Replacing Worn Composite Restorations with Porcelain
- Dr. Amanda Seay
- Sep 15
- 2 min read
Updated: Oct 3
Finding appropriate treatment options that fulfill patients’ functional and esthetic goals while working within their personal budgets is a challenge that clinicians face every day. The young female patient in this case had suffered from undiagnosed acid reflux for many years, resulting in erosive facial lesions on her maxillary teeth. More than 10 years earlier, these teeth had been restored with composite. Although the composite maintained her risk prognosis and prevented further enamel loss, the material displayed some pitting from chemical and mechanical wear over time.
After discussing treatment options, the decision was made to replace the composite with porcelain in a way that would avoid any further preparation. The erosive lesions on the patient’s lower arch would be treated with composite using the injection mold technique in a transitional bonding approach.
First, a smile design was completed to determine the ideal positioning of the teeth within the framework of the face and lips. The central incisors needed to be lengthened to create a more pleasing smile curve. To fill the buccal corridor, it would have been ideal to extend the porcelain restorations to the second premolars or first molars; however, to accommodate the patient’s financial goals, the decision was made to focus only on the teeth that had suffered significant enamel loss. The resulting treatment plan involved placing porcelain restorations on teeth Nos. 5 through 12, with the goal of filling the buccal corridor as much as possible until the patient was ready to add prepless veneers to her second premolars and molars in the future.
Although the patient demonstrated acceptable function, over the years chemical wear had outpaced mechanical wear, creating areas of deep dentin exposure.
