Re-anatomization of anterior eroded teeth by stratification with direct composite resin.

UNLABELLED: Gastroesophageal reflux disease (GERD) is a condition where stomach acids are chronically regurgitated into the esophagus and oral cavity, resulting in the irreversible erosion of tooth structure. The dentist often is the first health care professional to identify the affected dentition. Restorative treatment should be accomplished after management of the systemic condition. Dental treatment improves the patient's oral hygiene, reduces thermal sensitivity, prevents pulpal involvement and further abrasion, and esthetics are improved. This article presents a case report where dental erosion was present because of GERD. Conservative dental treatment of the eroded dentition is described, including diagnosis, treatment planning, bleaching, and restorative reconstruction with direct composite layering techniques without any preparation of the tooth structure. After 1 year of clinical service, the restored teeth present an excellent clinical appearance and require no repair or polishing. CLINICAL SIGNIFICANCE: The treatment of eroded teeth, caused by gastroesophageal reflux disease (GERD), with direct composite resin appears to be a conservative and esthetic procedure that is well accepted by patients. However, this treatment can be carried out only after complete management of the causes of the GERD. (J Esthet Restor Dent 21:304-317, 2009).