Contemporary direct composite approaches for the restoration of tooth wear

Pathological tooth wear is increasing, making minimally invasive, adhesive restorations more relevant. This webinar presents freehand, IMT and Stamp techniques for rebuilding worn teeth, covering indications, materials, workflows, advantages, limits and expected longevity.

The number of patients presenting with tooth wear has increased dramatically over the past 15–20 years. When tooth wear becomes pathological, rehabilitation of the worn dentition is often required. In younger patients, a dynamic, minimally invasive, adhesive treatment concept is preferred, consisting of localised or generalised build-up of worn teeth using direct composite restorations.

Restoring the morphology and function of worn teeth with direct composite restorations remains a challenge for many clinicians. To be well prepared for an extensive rehabilitation, it is recommended that the practitioner carefully plans the restorative treatment using study models, intraoral and extraoral photographs, as well as a diagnostic wax-up and mock-up.

Several techniques are available to translate a diagnostic wax-up into aesthetic and functional composite restorations. A highly skilled dentist with a thorough understanding of tooth morphology may restore moderately worn teeth using freehand composite modelling.

More commonly, general dentists can rely on guided techniques such as the IMT technique or the Stamp technique, which allow for precise and predictable transfer of the diagnostic wax-up into aesthetic and functional composite restorations using a rigid transparent silicone index. The IMT technique utilizes a highly filled flowable composite, whereas the Stamp technique employs a conventional nanohybrid composite.

In this webinar, these three techniques for restoring tooth wear with direct composite restorations will be presented. For each technique, the indications, materials, clinical protocols, advantages and limitations, as well as the expected longevity of the restorations will be briefly discussed.

• Learning objective 1: Identify pathological tooth wear and determine when minimally invasive, adhesive rehabilitation is indicated.
• Learning objective 2: Perform structured treatment planning for worn dentitions using diagnostic wax-ups, mock-ups, and clinical documentation.
• Learning objective 3: Differentiate between freehand composite modelling, the IMT technique, and the Stamp technique, including their indications and limitations.
• Learning objective 4: Apply step-by-step clinical protocols to accurately translate a diagnostic wax-up into functional and aesthetic direct composite restorations.
• Learning objective 5: Select appropriate materials and techniques to achieve predictable outcomes and long-term success in the restoration of tooth wear.