TOOTH WEAR: A SYSTEMATIC REVIEW OF TREATMENT OPTIONS

Statement of problem. Treatment of tooth wear is increasing. Because no evidence-based guidelines are available, the clinician may have difficulties deciding which treatment option to choose to resolve complex situations. Purpose. The purpose of this systematic review was to identify similarities among treatment options for generalized tooth wear and to develop an approach to rehabilitation based on the best evidence available. Material and methods. A Medline and Cochrane search (for articles published from January 31, 2003, to January 31, 2013) was conducted. Minimally invasive and fully described treatments for generalized tooth wear with esthetically satisfying results were included. Five steps within the treatment procedures were analyzed: diagnostic waxing (DW), occlusal positioning (OP), vertical dimension increase (VDI), restoration, and follow-up. Results. Common threads were established within the 5 treatment steps. Nine studies used DW, and 6 performed diagnostic tooth arrangement (DTA). Centric relation was used in 5 studies, and VDI was tested in 8 studies, 5 of which used a removable appliance. Seven studies implemented a provisional stage, and 5 used composite resin at that time. For definitive treatment, composite resin (6 studies) and glass ceramic (6 studies) were used. Seven studies applied a protective appliance, and 5 scheduled regular posttreatment evaluation as means of aftercare. Conclusions. Within the limitations of this systematic review, the present evidence is not strong enough to form conclusions, and the presented similarities cannot be substantiated with evidence. Therefore, comprehensive clinical research into the designated treatment of generalized tooth wear is recommended.