Update on the ‘index technique’ in worn dentition: a no-prep … · 2018-12-10 · 516 THE...

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516THE INTERNATIONAL JOURNAL OF ESTHETIC DENTISTRY

WINTER 2018

CLINICAL RESEARCH

Update on the ‘index technique’ in

worn dentition: a no-prep restorative

approach with a digital workflow

Riccardo Ammannato, DDS

Private Practice, Genova, Italy

Daniele Rondoni, CDT

Private Practice, Savona, Italy

Federico Ferraris, DDS

Private Practice, Alessandria, Italy

Correspondence to: Dr Riccardo Ammannato

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AMMANNATO ET AL

prep restorative approach to the man

minimal, moderate, and severe hard tis

vasive adhesive composite restorations

to each tooth: direct and indirect partial

composite resin directly onto the tooth

(Int J Esthet Dent 2018;13:516–537)

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CLINICAL RESEARCH

This device

7,8 aiding the condyles

1 In recent years,

hygiene and maintenance protocol, in

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tion, and esthetics as well as to prevent

9 avoids or

also that ceramic wears three times slow28

alternative to composite resin restor

present enamel and dentin, the endodontic and periodontal implications, and

that in some cases it is not necessary to

composite resin to restore worn dental 9

large and deep cavities are present on

9 However, with evolving technology there are now composites on the

tion stress, and a good chromatic inte

ties, and moderately worn posterior and

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the same time, depending on the time

ramic crowns, the conventional prosthet

when applying indirect restorations, since all the direct restorations will al

A clinical case

sion in the posterior teeth, and a slight ten

wanted to change the shape and size

proceed with treatment once this tension

jet prior to considering any restorative

tion interposition in CR at the new OVD

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Fig 1 Fig 2

Fig 4 Fig 5

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clinician and technician to choose the

CAM, where in this case a monochromat

Anterior and posterior temporary

the therapy, since the patient, clinician,

leading to a connected temporary res

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Fig 8 Fig 9

Fig 10 Fig 11

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the clinician, technician, and patient a

phonetics, and static and dynamic oc

restorations

the material over the digital restorative

Fig 12

Fig 13

Fig 14

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Fig 15 Fig 16

Fig 17

Fig 18

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The teeth were not prepared with ro

adhesion31

The preheated composite was ap

enamel on the perimeter and the dentin

two matrices that were placed to protect

composite shape while molding, and to

Fig 19 Fig 20

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Fig 21 Fig 22

Fig 23 Fig 24

Fig 25

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missing the patient, to provisionally re

Fig 26 Fig 27

Fig 28 Fig 29

restorations

9 there are three options to manage

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Fig 30 Fig 31

enamel, whereas on the eroded dentin

to protect the adjacent teeth, and to have

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Composite shades were chosen prior to

Fig 32

Fig 33 Fig 34

prior to placing the increments on each

composite resin was then layered with a

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Fig 35 Fig 36

Fig 37

emergence level near the gingival mar

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Fig 38 Fig 39

Fig 40

Fig 41

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Fig 42 Fig 43

Fig 44

Fig 45

canines,36 and only a shimming contact

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Complications and repair

Fig 46 Fig 47

Fig 48

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wear characteristics,37

it is very easy to repolish this material

Fig 49

Fig 50 Fig 51

Fig 52 Fig 53

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CLINICAL RESEARCH

poses a conservative and alternative

38 Adhesion and com39

ing strength and composite chromatic

prehensive and conservative

concepts and clinical ration

Approaches to Vertical

ment Planning: Principles,

severely worn dentition with minimally invasive prosthetic

Periodontics Restorative Dent

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tion: a new and conservative

ior toothwear with composite restorations at an increased

tooth loss with composite

protecting worn palatal

Periodontics Aesthet Dent

treated with direct composite restorations at an increased

and direct resin composites

HS, Kelleher MG, Porter RW,

direct composite restorations

anterior dentition – clinic

and indirect restorations

J Prosthodont Restor Dent

R, Cenci MS, Opdam NJ,

worn teeth: A systematic

Esthetic restorative materials

toward the light? J Dent Res

approach in direct class IV

Update on the ‘index technique’ in worn dentition: a no-prep … · 2018-12-10 · 516 THE...

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