Koubi Stefen, Gurel Galip, Margossian Patrice, Massihi Richard, Tassery Herve
Int J Periodontics Restorative Dent. 2018 Mar/Apr;38(2):189-197. doi: 10.11607/prd.3186.
Treatment of tooth wear has increased over the last two decades. However, the treatments involved have not been satisfactory to most patients, nor have they achieved the expected goal on some worn teeth. New approaches have emerged to reconstruct full arches in a minimally invasive way that take advantage of developments in the field of adhesive dentistry. These new concepts constitute a revolution in dentistry and their application requires adapted techniques and training. The purpose of this article is to suggest a precise and reproducible method that simplifies the treatment of worn dentition. A wax-up and a mock-up are primarily used to design the esthetic outcome and then used as a guide for the preparation of anterior teeth or the occlusal surfaces of posterior teeth. This not only provides the exact new vertical dimension of occlusion but serves as a guide for precisely controlling occlusal preparation simultaneously with buccal preparation. The classical cavity design for a partial bonded restoration on posterior worn dentition is also reviewed. The authors believe that during the preparation of the occlusal surfaces of the posterior teeth surfaces, the marginal ridges must be preserved to reduce the biologic cost and mechanical stress leading to fracture. A new type of thin and reduced restoration called tabletop is presented.
在过去二十年中，牙齿磨损的治疗有所增加。然而，所涉及的治疗方法对大多数患者来说并不令人满意，在一些磨损牙齿上也未达到预期目标。利用粘结牙科领域的发展，出现了以微创方式重建全牙弓的新方法。这些新概念构成了牙科领域的一场革命，其应用需要适配的技术和培训。本文的目的是提出一种精确且可重复的方法，简化磨损牙列的治疗。初步使用蜡型和模型来设计美学效果，然后用作制备前牙或后牙咬合面的指导。这不仅提供了精确的新咬合垂直距离，还作为在颊侧制备的同时精确控制咬合制备的指导。还回顾了后牙磨损牙列部分粘结修复的经典洞型设计。作者认为，在制备后牙表面的咬合面时，必须保留边缘嵴以降低导致骨折的生物成本和机械应力。提出了一种新型的薄型和简化修复体，称为桌面型修复体。
