Objective To examine the clinical performance of resin-based composite restorations placed at an increased vertical dimension when used to manage localised anterior tooth wear. Design A retrospective analysis of cases treated at a single centre. Setting UK Hospital setting in the year 2000. Subjects and Methods Two hundred and twenty five restorations placed in 31 subjects were included. Assessment was made following examination of study casts and projected slides. Modified United States Public Health Services criteria were used and data analysed using the software Statistical Programme for Social Sciences (SPSS). Survival analysis was carried out at two levels, major failure only and all types of failure. Kaplan-Meier survival plots were produced against different variables and modes of failure were also noted. Results Major failure requiring replacement of the restoration was uncommon within the first five years. Minor failure requiring repair or refinishing presented mainly as wear, marginal discolouration or marginal fracture. Median survival was 4 years 9 months when all types of failure were considered. The restorations have good appearance and are well tolerated. Conclusion Placement of resin-based composite restorations at an increased vertical dimension to treat localised anterior tooth wear, has good short to medium term survival. The technique is conservative and relatively easy to maintain.Tooth wear appears to be an increasingly significant problem affecting all ages. 1,2 In particular there is an increased incidence of young patients presenting with moderate to severe, erosive wear caused by intrinsic and extrinsic acids. [3][4][5] Erosion is the most significant cause of tooth wear and has been implicated in 89% of all cases. 6

Patients requiring combined orthodontic and orthognathic surgical treatment make up 7% of a UK-based Orthodontic Consultant's caseload. This has significant time and cost implications within the NHS. In a climate of spending cuts across our health service, a need has arisen to justify service provision. Accordingly, a new index has been devised to aid in the prioritization and provision of care for orthognathic patients. CPD/Clinical Relevance: To carry out a retrospective audit of 44 patients who had orthognathic surgery in the NHS between May 2012 and October 2014, assign each an Index of Orthognathic Functional and Orthodontic Treatment Need, IOFTN and IOTN, score, respectively and identify any differences.