Broken teeth come in different types. There are two major scenarios, the first is due to some type of trauma – often sports or some other event the patient is aware of when the damage happens. The repair of this type of damage is pretty straightforward. Small repairs can be done in a single visit with filling materials. The modern composites can match tooth colors well and be undetectable without magnification. Larger repairs require more strength than can be provided by simple filling materials and need lab processed materials such as porcelain. This means two visits to complete the repair. On the first visit the remaining tooth is shaped to accommodate the repair material and an impression is made. The lab works indirectly from these models and the finished repair is bonded to the tooth on a follow up visit.
The second type of damage typically occurs without the patient aware of when it happened or during a non-traumatic activity. This is the more insidious type of damage because it is generally the result of subconscious activity of bruxing (teeth grinding). A further clue to this cause is the presence of flattened, worn, shortened, or chipped adjacent teeth. Here, simply replacing the missing structure doesn’t work well because it will still be in the same pathway of destruction that caused the original breakage. Since any repair will always be weaker than the original intact enamel, the repair will be at high risk for failure. In order to have a successful repair of this area, the underlying cause must be appropriately managed first. Some forms of bruxing can be eliminated with bite treatment and others cannot. A differential diagnosis must be made to before going forward with treatment to improve the longevity of the repair.