Orthodontic-assisted one step-no prep technique: A straightforward and minimally-invasive approach for localized tooth wear treatment using polymer-infiltrated ceramic network CAD-CAM prostheses

Sep 27, 2026

Uploaded by dawugda

Objectives introduce a minimally invasive, simple ortho-pros approach for localized tooth wear treatment. Four patients with localized anterior and/or posterior wear underwent occlusal analysis and individualized wax-up or digital setup based on estimated tissue loss. CAD-CAM PICN (Vita Enamic) no-prep partial-coverage restorations were bonded in supraocclusion to create a posterior open bite, followed by brief orthodontic extrusion (~2 months) to re-establish posterior contacts. Follow-up (15–47 months) showed 100% success for PICN anterior restorations, minor border chipping on thin posterior veneers, and positive patient-reported outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Introduction

Tooth wear overview and clinical relevance

Minimally invasive and adhesive dentistry approaches

Dahl concept and one step-no prep technique

DOI: 10.1111/jerd.12630 CLINICA L ARTICLE Orthodontic-assisted one step-no prep technique: A straightforward and minimally-invasive approach for localized tooth wear treatment using polymer-infiltrated ceramic network CAD-CAM prostheses Amélie Karine Jacques Mainjot DDS, MS, PhD1,2 | Carole Charavet DDS, MS, PhD3 1Dental Biomaterials Research Unit, University of Liège (ULiège), Liège, Belgium 2Dept of Fixed Prosthodontics, University hospital center (CHU) of Liège, Liège, Belgium 3Dept of Orthodontics and Dentofacial Orthopedics, University hospital center (CHU) of Liège, Liège, Belgium Correspondence Amélie Karine Jacques Mainjot, Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, Quai G. Kurth 45, B-4020 Liège, Belgium. Email: [a.mainjot@chuliege.be](a.mainjot@chuliege.be) Abstract Objectives: To introduce a minimally invasive and simple ortho-pros approach for localized tooth wear treatment. Clinical considerations: Four patients with localized anterior and/or posterior tooth wear were treated. Occlusal analyses were performed, and localized wax-up or digital setup were designed based on estimated tissue loss. No-prep anterior and posterior partial-coverage polymer-infiltrated ceramic network (PICN, Vita Enamic) restorations (eg, palatal and occlusal veneers) were computer-aided designed and manufactured (CAD-CAM), tried in, and bonded in supraocclusion, creating a posterior open bite. Then, brief partial (three patients) or global (one patient, for anterior teeth alignment request) orthodontic treatment was performed to extrude the posterior teeth and re-establish posterior occlusal contacts. The orthodontic treatment duration was ~2 months for extrusion. Direct composites were performed to mask the labial finish line of palatal veneers. Clinical results were successful after a follow-up of 15, 21, 23, and 47 months, with 100% success rate of PICN anterior restorationsand some minor chippings of borders of thin (0 .2 mm) posterior occlusal veneers. Patient-reported outcomes were positive. Conclusion: Orthodontic-assisted one step-no prep technique is an advantageous and straightforward evolution of the Dahl concept. PICNs exhibit several advantagesin this interdisciplinary approach. Clinical significance: New hybrid-ceramic CAD-CAM materials and a collaborative interdisciplinary approach support the evolution of the Dahl concept for conservative treatment of worn dentitions. The orthodontic-assisted one step-no prep technique is predictable, efficient, and well tolerated by patients and conserves tooth structure. KEYWOR DS dental material, digital dentistry, erosion, occlusion, orthodontics/restorative 1 | INTRODUCTION Tooth wear is an important and increasing pathology, particularly in young patients.1-3 A recent systematic review and meta-regression analysis reported an estimated prevalence of erosive wear in permanent teeth of children and adolescents of 30.4%, with rates ranging from 7 .2% to 74% .1 Two subtypes of tooth wear can be distinguished in the clinical signs and patient-reported medical history4: (a) chemical J Esthet Restor Dent. 2020;1–17. [wileyonlinelibrary.com/journal/jerd](wileyonlinelibrary.com/journal/jerd) © 2020 Wiley Periodicals LLC 1 wear, due to, for example, acidic food/drink consumption or gastroesophageal reflux, and (2) mechanical wear, due to bruxism. If the origin of the problem is not treated, the development of severe tooth wear would lead young adults to seek dental treatment, which is currently indicated in case of substantial loss of tooth structure, dentin exposure and significant loss (≥ 1/3) of the clinical crown, and patient esthetic or functional (eg, tooth pain) complaints.5 Current guidelines emphasize the importance of developing minimally invasive treatments that preserve as much as possible tooth tissues,5 which are now possible due to the development of adhesive dentistry. However, treatments must be adapted to t

FAQs

What is the main purpose of the orthodontic-assisted one step-no prep technique?

It is designed to provide a minimally invasive, straightforward ortho-pros approach for localized tooth wear treatment while preserving tooth structure.

How are CAD-CAM PICN restorations and orthodontics combined in the treatment?

PICN (Vita Enamic) no-prep partial-coverage restorations are CAD-CAM designed and bonded in supraocclusion to create a posterior open bite, then brief orthodontic extrusion is used to re-establish posterior occlusal contacts.

What were the reported clinical outcomes and patient responses?

The follow-up showed successful outcomes for PICN anterior restorations with minor chipping on thin posterior veneers, and patient-reported outcomes were positive.

Sep 27, 2026

Uploaded by dawugda