When (and when not) to use the Dahl Concept

Abstract

The Dahl Concept describes the re-establishment of occlusal contacts after the provision of a planned localised appliance or restoration in supraocclusion. Initially developed to create space for prosthetic rehabilitation of anterior teeth suffering from localised wear, the principle has later been successfully applied to a variety of situations, including the Hall technique and resin-bonded bridges cemented in supraocclusion. Despite high levels of success seen in the relevant literature and widespread adoption in specialist care, the wider profession appears to be far more cautious in its use. This article aims to provide a brief summary of the Dahl Concept and discuss the local and general factors that influence its successful implementation in the hope of promoting its increased adoption by the broader dental profession.

Key points

The Dahl Concept is a predictable treatment modality involving the triad of tooth intrusion, tooth extrusion and mandibular distalisation.

General considerations include age, occlusal adaptability, skeletal and incisal pattern, history of temporomandibular disorders, parafunctional habits and altered bone metabolism.

Local considerations include the presence of retainers/splints and implants/fixed prostheses, as well as periodontal status, restoration choice and restoration material and thickness.