*Edina Lempel, DMD, PhD, Habil, assistant professor, Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Hungary.
Kinga Dorottya Németh, DMD, Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Pécs, Hungary.
Oper Dent. 2021 Nov 1;46(6):594-608. doi: 10.2341/20-190.
Localized anterior maxillary tooth wear caused by erosion and attrition with loss of interocclusal space is difficult to manage. This observational case-series study reports six cases with worn anterior dentition treated with labial ceramic and palatal direct resin composite veneers at an increased vertical dimension of occlusion without restoration of unaffected posterior teeth. Thirty-six palatal direct veneers were made in six patients from a nanohybrid resin composite with the help of a wax-up-based template at an increased vertical dimension. After the complete re-establishment of posterior occlusion, 40 labial lithium-disilicate ceramic veneers were fabricated with a mock-up-guided method. The sandwich veneers were evaluated according to the United States Public Health Service (USPHS) criteria after a mean service time of 22.7 months. Re-establishment of posterior contacts as well as subjective patient satisfaction and function were evaluated. The overall success of the labial ceramic veneers was excellent. The quality of the palatal resin composite restorations was found to be good with predominantly "Alpha" scores. The marginal quality (11.1% and 33.3% of integrity and discoloration, respectively) and surface roughness (16.7%) showed small deteriorations indicated by "Beta" scores. The resin composite showed, in general, signs of wear facets which resulted in "Beta" scores in 44.4% of the cases. Posterior contacts re-established firmly within 4 weeks in all cases. Patient satisfaction with esthetics and function was high. The short-term outcome of this non-invasive treatment option is favorable and promising.
由侵蚀和磨损导致的局部上前牙牙釉质磨损伴有咬合间隙丧失的情况较难处理。本观察性病例系列研究报告了 6 例上前牙磨损的病例，这些病例采用唇侧陶瓷和腭侧直接复合树脂贴面修复，在上颌增加垂直向颌间距离，而不修复未受影响的后牙。在增加垂直向颌间距离的情况下，从纳米复合树脂中制作了 36 个腭侧直接贴面，使用蜡基模板协助。在完全重建后牙咬合后，使用模板引导的方法制作了 40 个唇侧锂硅瓷贴面。贴面修复完成后，根据美国公共卫生服务标准（USPHS）对唇侧陶瓷贴面进行评估，平均随访时间为 22.7 个月。对后牙接触、患者主观满意度和功能进行评估。唇侧陶瓷贴面的总体成功率为优秀。腭侧树脂复合修复体的质量被认为是良好的，主要为“Alpha”评分。边缘质量（完整性和变色的分别为 11.1%和 33.3%）和表面粗糙度（16.7%）显示出较小的恶化，表现为“Beta”评分。总体而言，树脂复合材料显示出磨损面的迹象，导致 44.4%的病例出现“Beta”评分。所有病例的后牙接触均在 4 周内稳定重建。患者对美观和功能的满意度很高。这种非侵入性治疗方案的短期效果良好，具有很大的发展潜力。
