Pathological tooth wear: a comprehensive online school. For restorative dentists, functional dentists, and dental technicians

Pathological tooth wear: a comprehensive online school. For restorative dentists, functional dentists, and dental technicians

Category: Functional Dentistry

Instructor(s): Jacek Glebocki, Carlo Poggio, Jean-Daniel Orthlieb, Riccardo Ammannato, Benett Amaechi, Francisco J. Pereira Jr, Daniel Paesani, Maurizio De Stefano, Devang Patel, Marco Veneziani, Antonello Francesco Pavone, Graham Woolley

Course structure: Lessons: 16 lessons | Duration: 20 h 47 min

Course overview

Comprehensive online school on treating pathological tooth wear for restorative dentists, functional dentists, and dental technicians!

During this training, you will learn:

Course lessons

Lesson 1: The role of bruxism in the mechanism of tooth wear

• Etiological factors and the mechanism of development of tooth wear: abrasion, erosion, attrition
• Bruxism and musculoskeletal dysfunctions: the main paradigms
• Occlusive splints in the diagnosis of bruxism:
• Bruxism without tooth wear
• Tooth wear without bruxism
• Tooth wear with bruxism.
• Bruxism vs erosion: distinctive features
• Increased tooth abrasion: histological aspects
• The effect of the quantity and quality of saliva on tooth wear
• Strategy for the management of patients with increased tooth wear: step-by-step protocol
• The role of the tongue in the development of tooth wear
• Relationship between gastroesophageal reflux, bruxism and pathological tooth wear
• Questionnaires that help identifies the true source of problems with tooth wear.

Lesson 2: Treatment of dental erosion as one of the factors of tooth wear development

• Erosion of teeth: definition and diagnosis
• Types of tooth wear: attrition, non-carious cervical lesions, abrasion, erosion
• Clinical signs of erosion
• Etiology of erosion development:
• Gastro-esophageal reflux disease
• Bulimia nervosa
• Gastric surgery
• Cyclic or psychogenic vomiting syndrome
• Pregnancy induced vomiting
• Chronic alcoholism
• Dietary
• Taking medications
• Industrial workers
• Professional wine tasters.
• Factors affecting the development of erosion: saliva, soft tissues of the oral cavity, temperature of drinks
• Prevention and control of erosion: step-by-step protocol
• Determination of the degree of erosion: BEWE index
• Method of recording and measuring erosion using a silicone key
• Tactics of managing patients with erosions: methods of protecting the damaged surface
• Hypersensitivity of teeth: diagnosis and principles of treatment.

Lesson 3: Composite protocol: index technique. Introductory lesson

• Philosophy of minimally invasive dentistry
• Free-hand layering technique
• Causes of tooth wear: friction, abrasion, erosion, perimolysis
• Copy-paste approach in adhesive restoration
• Index technique (single silicone key technique): advantages
• Index technique for tooth wear: digital and analog protocols
• New technique devised by the author of injection with thermo-viscose composites and double-layer mask
• Additional palatine incisor restorations: technique
• Adhesive restoration planning: aesthetic analysis and DSD, diagnostic Wax-up and Mock-up
• Fixation of composite overlays: adhesive protocol
• Durability of direct composite restoration with tooth wear
• Maintenance.

Lesson 4: Composite protocol: index technique

• Philosophy of minimally invasive dentistry
• Free-hand layering technique
• Causes of tooth wear: friction, abrasion, erosion, perimolysis
• Copy-paste approach in adhesive restoration
• Index technique (single silicone key technique): advantages
• Index technique for tooth wear: digital and analog protocols
• New technique devised by the author of injection with thermo-viscose composites and double-layer mask
• Additional palatine incisor restorations: technique
• Adhesive restoration planning: aesthetic analysis and DSD, diagnostic Wax-up and Mock-up
• Fixation of composite overlays: adhesive protocol
• Durability of direct composite restoration with tooth wear
• Maintenance.

Lesson 5: Classic way of prosthetic restoration of worn dentition

• Tooth wear: causes and diagnosis
• The main types of tooth wear
• Methods of treatment of pathological tooth wear
• Total rehabilitation vs dentistry of one tooth: principles of occlusion
• Algorithm of occlusal evaluation in case of pathological tooth wear
• Signs and symptoms of parafunction
• Reorganization approach: protocol and advantages of the method
• DAHL-technique: basic principles
• Limiting factors in the total rehabilitation of the dentition with pathological tooth wear.

Lesson 6: Classic Wax-up and Mock-up protocols for tooth worn treatment

• The main stages of total rehabilitation in case of pathological tooth wear
• Diagnostic Wax-up and Mock-up
• Plastering of models in the articulator: technique
• Features of modeling the palatine surface
• The technique of making composite veneers in a direct way using a silicone key
• Mock-up: methodology and criteria for Mock-up control in a week
• Adhesive total rehabilitation: DAHL technique
• The technique of restoring the anterior teeth:
• Using a transparent silicone key
• Injection formation technique
• Composite indirect facets.
• Stabilization of posterior teeth contacts: strategies and techniques
• Restoring posterior teeth with composite materials: techniques
• Restoration of posterior teeth by the imprint method: tips and recommendations
• Stabilization of treatment results: the use of a Michigan splint
• Maintenance protocol.

Lesson 7: Perfect VDO and CR in worn dentition treatment by Kois Center mentor

• Causes of pathological tooth wear
• Types of chewing: the relationship with the pathological tooth wear
• Range of function: norm and pathology, limited range
• Signs of pathological tooth wear
• Mechanical tooth wear: causes and mechanism of development
• Determination of the centric relation: methodology
• Principles of treatment of the tooth wear
• Principles of working with the Kois articulator: analog and digital protocol
• Kois deprogrammer: specifics of the work
• Criteria for restoring the correct vertical dimension.

Lesson 8: Total adhesive restorations - direct and indirect techniques

• Total rehabilitation using the injection formation technique: principles
• Methods of isolation of the working field
• Three-layer silicone key: operation protocol
• Wax-up and Mock-up in the protocol of total rehabilitation
• Adhesive protocol with tooth wear
• Method of forming composite material
• Indirect methods of total compositional rehabilitation: a three-stage protocol
• Planning based on facial features, aesthetic analysis
• Method of biologically oriented preparation
• Ceramic overlays and crowns: indications and protocols
• Total rehabilitation for erosion and abrasion: step-by-step protocol
• Increasing the vertical dimension of the occlusion: predictability and safety
• Laminate veneers made of zirconium dioxide: protocol.

Lesson 9: Bruxism: from management to oral rehabilitation. Part 1

• Definition of bruxism based on clinical examples
• Classification of bruxism
• Analysis and comparison between awake bruxism and sleep bruxism
• Evaluation of oral behaviors in relation to sleep disorders:
• Bruxism as a protective factor
• Bruxism as a risk factor
• Association with other disorders and health conditions.
• Clinical case analysis and bruxism evaluation:
• Patient evaluation and clinical examination
• Supplementary diagnostic exams that aid in bruxism assessment
• Identifying the risk factors associated with bruxism.

Lesson 10: Bruxism: from management to oral rehabilitation. Part 2

• Cognitive-behavioral approach for patients diagnosed with bruxism
• Protocols for controlling other disorders and health conditions that may influence bruxism
• Protocols of splint therapy:
• Splint classification and analysis of different types
• Steps to designing splint appliances.
• Pharmacological approach to managing bruxism
• Evaluation of drugs inducing bruxism
• Analysis of medications reducing bruxism
• Full-mouth rehabilitation protocols.

Lesson 11: Dental anti-aging: main principles when working with worn dentition

• Tooth wear: definition and classification
• The difference between physiological and pathological tooth wear
• Etiopathogenesis of pathological tooth wear
• Preventive protocols for pathological tooth wear
• Types of tooth wear and the compensatory response of the stomatognathic system
• Classification of tooth wear based on localization
• Protocols for interdisciplinary diagnosis of worn dentition
• Orthodontics prior to full-mouth rehabilitation: why, when, and how?
• Localized restorative protocols
• Protocols for full-mouth reconstruction
• Maintenance over time of dental rejuvenation.

Lesson 12: Gummy smile and short tooth syndrome: interdisciplinary aesthetic rehabilitation

• Etiopathogenetic causes of gummy smile (GS) and short tooth syndrome (STS)
• Smile line assessment and its application in aesthetic evaluation
• The proposed classification system for adult patients with GS and STS and the diagnostic process used within this classification
• Biological and restorative approaches employed in treating gummy smile and short tooth syndrome
• The significance of surgically exposing the cemento-enamel junction when addressing gummy smile cases
• Compensatory eruption with orthodontics
• Protocols for balancing the gingival smile line
• Analysis of the interdisciplinary approach to treatment
• Maxillofacial surgery and aesthetic rehabilitation
• Protocols of interdisciplinary aesthetic rehabilitation
• Analysis of full-mouth restorative protocols: from smile analysis to post-treatment evaluation.

Lesson 13: Psycho-behavioral approach, splint therapy, composite restorations

• Addressing excessive bruxism through a psycho-behavioral approach
• Bruxism treatment modalities:
• Occlusal splint and its limitations
• Importance of a dual psychological approach and stress management.
• Holistic approach to bruxism treatment and nasal breathing for improved sleep quality
• Integration of proprioceptive stimulation:
• Occlusal proprioceptive stimulation
• Reinforcing the psycho-behavioral approach.
• Utilizing composite restorations for effective results.

Lesson 14: The simple prosthetic approach of tooth wear treatment. DAHL technique

• The rate and severity of wear
• Monitoring of tooth wear
• Establishing a new occlusion
• Increasing the VDO
• Centric relation
• Protocols for the choice of occlusal scheme and occlusal analysis
• Choice of articulator
• Materials for crown restoration
• Parafunctiona and worn dentition
• The Dahl technique.

Lesson 15: Treatment of Worn Dentition with Ceramic Restorations

• Step-by-step analysis of clinical cases of worn dentition:
• Diagnosis and case clinical history analysis
• Radiological, functional, and occlusal analysis
• Treatment planning and objectives of the treatment
• Facially generated treatment planning and digital smile design
• Splint therapy and lower jaw repositioning protocols
• Evaluation of occlusal plane on the articulator
• Protocols for adhesive mock-up and analysis of neuromuscular pattern.
• Clinical performance of porcelain laminate veneers
• Incisal WRAP veneer prep vs. Butt-joint
• Tooth wear evaluation system
• Protocols to increase the occlusal vertical dimension (OVD)
• Ceramic veneers or direct molded veneers?

Lesson 16: Prosthodontic and interdisciplinary bruxism treatment

• Goals and objectives of prosthodontic treatment
• The concept of "non-invasive" in the treatment of bruxists
• Rehabilitation or aesthetic dentistry: treatment tactics for bruxism
• Indications for changing occlusal relationships
• Full crowns or partial adhesive restorations: selection algorithm
• Digital bruxism treatment protocol: benefits
• Total prosthetic rehabilitation: clinical examples
• Occlusion: a role in bruxism treatment planning
• An interdisciplinary approach in the treatment of bruxism
• Occlusion on implants: risks of bruxism.

Who is this course for?

This online course is designed for dentists and dental professionals interested in functional dentistry, clinical decision-making and evidence-informed dental practice.