Posterior Dahl: A Minimally Invasive Method for the Treatment of Localized Posterior Tooth Wear

• Published in: The journal of adhesive dentistry Vol. 25; no. 1; pp. 31 - 38
• Main Authors: Hoekstra-van Hout, Pauline M J, Schols, Jan G J H, Mehta, Shamir B, Opdam, Niek J M, Pereira Cenci, Tatiana, Loomans, Bas A C
• Format: Journal Article
• Language: English
• Published: Germany 26.01.2023
• Subjects: Dental Restoration, Permanent - methods; Humans; Patient Satisfaction; Retrospective Studies; Tooth Wear - therapy; Vertical Dimension; Dahl concept; restorative dentistry; direct resin composite restorations; bite raising; tooth wear; vertical dimension of occlusion
• ISSN: 1757-9988
• DOI: 10.3290/j.jad.b3837959

This retrospective case series of 9 patients aimed to describe clinical outcomes and patient satisfaction following the implementation of the posterior Dahl concept to manage localized posterior tooth wear. Localized occlusal space was created in the posterior dentition. Supra-occluding direct restorations were placed bilaterally for the restoration of molars. Intraoral scans were taken at the pre-treatment stage, immediately post-restoration, and during follow-up appointments. Scans were used to undertake analysis of any occlusal changes and re-establishment of the occlusion. A questionnaire was used to assess patient satisfaction, alleviation of any pre-treatment concerns, and evaluation of post-treatment complaints. Immediately post-treatment, all patients showed an increase in the vertical dimension. Opening of the bite in the untreated areas following restoration of worn posterior molars resulted either in a tendency towards or the actual reestablishment of the occlusion. One patient completely lacked compensatory vertical tooth movement in the untreated areas, culminating in the persistence of a vertical open bite. One restoration displayed cohesive fracture after 4 months. Pre-treatment problems (eg, sensitivity) were fully resolved amongst all patients after 6 months. Post-treatment complaints were minor and demonstrated resolution within a relatively short period of time. Eight patients reported being "very satisfied" with their treatment outcomes. Application of the posterior Dahl concept appears to offer a promising, relatively simple, minimally invasive and effective approach for the management of localized posterior tooth wear, which is well accepted by patients.