The existing crown may have large restorations and may not offer adequate resistance and retention form without substantial alteration. The use of caution, in conjunction with careful diagnosis, treatment planning, and sequencing, is necessary before the final rehabilitation is provided. The etiology underlying the mutilated dentition can be diverse. It may present as developmental, occlusal, chemical, psychological, or systemic in nature. It may also be a combination of these etiologies.
Genetic anomalies can lead to severe wear through developmental disturbances.
Dentinogenesis imperfecta is dentinal dysplasia, a hereditary defect of dentin formation distinguished by low mineral content and high water and organic content. It is characterized by the irregular direction of dentinal tubules in a granular matrix. In addition to significant wear of the occlusal surfaces, the teeth may be translucent or opalescent and the enamel easily fractures, Other findings include the staining of exposed dentin and obliteration of pulp chambers and canals. One of every 8,000 persons is affected by this autosomal dominant inheritance. Both deciduous and permanent teeth are affected.