There are several issues with this patient's teeth. He is a heavy grinder, which is what causes the edges of the teeth to chip away, and the grinding is what causes the wear patterns you can see in the lower image. The yellowish area is the second layer of tooth structure, which is the dentin. The dentin is much softer than the outer layer of tooth, which is enamel. If you look closely at the top image, you will also see that the teeth are starting to wear away at the gum line, which can be caused by grinding or it can be caused by brushing too hard.

The treatment consisted of composite bonding at the gum line, at the edges of the teeth, and on the inside as well as making a nightguard to protect not only the composite but the tooth structure as well. The results were very good when compared to the before images. The patient did not want the space closed.

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