Diagnosis and Treatment plan• The cause of TSL was not entirely clear. Gastric reflux combined with wrong brushing pattern were suspected.• Treatment plan• 1. Control aetiology• 2. Diagnostic casts with occlusal records in RCP (CR)• 3. Diagnostic wax-up• 4. Prepare silicone indices on the wax-up• 5. Build up teeth with direct composites using the indices as matrices for developing the desired anatomy• 6. All the anteriors and right side posteriors to be built up in composite. The left side posteriors to be allowed to supra-erupt.• 7. Provision of Hard Acrylic splint for protection of restorations Slide No. 4 Dr. Abhijit Lele Poster No. 27
  5. 5. Post-operative Direct Composite Protrusive Contacts Post-op Build-upsPosterior Disclusion Post-op Centric ContactsIn Lateral excursionSlide No. 5 Dr. Abhijit Lele Poster No. 27
  6. 6. Conclusion Management of TSL with direct composite restorations offers following advantages- •Ultra-conservative •Economical •Less stressful •Quicker Quicke Drawbacks- •Needs complex clinical skills •Long periods of intra-operative time •Life of restorations may be shorter than indirect restorations •Fear of getting ridiculed by peersSlide No. 6 Dr. Abhijit Lele Poster No. 27
  7. 7. Conclusion Management of TSL with direct composite restorations offers following advantages- •Ultra-conservative •Economical •Less stressful •Quicker Quicke Drawbacks- •Needs complex clinical skills •Long periods of intra-operative time •Life of restorations may be shorter than indirect restorations •Fear of getting ridiculed by peersSlide No. 6 Dr. Abhijit Lele Poster No. 27

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