CPR for the Worn Dentition with Dr. Denn...

JOIN ELEVATED GP: theelevatedgp.com

How do you restore a severely worn dentition without committing a single bur to the tooth? Dr. Dennis Hartlieb walks through CPR for the Worn Dentition (Concept, Prototype, Restoration), a reversible, additive composite bonding workflow that lets patients test drive a new vertical dimension, tooth length, and smile design for months before any definitive dentistry. After nearly 40 years in practice, he explains why prototyping in direct composite is safer for both the patient and the dentist than going straight from a wax-up to porcelain veneers or crowns.

In this episode, you'll learn:

• What CPR means for worn teeth: concept, prototype, restoration
• Why direct composite prototypes on unprepared teeth are reversible, faster, and more affordable (single-shade composite, no layering)
• How a three-month prototype phase exposes bruxism, parafunction, failing bonding, loose teeth, and TMJ-related bite changes before you prep
• Why porcelain veneer provisionals can't reliably test anterior guidance and function
• Night guards during the prototype phase, airway considerations, and patients who won't wear an occlusal splint
• The habits that break bonding and porcelain, and how he coaches patients that teeth are not tools
• Why repairable composite beats chipped lithium disilicate or feldspathic porcelain in high-risk patients
• His records workflow: photographs, intraoral scan, facebow, analog wax-up, CBCT when joint or airway issues are suspected, and a centric relation bite with a leaf gauge
• Using a bis-acryl trial smile to test aesthetics and phonetics, including catching a lisp before treatment
• Bonding prototypes over existing crowns, zirconia, lithium disilicate, gold, and amalgam with the right surface treatment

Questions answered in this episode:

Can you open vertical dimension reversibly? Yes. Additive composite on unprepared teeth can be removed with carbide burs and discs if the patient isn't happy, returning them to where they started.

How long should a patient wear composite prototypes? Dr. Hartlieb asks patients to live with them for at least three months to watch for failures, bite changes, and aesthetic concerns.

Why not go straight to veneers or crowns? Once a bur touches the tooth, you are committed. Prototypes let the dentist and patient find common ground on function, aesthetics, and phonetics first.

About the guest: Dr. Dennis Hartlieb is a restorative and cosmetic dentist who has practiced for nearly 40 years and teaches the CPR for the Worn Dentition approach to prototype-driven, minimally invasive rehabilitation.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.