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aesthetic and restorative dentistry case report | times based on personal experience and belief, rather than on scientific or clinical evidence. The rather abundant clinical literature dealing with the clinical behaviour of composite and ceramic inlays and on lays has not shown a major advantage of either ma terial.33, 34 I clearly favour composite in the context of tooth wear. Were ceramics to be chosen, the Empress material (Ivoclar Vivadent), which has shown limited annual failure rates,35 and, of course, today’s new lithium disilicate pressed ceramic (IPS e.max Press, Ivoclar Vivadent), with improved flexural strength and fatigue resistance,36 would be considered the best choice. Longevity of restorations placed to correct severe tooth wear and erosion Clinical studies have demonstrated that the perfor mance of composite in the treatment of advanced tooth wear is adequate and that partial fractures represent the most likely complication. These can be corrected by a repair or uncomplicated replacement of the restoration.3739 The ten year survival rate of porcelainfusedtometal crowns has been proved to be slightly superior to that of composite restorations, but with much more severe complications: Porce lainfusedtometal failures led mainly to endodon tic treatments or to extractions, while composite fail ures or fractures could be either repaired or replaced.40 This again demonstrates the reason the conservative and adhesive approach is favoured for treating all kinds of mild to moderate forms of tooth wear and erosion. Conclusion The incidence of tooth wear represents an increasing concern for the dental team and has multifactorial origins. Behavioural changes, an unbalanced diet, various medical conditions and medications inducing acid reflux or influencing salivary composition and flow rate trigger erosion. In addition, awake and sleep bruxism are widespread functional disorders that cause severe abrasion. It is then increasingly import ant to diagnose early signs of tooth wear so that proper preventive and, if necessary, restorative mea sures are taken, with the focus on biomechanics and longterm tissue preservation. Acknowledgments I would like to thank Serge Erpen (Oral Pro, Geneva, Switzerland) for the fabrication of the waxups presented in Figures 2d and f._ Editorial note: This article was first published in Clinical Masters magazine 1/2016. Fig. 2r Fig. 2s Figs. 2r & s: Five-year recall. The patient never did wear a night guard despite it being recommended. We can observe some additional tooth wear, mainly of an erosive nature (see, for instance, the cervical areas of the mandibular premolars). The restorations however show minimal wear or volume loss, apart from microfractures of a few margins (i.e., teeth #46 and 47). A complete list of references is available from the publisher. contact Dr Didier Dietschi, is a senior lecturer at the Department of Cariology and Endodontics at the University of Geneva School of Dental Medicine, Switzerland. He is also an adjunct professor at the Department of Compre- hensive Care at Case Western Reserve University School of Dentistry, Cleveland, Ohio, USA. Dr Dietschi also works at the Geneva Smile Center, a private practice and education centre, in Switzerland. He can be contacted at ddietschi@genevasmilecenter.ch. Geneva Smile Center Quai Gustave-Ador 2 1207 Geneva Switzerland cosmetic dentistry 1 2017 31