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Minimizing opposing tooth wear from composite anterior bite ramps: material considerations for clinicians
Summary
This clinical review discusses how composite resin anterior bite ramps used in orthodontics can cause enamel wear on opposing teeth, and highlights material factors — filler size, hardness — that affect abrasiveness, including a brief note on microplastic release concerns.
Anterior bite ramps facilitate overbite reduction by discluding posterior teeth, but may contribute to enamel wear on opposing teeth, particularly when made from resin composites. This article highlights clinical cases of tooth surface loss associated with composite anterior bite ramps and explores material-related factors influencing abrasiveness, such as filler size and hardness. Techniques, such as layering with compomers or flowable composites, may reduce enamel wear while maintaining structural durability. Environmental and biological concerns, including microplastic release, are also discussed. Clinicians are encouraged to consider material properties, apply polishing protocols, and routinely monitor opposing dentition to mitigate risks and inform treatment planning. CPD/Clinical Relevance: It is important to monitor and manage the effects of anterior bite ramps to minimize wear on opposing dentition and reduce the risk of long-term enamel damage.