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DENTAL EROSION
CONTROL VISIT
THE FOLLOW-UP
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The Control visit is the visit where the clinician meets the patient again after delivering of the White Bite. While the mock-up visit can be scheduled independently from the rest of the therapy, the White Bite, the Control visit and the bonding of the anterior restorations must be planned together. Following an ideal 3STEP schedule, the Control visit is planned after 1 week from the White Bite, and the delivery of the Anterior Adhesive Additive Restorations (A3Rs) generally takes another week to allow the lab tech to fabricate the restorations and the patient to keep adapting to the modified occlusion. The first week time before the Control visit is necessary to test the new posterior support so that the patient can better distinguish between a normal functional adaptation problems (that in one week improve by themselves) and not correct occlusion problems (which persist and/ or become worse). If the Control visit is scheduled too early after the delivery of the White Bite, patients may demand excessive modifications because of insufficient time of integration. On the other hand, waiting too long, and leaving the patient with an anterior open bite, is not recommended, especially in case of vertical wear and the tendency of the patient to be Implosive and a clencher. For the elevated risk of anterior teeth supraeruption and loss of the planned anterior restorative space, the anterior contact points must be restored in a short time (max 2 weeks). There are a few exceptions, such as in case of intact anterior teeth, where the clinician may plan to wait on purpose to see if the anterior open bite resolves by itself.
STEP 3
After the delivering of the White Bite, an anterior open bite is created, providing the space to restore the anterior maxillary teeth in an additive manner, as an alternative to crowns. There are 3 types of Anterior Adhesive Additive Restorations (A3Rs) delivered during the 3STEP:
PALATAL VENEER: a (CAD/CAM monolithic) composite restoration, which mostly addresses the palatal damage and the worn-down incisal edges. The facial limit of this veneer is positioned on the vestibular surface with an overlap (additive chamfer), which could be blended by adding a direct composite or by just polishing the step.
TACO: a (CAD/CAM monolithic) composite restoration, which reconstructs the palatal and the vestibular surfaces at the same time. It has a V shape because the interproximal contact points of the teeth are left intact.
STEP VENEER: this restoration is a modified facial veneer which presents a step at the level of its palatal margin. During the bonding procedure, the step will guide the delivery of an additional direct composite restoration, to obtain a thicker palatal aspect. This restoration can be fabricated both in ceramic or in CAD/CAM composite.
