Treatment of tooth wear using a digital workflow and occlusal veneers: a case report

Abstract

This case report details the use of a digital workflow and ultrathin laminate veneers to restore esthetics and function to teeth with wear caused by bruxism and dental erosion. A 39-year-old man presented with wear on the occlusal surfaces of the posterior teeth, absence of anterior guidance, a noncarious cervical lesion (NCCL) in the maxillary right premolar, and esthetic concerns. A digital workflow was employed to create indirect laminate occlusal veneers (also known as tabletops), perform dental reanatomization with composite resin in the anterior region, and produce a veneer using a direct-indirect technique for the premolar with the NCCL. Evaluations revealed that there was no loss of vertical dimension or need for additional preparation. Ultrathin tabletops were manufactured from hybrid ceramic blocks using computer-aided design/computer-aided manufac¬turing technology and cemented with A2 shade flowable composite resin. A surface sealant was applied to protect the cement interface. For anterior reanatomization, a mock-up and palatal guide to composite resin layering were fabricated from the digital wax-up. The direct-indirect restoration for the NCCL was created outside the patient's mouth to ensure better precision and enable adjustment. The combination of a digital workflow and tabletop restorations for treatment of posterior tooth wear preserves natural tooth morphology in cases where no prior tooth preparation is required.

Keywords: composite resin; digital workflow; occlusal veneers; restorative dentistry; tooth wear; vertical dimenson.