Tooth wear: a systematic review of treatment options.
BACKGROUND
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.


OBJECTIVE
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.


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.
Assistant Professor, Department of Fixed and Removable Prosthodontics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: info@erikjanmuts.nl.
Erik-Jan
EJ
Muts
Associate Professor, Department of Fixed and Removable Prosthodontics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Hans
H
van Pelt
Tenured Associate Professor, Department of Prosthodontics, Dental School, Ludwig-Maximilians-University, Munich, Germany.
Daniel
D
Edelhoff
Professor and Chairman, Division of Cariology and Endodontics, School of Dentistry, University of Geneva, Geneva, Switzerland.
Ivo
I
Krejci
Professor and Chairman, Department of Fixed and Removable Prosthodontics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Marco
M
Cune
D003793:Dental Restoration, Permanent / Q000379:methods; D004955:Esthetics, Dental; D006801:Humans; D010347:Patient Care Planning; D057085:Tooth Wear / Q000175:diagnosis / Q000628:therapy*