Treating Anterior Wear With Composite Veneers
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Zachary S. Sisler, DDS
Composite resin lends itself to being one of the most minimally invasive treatment options in a clinician's armamentarium. It can be utilized in a whole gamut of procedures, from routine general dentistry to high-end esthetic cases and fine-tuning occlusal relationships. Although composite can facilitate a wide array of treatment modalities, this article focuses on its use for the placement of composite resin veneers coupled with bonded incisal edges to ensure optimal occlusion.
A 50-year-old male patient presented to the practice unhappy with his smile due to the uneven edges of his maxillary anterior teeth. A thorough exam was performed, which revealed that the patient exhibited moderate wear on his maxillary and mandibular anterior teeth with minimal wear facets in the posterior region. This was deemed to be associated with a parafunctional bruxism habit related to an underlying diagnosis of sleep apnea. The patient reported that he was being successfully treated for his underlying sleep apnea condition through the use of a continuous positive airway pressure (CPAP) machine.
With treatment options presented that included both porcelain and composite veneers, the patient ultimately chose to take the composite route for teeth Nos. 5 through 12. The primary factors behind his decision were the minimally invasive nature of the treatment, the lower cost, and that the composite could be more easily repaired.
The occlusal scheme would include the creation of stable centric stops with posterior disclusion by way of anterior guidance. For this particular patient, the goal was to create smooth transitions in laterotrusive movements that would allow for less damaging forces to be applied to the teeth. These movements were established and fine-tuned through equilibration that involved the use of composite resin on the mandibular incisal edges.
About the Author
Zachary S. Sisler, DDS
Accredited Member
American Academy of Cosmetic Dentistry
Private Practice
Shippensburg, Pennsylvania