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  • Quintessence Publishing USA
Débora R. Vilaboa / Beatriz R. Vilaboa / Jose Manuel Reuss / Débora Reuss

Tooth Wear

The Quintessential Challenge

1st Edition 2023
Hardcover; 21 x 28 cm; With a 16-page supplement for patients, 408 pages, 1284 illus
Language: English
Categories: Prosthodontics, Esthetic Dentistry

Stock No.: BG155
ISBN 978-1-78698-120-2
QP Deutschland


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Tooth wear is a significant challenge. Progressive, irreversible, and multifactorial in nature, it requires a patient-centered methodology for successful treatment. In this impressive book, the authors advance an integrative and multidisciplinary approach to worn dentitions that promotes early detection, thorough assessment, and conservative modalities and also understands that comprehensive treatment can require surgery, implants, orthodontics, and indirect restoration to improve oral health and achieve esthetic results. Overall, this book effectively compiles all clinical aspects of tooth wear—from concept and diagnosis, treatment and communication, to prevention and long-term maintenance.

Section I. Understanding Tooth Wear
Chapter 01. Tooth Wear: A Major Health Issue

  • The Global Burden of Tooth Wear
  • Physiologic Versus Pathologic Wear
  • Anthropologic and Contemporary Tooth Wear
  • Prevalence of Tooth Wear
  • Tooth Wear and General Health
  • The Quintessential Challenge of Tooth Wear
  • The Economy of Tooth Wear: The TW Curve Shape
  • The Geography of Tooth Wear
  • Key Points
  • References

Chapter 02. Tooth Wear and Saliva: The First Line of Defense

  • The Oral–General Health Connection
  • Saliva and the Oral Microbiome: Defenders of Oral and General Health
  • Saliva, the Oral Microbiome, and Tooth Wear
  • The Importance of Unstimulated Salivary Flow for the TW Patient
  • Saliva and Erosion
  • The Critical pH
  • Bruxism and Saliva
  • Improving Salivation: The Invisible Guard
  • Key Points
  • References

Chapter 03. Etiology and Types of Tooth Wear

  • Tooth Wear: Classical Nomenclature
  • The Etiology of Tooth Wear
  • Tooth Wear and the Pediatric Patient
  • Tooth Wear in Adolescents and Adult Patients
  • Tooth Wear Indices
  • Following Tooth Wear Clues: Lifestyle and Health TW Questionnaire
  • Key Points
  • References

Section II. Assessing and Treating Tooth Wear
Chapter 04. Diagnosis and Treatment Planning in Tooth Wear

  • Initial Visit of the Patient with TW
  • Anamnesis of the Patient with Tooth Wear
  • Informed Consent for the Patient with Tooth Wear
  • Patient-Centered Path in Tooth Wear Treatment
  • The Ideal Occlusal Scheme
  • Material Selection: When to Subtract and When to Add
  • Accuracy and the Preservation Principle
  • Traditional Acquisition of Data
  • Digital Acquisition of Data: Cross-Mounting in the Digital Era
  • Traditional and Digital: Hop-On, Hop-Off Workflow
  • Sequence of Reconstruction by Sector
  • Key Points: TW Treatment Flowchart
  • References

Chapter 05. Incipient Tooth Wear

  • The Onset of Tooth Wear
  • Erosion and Caries: Is There a Link?
  • A Close-Up Look at the Incisal Edges
  • Anterior and Canine Guidance in Incipient Tooth Wear
  • Intercepting Tooth Wear with Orthodontics
  • Restoration of Canine and Anterior Guidance
  • Intercepting Incipient Erosive Damage
  • Key Points: Incipient TW Flowchart
  • References

Chapter 06. Moderate Tooth Wear: Treatment Strategies

  • Moderate TW: The Space Issue
  • Adhesion to Worn Surfaces
  • Composite for Moderate Tooth Wear: Direct versus Indirect
  • Palatal Restorations for Tooth Wear
  • Porcelain Laminate Veneers for Tooth Wear
  • Increasing VDO: A Tool More than a Target
  • Non-Carious Cervical Lesions
  • Key Points: Decision Making in Moderate/Severe TW
  • References

Chapter 07. Severe Tooth Wear: Treatment Strategies

  • From Moderate to Severe Tooth Wear
  • Wax-Up: The Blueprint
  • Additive Approach with Porcelain Laminate Veneers for Anterior Guidance
  • Occlusal Scheme: Vertical Dimension of Occlusion and Centric Relation
  • Indirect Bonded Inlays/Onlays
  • Partial and Full Crowns for Single-Tooth Restorations: Occlusal Adjustment and Polishing
  • Key Points: Decision Making in Severe TW
  • References

Chapter 08. Orthodontics in Tooth Wear Treatment

  • Malocclusion and Tooth Wear
  • Orthodontics to Intercept Tooth Wear and Preserve Tooth Structure
  • Orthodontics to Provide Missing Space and Preserve Tooth Structure
  • Communication: A Key Player in the Tooth Wear Outcome
  • Timing of Orthodontic and Restorative Interventions
  • Key Points: TW Treatment Planning: Considerations for the Orthodontic-Restorative Team
  • References

Chapter 09. Implants in Patients with Tooth Wear

  • Biologic and Mechanical Considerations
  • Clinical Recommendations
  • Overload and Implant Failure in Patients with Tooth Wear
  • Implants and Occlusal Space in Patients with Severe TW: Management of Vertical Collapse
  • Digital Cross-Mounting and Advantages of Digital Protocols in TW Treatment
  • Maintenance Protocols in Patients with TW and Implants
  • Key Points: Implants in TW
  • References

Section III. Prevention and Long-Term Maintenance in Tooth Wear Treatment
Chapter 10. Are we in Time to Flatten the Tooth Wear Curve?

  • 30 Years of Treating Tooth Wear: What have we learned?
  • Modern Lifestyle: Change what is possible
  • Targeting Nutritional Risk Factors: The Benefits of Erosion-Protective Foods
  • Parafunctional Habit Control and Ideal Occlusal Scheme: Keys to Long-Term Maintenance
  • Oral Hygiene and Tooth Wear
  • New Strategies in TW Prevention: Enhancing Healthy Saliva, The Day and Night Bodyguard
  • Long-Term Maintenance of the Patient with TW
  • Patient-Centered Long-Term Management of TW: Quality of Life, Prems, and Proms
  • Key Points: General Maintenance Guidelines for the Patient with TW
  • References

Dr. Débora R. Vilaboa

Spain, Madrid

Dr Debora R. Vilaboa graduated from the Complutense University Faculty of Medicine and Surgery in Madrid. The same year, she was accepted at the Seville School of Dentistry, where she obtained her dental degree. Later on she chose to attend the Advanced Pediactric Dentistry Program at the University of Southern California in Los Angeles. After establishing the Vilaboa Clinic in 1987, she found that some cases could not be explained by caries nor periodontal disease and began gathering data. She lectured on tooth wear as early as 1992, both in Spain and the United States. Understanding how to approach the treatment of young children helped Dr Deborah Vilaboa in her work with tooth wear patients, many of whom had a fear of dentistry. As a pioneer in the field of porcelain laminate veneers, she treated such cases with a novel adhesive concept. Dr Debora Vilaboa soon became a member of the Spanish Society of Stomatological Prosthetics (SEPES) and the Spanish Society of Periodontology (SEPA). Her passion for treating patients and continuing education was rewarded in becoming an active member of the European Academy of Esthetic Dentistry (EAED). She was then able to pursue her restorative and prosthodontic interests, thanks to a truly collaborative and generous exchange of knowledge among the active members that is still a driving force for the team at Vilaboa Clinic. She is also an active member of the Italian Academy of Esthetic Dentistry (IAED). Dr Debora Vilaboa was invited by the San Pablo CEU University to create an undergraduate Esthetic Dentistry Department that she co-directs with her sister, Dr Beatriz Vilaboa. She lectures worldwide in esthetic dentistry, with a focus on tooth wear. She was a contributor to Esthetics in Dentistry (Quintessence, 2016). Given her medical background, Dr Deboarh Vilaboa is devoted to understanding and treating conditions arising from medical and oral imbalances, and through her research, she has obtained several patents related to her work. She is an active member of the American Academy of Oral Medicine (AAOM), a fellow member of the International College of Dentists (ICD), and an academic at the Pierre Fauchard Academy.


Dr. Beatriz R. Vilaboa PhD

Spain, Madrid

Dr Beatriz R. Vilaboa received her degree in medicine and surgery with honours from the Complutense University of Madrid from which she also attained her specialty in stomatology. She joined Clinica Vilaboa in Madrid soon after her sister Dr Debora R. Vilboa founded it in 1987. She enjoys her private practice at the Vilaboa Clinic, dedicated to esthetic and restorative dentistry.Her devotion to treating patients using the most conservative approach possible motivated her to embrace the adhesive-additive concept to provide solutions to the tooth wear patient. Her interest in tooth wear culminated with a PhD from San Pablo CEU University Faculty of Medicine in Madrid, where she is now Co-Director of the undergraduate Esthetic Dentistry department. Dr Beatriz Vilboa’s passion for teaching is also evident in the many courses that she and her sister have given over the last 30 years. Dr. Beatriz Vilaboa has the honour of being an active member of the European Academy of Esthetic Dentistry (EAED) and the Italian Academy of Esthetic Dentistry (IAED). She is also founding member of the International Academy of Adhesion (IAA). Her desire to better help patients suffering from cancer and other major medical conditions pushed her to become a member of the American Academy of Oral Medicine (AAOM). She is also a member of the Spanish Society of Stomatological Prosthetics (SEPES) and Spanish Society of Periodontology (SEPA), as well as a fellow member of the International College of Dentists (ICD) and an academic from the Pierre Fauchard Academy. She lectures worldwide on esthetic and restorative dentistry and especially on tooth wear. Dr Beatriz Vilaboa treasures friendship with colleagues worldwide and believes that the common passion for dentistry goes beyond borders.


Dr. Jose Manuel Reuss

Spain, Madrid

Dr Jose Manuel Reuss graduated in dentistry from the University Complutense of Madrid, where he also obtained a Master´s Degree of Science. As a postgraduate in surgical implant dentistry at the University of California at Los Angeles, he was a recipient of a grant from the American Academy of Implant Dentistry for preclinical and clinical research. During his postgraduate research, he focused on bone regeneration with growth factor technologies. Dr Jose Manual Reuss’s clinical background both in implant surgery and prosthodontics has led him to develop a facially guided restoration concept. In particular, severe tooth wear or highly dysfunctional cases can benefit from the combination of digital protocols and a more traditional classical workflow. His current clinical and research foci relie on the integration of facial scanners into guided surgery systems, restorative protocols, and clinician-technician communication. As an affiliate member of the European Academy of Esthetics Dentistry, he is an enthusiast of multidisciplinary thinking and is therefore also a member of the Spanish Society of Prosthodontics (SEPES), the Spanish Society of Periodontics (SEPA), the Academy of Osseointegration (AO), and the European Academy of Osseointegration (EAO). Dr Jose Manuel Reuss is a Collaborating Professor in the Postgraduate Prosthodontics Department in the field of implant and restorative dentistry at the University Complutense of Madrid, the University of Leon, and at the Esthetic Dentistry Department at the University San Pablo CEU of Madrid. His current focus of research is digital implant dentistry and severe tooth wear with the aim to optimize diagnostic and treatment phases and engage the working team in research. His goal to simplify the communication between the team members of an integrated multifaceted treatment plan challenges Dr Reuss almost as much as his passion for sports in his personal life.


Dr. Débora Reuss

Spain, Madrid

Dr Debora Reuss obtained her Master’s Degree in Orthodontics at the European University of Madrid, 4 years after graduating as a dentist from San Pablo CEU University of Madrid. Having completed several postgraduate specialty courses (including Damon self-ligating and Invisalign systems), she joined the Spanish Orthodontics Society (SEDO) and the Spanish Society of Aligners (SEDA). As a Member of the American Association of Orthodontics (AAO), she is a firm believer in facial- and profile-guided orthodontics. Dr Reuss trained in occlusion at the Pankey Institute of Miami and believes that a classical concept of occlusion must be a driving force in treating orthodontic patients. Her passion for treating patients within a multidisciplinary approach has inspired her to attend continuing education courses on occlusion, restorative, and prosthodontic topics and is the reason behind her affiliation with the Spanish Society of Stomatological Prosthetics (SEPES) as well as the reason why she became affiliate member of the European Academy of Esthetic Dentistry (EAED) and the Italian Academy of Esthetic Dentistry (IAED). Dr Reuss teaches at the Esthetic Dentistry Department at San Pablo CEU University of Madrid. Multidisciplinary thinking led her to join the Vilaboa Team in Madrid to help treat tooth wear patients with a minimally invasive philosophy to prevent further wear and to ensure conservative performance of the required restorations. An education in three-dimensional thinking as an orthodontist is key in leading the tooth wear team to a facially guided restoration as an architect of the oral complex.

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Cover, Vilaboa: Tooth Wear

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