About the Event

In Northern Ireland 88% of adults have toothwear that extends into dentine . We all have these patients in our practices but struggle with when to intervene and how to treat them predictably.

Francesca Vailati has come up with a revolutionary, highly conservative yet simple technique to treat these patients in a cost effective, confident and practical way.

This conference will provide you with accessible skills and techniques you can implement immediately in your practice or laboratory  with the tools and materials you already have.

ADDITIVE DENTISTRY- Aesthetic and functional rehabilitation of toothwear using the three step technique.

Dental wear is a frequently underestimated pathology that nowadays affects an increasing number of individuals.

Teeth in general are wearing down faster, not only for the excessive presence of acid in the mouth, but also because of parafunctional habits.

Generally, the affected patients are left untreated until more damage occurs and conventional treatments are more justified (subtractive dentistry based on crowns). Instead of leaving these dentitions degrading further a non-invasive (additive) intervention should be proposed, based on an increase of vertical dimension of occlusion (VDO).

This increase represents often a challenge for many clinicians, not only because it is necessary to treat several teeth at the same time, but also because there is a generalized fear for the potential clinical complications.

The 3 STEP technique helps clinicians to plan and executed more global rehabilitations simplify the procedure, while maintaining the quality of the intervention very high.

DIAGNOSIS

Before starting any dental treatments, a diagnosis of the origin of the tooth wear should be made.  Even though loss of tooth structure is often multi-factorial, clinicians should try to identify the causes, to explain patients also how the restored dentition will be ageing in the future.

The participants will learn how to recognizing the signs of early tooth wear at the level of the anterior and the posterior teeth and be capable to predict the type of evolution if the dentition is left untreated.

CLASSIC 3 STEP, an overview

Despite the tendency for adhesive techniques to rather simplify the involved clinical and laboratory procedures, treatment of patients affected by severe dental erosion still remains a challenge.

An innovative approach, called the CLASSIC 3 STEP technique has been developed by dr. Vailati in 2005. The 3 STEP technique is a structured project to achieve a full-mouth ADDITIVE adhesive rehabilitation with the most predictable result, the minimal tooth preparation, and the highest level of patient acceptance.

Due to a raising awareness about dental erosion, several clinicians would like to propose treatments even at the initial stages of this disease. However, when the loss of tooth structure is visible only by an attentive eye and it has not affected the esthetic of the smile, proposing a full-mouth rehabilitation is not easy.Reduction of the cost of the therapy, simplification of the clinical steps, and NON-invasive adhesive techniques may promote patient’s acceptance.With the modified approach of the 3 STEP technique, initial cases of dental erosion could be treated, skipping some clinical and laboratory steps, to make the therapy faster and less expensive for the patients. In addition a modified approach can be used to lower the price of the rehabilitation even in more severe cases of tooth wear.

CLINICAL CASES not only of erosion

Clinicians are generally not very keen to start treating patients affected by parafunctional habits (e.g bruxism), since they are afraid of the mechanical failure of the restorations delivered. A common attitude is to wait for more damage to occur, to be then obliged to intervene. However, this late intervention is responsible for a further degradation of the original dentition, and a more complicated and expensive therapy. Generally subtractive techniques are then selected and healthy tooth structure removed, leading to further weakening of the dentition. Nowadays, however, these conventional rehabilitations (based on crowns) are very rarely accepted by patients, not only for their biological loss, but also for their important cost.

If dentists are not prepared to treat parafunctional patients, and patients are reluctant to restore their teeth with subtractive techniques, questions on the time of intervention should be raised.

Additive dentistry can be the alternative to propose to this population of patients, based on an early intervention with the maximum preservation of their tooth structure.

Dr Francesca Vailati, MD DMD MSc, Senior Lecturer, Dept of Fixed Prosthodontics and Occlusion, School of Dental Medicine, University of Geneva, Switzerland Private practice, Geneva Dental Studio, Switzerland