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The Diagnosis of Wear Patterns

Published by Brian Homann DDS

This section reviewed how tooth wear occurs in relation to how it can be treated.

  • The pattern of wear often gives us clues as to what treatment can be completed.
  • Sometimes tooth wear occurs only in one area, like the anterior or posterior.
  • In this case, the bruxing habit may be protrusive in nature. There may also be a very steep jaw joint (so they can’t wear their posterior teeth). They may also have an erosive habit that only contacts their anterior teeth.
  • In this case, vertical dimension is likely not lost.
  • A treatment planning error would be to increase the VDO.
  • In a second case, there is more posterior wear than anterior wear.
  • This can often be caused by gastric reflux, or citrus fruit mulling, or bruxism with an anterior open bite.
  • The patient that would most likely need their bite opened is the patient that has even wear on all of their teeth.
  • This will be dictated by the patient’s face. Where their incisal edges are located play a large role in the planning.
  • A unilateral bruxism pattern can be difficult to treat without crown lengthening or orthodontic intrusion.

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