Orthodontic‐assisted one step‐ no prep technique: A straightforward and minimally‐invasive approach for localized tooth wear treatment using polymer‐infiltrated ceramic network CAD‐CAM prostheses

Publication type: 
Article
Author(s): 
Amélie K. J. Mainjot & Caroline Charavet
Citation: 

Mainjot, A. K. J. & Charavet, C. (2020) Orthodontic‐assisted one step‐ no prep technique: A straightforward and minimally‐invasive approach for localized tooth wear treatment using polymer‐infiltrated ceramic network CAD‐CAM prostheses, Journal of Esthetic and Restorative Dentistry, 1-17, https://doi.org/10.1111/jerd.12630

Description: 

Objectives
To introduce a minimally invasive and simple ortho‐pros approach for localized tooth wear treatment.
Clinical considerations
Four patients with localized anterior and/or posterior tooth wear were treated. Occlusal analyses were performed, and localized wax‐up or digital setup were designed based on estimated tissue loss. No‐prep anterior and posterior partial‐coverage polymer‐infiltrated ceramic network (PICN, Vita Enamic) restorations (eg, palatal and occlusal veneers) were computer‐aided designed and manufactured (CAD‐CAM), tried in, and bonded in supraocclusion, creating a posterior open bite. Then, brief partial (three patients) or global (one patient, for anterior teeth alignment request) orthodontic treatment was performed to extrude the posterior teeth and re‐establish posterior occlusal contacts. The orthodontic treatment duration was ~2 months for extrusion. Direct composites were performed to mask the labial finish line of palatal veneers. Clinical results were successful after a follow‐up of 15, 21, 23, and 47 months, with 100% success rate of PICN anterior restorations and some minor chippings of borders of thin (0.2 mm) posterior occlusal veneers. Patient‐reported outcomes were positive.
Conclusion
Orthodontic‐assisted one step‐no prep technique is an advantageous and straightforward evolution of the Dahl concept. PICNs exhibit several advantages in this interdisciplinary approach.
Clinical significance
New hybrid‐ceramic CAD‐CAM materials and a collaborative interdisciplinary approach support the evolution of the Dahl concept for conservative treatment of worn dentitions. The orthodontic‐assisted one step‐no prep technique is predictable, efficient, and well tolerated by patients and conserves tooth structure.

Year of publication : 
2020
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Magazine published in: 
Journal of Esthetic and Restorative Dentistry