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Video Details
Conservative Treatment for Tooth Wear

Description:
Diagnosis of bruxism must be observed by the hygienist or dentist at the earliest possible time. If caught early treatment to restore the beauty of the smile consists of cosmetic contouring.

Date Added:
3/23/2011

Author(s):

Ronald Goldstein, DDS Ronald Goldstein, DDS
Dr. Ronald Goldstein is currently Clinical Professor of Oral Rehabilitation at Georgia Regents University College of Dental Medicine in Augusta, Georgia, Adjunct Clinic...
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Online Videos / Restorative / Contouring / Conservative Treatment for Tooth Wear




Questions & Comments
Ronald Goldstein - (11/8/2017 9:39 PM)

The problem with veneering protruded teeth if creating a much lighter shade is that it creates the illusion of the teeth looking like they stick out even more. Although I don't like the idea of reducing a perfectly good tooth for a full crown when esthetics is the primary concern for the patient...if you cannot motivate the patient to undergo orthodontics first or as an ideal solution...full crowns may well be the compromise option. Consider a combination of ortho first and then veneers if bleaching does not work

william moore - (11/7/2017 8:27 AM)

to veneer or crown protrusive anterior wear .. sound, un-restored anteriors ... guidelines.

Sanjit Singh - (11/20/2012 1:58 PM)

Thank you for your reply.

Ronald Goldstein - (11/8/2012 12:12 PM)

Constantine, you ask good questions: First, the basic indications are to alter tooth structure, esthetically correct minor orthodontic problems, removal of stains and other discolorations, and esthetically correct the wear effects due to bruxism. These indications are explained in detail in the chapter on Cosmetic Contouring in my textbook, Esthetics in Dentistry, Vol 1 second edition (Amazon) which you probably have in your school library. The contraindications are hypersensitive teeth, large pulp canals, thin enamel, occlusal interferences, and others also explained in the chapter. Hope this helps answer question 1. The answer to your second question is that cosmetic contouring is not meant to eliminate or prevent bruxism although in can help in many instances. And yes, it will help to use articulating paper to make sure you are not destroying pathways of occlusion that need to be preserved. Good luck in your career, Constantine! Ron

Ronald Goldstein - (11/8/2012 12:00 PM)

Jai, The best book is the textbook I have authored, Esthetics in Dentistry, Volumn 1 (Amazon) which has a chapter on Cosmetic Contouring....Good luck, Ron

Ronald Goldstein - (11/8/2012 11:57 AM)

Sanjit,

The answer to the first question is "yes" unless the adjacent and posterior labial surfaces are also reshaped in harmony with the new incisal curve of the smile. In the case I used for this video I could have made it better by contouring the right bicuspid labial surface to give an even younger look and avoid the perception of a reverse smileline.

Second question...Dr. Marvin Simring stated many years ago that you can change protrusive or centric but not both in the same mouth....and the answer to the 3rd question is more complex depending on when the patient's habit of bruxism is...if at night then obviously a night guard would help. But if during the day we would have to reverse the habit by having the patient put signs all around..."lips together, teeth apart" letting the patient understand that the teeth should never touch unless eating. In addition an analysis of the occlusion may well need to be a part of the treatment plan.

Sanjit Singh - (11/7/2012 3:17 PM)

Hi! Dr Goldstein. Thank you for the video. The question I had is that by contouring the incisors , wont we make the smile like reverse as the Cervico-incisal length of the the Incisors would decrease. Also during protrusive movement would it affect the anterior guidance and posterior dis occlusion? Finally how would this prevent and reduce patients habit of bruxism?

Jai Rawal - (10/21/2012 9:26 PM)

Hi! Ron
Some good tips.
Is there a good book on cosmetic recountouring?
Thanks

Constantine Stavrinoudis - (9/15/2012 11:42 PM)

Greetings- The answer to my question may be an understatement , but since I'm only a 3rd year student I'm going to ask; When is this procedure indicated or contraindicated? Will this procedure help alleviate the etiology of bruxism long-term? and would it help to use articulating paper to check for possible alternations in occlusion, especially lateral excursion?

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