Aesthetic Repair of Chipped and Worn Teeth
Clinical Analysis of Fracture and Wear
Aesthetic repair of chipped and worn teeth is not only correction of appearance; it requires functional restorative planning that considers the cause of the fracture, the amount of remaining tissue and bite relationships together. Trauma, bruxism, acid erosion or incorrect occlusion may direct different treatment pathways.
During examination, fracture depth, whether pulp vitality is threatened and whether the crack line widens under occlusal load are assessed.
Distinguishing Wear Types
Attrition may result from tooth-to-tooth contact, abrasion from external surface friction, and erosion from acid-related tissue loss. Identifying the wear type is important for treating the underlying cause; restoration alone may be insufficient if wear continues.
If night bruxism or daytime clenching is suspected, a night guard may be recommended for protection.
Restorative Options
Direct composite restoration may be applied in shallow fractures and mild wear. In moderate tissue loss, a covering restoration or onlay may support tooth walls.
In extensive damage, fragility after root-canal treatment or insufficient remaining wall thickness, crown or veneer may be assessed. If the pulp is exposed, root-canal treatment may be prioritised.
Occlusion and Function
After repair, occlusal contacts are balanced; premature contact may cause sensitivity or restoration fracture. Anterior guidance and posterior support are checked together.
Use of a mouthguard during sports activities may help prevent traumatic fractures.
Long-Term Follow-up
Limiting acidic drinks and treating reflux are important in erosion cases. At regular examinations, restoration margins, gum health and wear progression are monitored.
If the underlying cause is not treated, wear or fracture may recur; the result depends on use habits and protective measures.
Emergency Approach After Trauma
In traumatic fractures, a sharp edge may injure soft tissue; during emergency examination, pulp status and whether the broken fragment can be saved are assessed. Reimplantation or composite fragment bonding may be applied in selected cases.
In children with young teeth, pulp capping and composite crown alternatives are planned according to age and development.
In anterior fractures, aesthetic composite may be preferred; in posterior wear, more durable formulations may be selected. The choice of onlay or crown is determined according to remaining wall thickness; the same restoration is not used in every case.
Regular review is recommended to monitor wear progression and restoration integrity.