Purpose: This retrospective case series of 9 patients aimed to describe clinical outcomes and patient satisfaction following the implementation of the posterior Dahl concept to manage localized posterior tooth wear.
Keywords: restorative dentistry, direct resin composite restorations, Dahl concept, vertical dimension of occlusion, bite raising, tooth wear
Materials and Methods: Localized occlusal space was created in the posterior dentition. Supra-occluding direct restorations were placed bilaterally for the restoration of molars. Intraoral scans were taken at the pre-treatment stage, immediately post-restoration, and during follow-up appointments. Scans were used to undertake analysis of any occlusal changes and re-establishment of the occlusion. A questionnaire was used to assess patient satisfaction, alleviation of any pre-treatment concerns, and evaluation of post-treatment complaints.
Results: Immediately post-treatment, all patients showed an increase in the vertical dimension. Opening of the bite in the untreated areas following restoration of worn posterior molars resulted either in a tendency towards or the actual reestablishment of the occlusion. One patient completely lacked compensatory vertical tooth movement in the untreated areas, culminating in the persistence of a vertical open bite. One restoration displayed cohesive fracture after 4 months. Pre-treatment problems (eg, sensitivity) were fully resolved amongst all patients after 6 months. Post-treatment complaints were minor and demonstrated resolution within a relatively short period of time. Eight patients reported being “very satisfied” with their treatment outcomes.
Conclusion: Application of the posterior Dahl concept appears to offer a promising, relatively simple, minimally invasive and effective approach for the management of localized posterior tooth wear, which is well accepted by patients.