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Int J Esthet Dent. 2015 Spring;10(1):68-99.

The "index technique" in worn dentition: a new and conservative approach.


The development and reliability of adhesive resin composite systems have offered clinicians a further option for the management of tooth-surface loss. Patients with minimum, moderate, and severe hard tissue wear can be treated based on the application of minimally invasive adhesive composite restorations for posterior and anterior worn dentition. This article presents the "index technique", a new and very conservative approach to the management of worn dentition. The technique allows for a purely additive treatment without sacrificing healthy hard tooth tissue. It follows the principles of bioeconomics (maximum conservation of healthy tissue) and the reinforcing of residual dental structure. Depending on the severity of enamel and dentin wear, the number of caries, and the size of existing restorations, different treatment options can be applied to each tooth: direct and indirect partial restorations or full crowns. It is essential to diagnose and treat tooth-surface loss in order to properly restore biomechanics, function, and esthetics by means of adhesive restorations. This article proposes that the index technique is a fast and conservative approach for the planning and management of a fullmouth adhesive treatment in all cases of worn dentition. The technique is based on stamping composite directly on the tooth surface by means of a transparent index created from the full-mouth wax-up following an initially planned increase in occlusal vertical dimension (OVD).

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