How do you repair abfractions?

Abfractions are notches that can form in teeth on the facial surfaces near the Gingiva . If left uncovered the enlarge over time. One good way of handling them is to place tooth colored bonded restorations to repair and protect the teeth. If done properly they improve the appearance of the teeth as well.  The photo above shows large unrestored abfractions on on the left maxillary lateral incisor and cuspid teeth. Prior to taking this photo I restored large abfractions on the right maxillary lateral and central incisors.

The area was numbed with a local anesthetic, cord packed to slightly retract the gums ( cord still visible in photo) and the walls of the abfraction were scribed by a tiny round bur. The photo below shows this preparation.

At this point the tooth was ready for bonding. The secret to achieving an esthetic result is to use a tooth colored flowable composite as a liner under the outer composite. I use this to mask the dark amber colored dentin that is often found on the gingival part of the tooth. This liner is carefully placed and I make sure to keep it away from the  outer surface  of my preparation ( exposed flowable composite doesn't wear well, but is fine when covered by an over layer of a tougher composite ). After setting the flowable liner I carefully place and sculpt my final composite restoration . Afterwards I use sandpaper and fine diamond burs to finish the restoration. If kept clean these restorations can be serviceable for about 8-15 years and preserve and improve the appearance of the teeth. The photo below shows the repair of the left lateral incisor that was accomplished in about thirty minutes .