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Periodontal status and bruxism. A comparative study of patients with periodontal disease and occlusal parafunctions.

This study investigated a possible association between bruxism and severity of periodontal disease. Subjects consisted of 51 patients (mean age 47.3 years) referred to the Department of Periodontology for treatment of moderate to severe periodontal disease (Perio-group) and 40 patients (mean age 48.9 years) referred to the Department of Stomatognathic Physiology for treatment of symptoms related to bruxism (Bruxism-group). Examination of the two groups included measurements of the alveolar bone height, probing attachment level, tooth mobility, and attrition of teeth. A questionnaire was also used to gain information on the patient's awareness of bruxism and tooth mobility. Awareness of clenching and/or grinding was reported by 57% of patients in the Bruxism-group and 24% of patients in the Perio-group. The perio-patients reported significantly higher frequency of tooth mobility than did the bruxism-patients. Alveolar bone loss, attachment loss, and tooth mobility were significantly more pronounced in the Perio-group than in the Bruxism-group. The Bruxism-group showed a higher frequency of tooth attrition than the Perio-group. Periodontal disease and bruxism seldom occurred in the same individual, and the results indicate that the two phenomena are in general not closely associated.

Adult↗

[Prevalence of non carious dental lesions in the department of Dakar].

Non carious dental lesions are destructions of dental external surfaces originating from non bacterial cause in opposition to dental caries. We distinguish 5 types of non carious dental lesions: attrition, abrasion, abfraction, erosion and demastication. These lesions may be pathological or physiological. Data dealing with them are not very numerous in the literature. Their study shows a real interest in conservative dentistry because of problems both aesthetic and functional they set We carried out an epidemiological trial in the department of Dakar with as aim providing data on the prevalence of these lesions. Our results have disclosed the following rates of prevalence: 60% of attrition, 25,55% of abrasion, 7,22% of abfraction, 5,55% of demastication and 1,68% of erosion. The results indicate once more the importance of the need for clinical evaluation of those dental lesions.

Female↗

[Dentition of the older animal].

Ageing is accompanied by the natural loss and wear of hard and soft dental tissues. While ageing can influence pathological processes affecting the dentition, it is not the cause of these processes. The development, growth, attrition, abrasion, and loss of teeth is determined in part by ageing. Periodontal disease is the result of the accumulation of dental plaque and can occur in young animals. Unfortunately, gingivitis or periodontitis is often not diagnosed or diagnosed too late by pet owners and veterinarians.

Aging↗

A retrospective study of dental conditions of captive brown bears (Ursus arctos spp.) compared with free-ranging Alaskan grizzlies (Ursus arctos horribilis).

The teeth of 63 skulls of brown bears (Ursus arctos spp.) that had lived in the Bernese bear pit between 1850 and 1995 were examined and radiographed for occlusion, loss of teeth, calcified dental plaque and calculus, attrition, and caries. Dental pathology and periodontal status were evaluated with respect to age and location in the dentition. Further techniques such as computed tomography, microhardness testing, histologic sectioning, and scanning electron microscopy were used in selected cases to verify the macroscopic and radiographic diagnoses. Fourteen skulls originating from free-ranging wild Alaskan brown bears (Ursus arctos horribilis) were examined as a control group. For zoo bears over 10 yr old, severe enamel and dentinal attrition has been observed in canine teeth, with exposed pulp and proximal lesions in molar teeth. Deposits of calcified dental calculus were found in various locations and increased with age. A much lower degree of calculus deposition was found in the Alaskan grizzlies, whose average caries frequency was higher but with large individual variation and different locations in canine teeth and occlusal lesions in molar and premolar teeth. Radiographic evaluation of perialveolar osteolytic processes revealed a greater frequency of apical and combined apical-marginal lesions of the alveoli in zoo bears over 10 yr old. Stereotypical behavior like cage chewing is a suspected cause of canine tooth and secondary alveolar lesions, whereas a nutritionally inappropriate diet and inadequate opportunities for tooth-cleaning activities are responsible for the lack of natural cleaning and the extensive calculus formation that results. The methods used in this study are useful in assessing and comparing the dental health status of free-ranging bears, and those living in zoological gardens, by evaluating anesthetized bears or bear skull collections representing both groups.

Age Factors↗

Multiple regression models for age estimation by assessment of morphologic dental changes according to teeth source.

The aims of this study were twofold: (1). to measure parameters that contribute significantly to estimates of dental age, using a combination of classic methods and a computer-assisted image analysis procedure to avoid the bias inherent in observer subjectivity; and (2). to develop new mathematical regression models for age prediction according to postmortem interval. Two different populations were studied. Forty-three permanent teeth (Group I), extracted for valid clinical reasons, were taken from patients 25-79 years of age. The other population group (Group II) was composed of 37 healthy erupted permanent teeth obtained from human skeletal remains (age 22-82 years) with a postmortem interval ranging from 21 to 37 years. Morphologic age-related changes were investigated by measuring variables on intact and half-sectioned teeth. Multiple regression analyses were performed with age as the dependent variable for each sample source. In fresh extracted teeth, the variables that made the greatest contributions to predictions of age were dental attrition, dentin color, and translucency width, the latter measured with a computer-assisted image analysis method. In teeth from human skeletal remains, the variables that made the greatest contributions to age calculation were cementum apposition, pulp length measured by computer-assisted image analysis, dental attrition, root translucency, and dental color. We conclude by recommending different regression models to calculate age depending on the postmortem interval.

Adult↗

Prevalence of dehiscences and fenestrations in modern American skulls.

BACKGROUND: The purpose of this study was to examine the prevalence, distribution, and features of alveolar dehiscences and fenestrations in modern American skulls and correlate their presence with occlusal attrition, root prominence, and alveolar bone thickness. METHODS: A representative sample of 146 dentate modern American skulls from a collection at the National Museum of Natural History were examined. RESULTS: The skulls were from subjects ranging in age from 17 to 87 years old (mean 49.1 years). The mean number of teeth per skull was 22.7 and the mean number of either dehiscence or fenestration defects per skull was 3.0. Of the 3,315 individual teeth examined, 4.1% (135) had dehiscences and 9.0% (298) had fenestrations. A dehiscence was present in 40.4% of the skulls, and a fenestration was present in 61.6% of skulls. Mandibular canines were most often affected by dehiscences (12.9%), while maxillary first molars were most often affected by fenestrations (37.0%). Sixty-seven percent of dehiscences were found in the mandible, and 58% of fenestrations were found in the maxilla. CONCLUSIONS: The presence of dehiscences and fenestrations were positively correlated with thin alveolar bone and negatively correlated with occlusal attrition. African-American males and Caucasian females were significantly more likely to have dehiscences, while African-American females were significantly more likely to have fenestrations.

Adolescent↗

Dentinal dysplasia type I: review of the literature and report of a family.

A family is reported with dentinal dysplasia type I affecting both dentitions. Presenting features included unusual mobility of the teeth, followed by early exfoliation; normal clinical shape of the crowns of the teeth, but with an amber color without any sign of attrition or abnormal loss of enamel. Radiographic findings showed pulp-chamber and root-canal obliteration, poor root formation, radiolucent linear appearance of the pulp chamber parallel to the cementoenamel junction and frequent periapical radiolucencies. Histological studies have reported large masses of calcified tubular dentin, atypical osteodentin, and also true denticle.

Adult↗

A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion.

The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.

Dental Enamel↗

Erosion and attrition of human enamel in vitro part II: influence of time and loading.

OBJECTIVES: To determine the influence of load and time on enamel wear by attrition under neutral and acid environments in vitro. METHODS: Groups of 10 enamel cusp and smooth surface specimens obtained from unerupted third molars were opposed in a wear machine under loads of 200, 400 and 600 g in citric acid at pH 3.2 and in physiological saline at 35 degrees C for 30 min (2280 wear cycles). The experiment was repeated with a load of 600 g for 10 and 20 min accompanied by 10 taped specimens to measure erosion only. Erosion and attrition of smooth surface specimens was determined by profilometry. RESULTS: At a load of 600 g attrition in saline increased with time from 7.9 microm (SD 3.7 microm) at 10 min, 10.2 microm (SD 4.8 microm) at 20-25.5 microm (SD 9.1 microm) after 30 min and combined attrition/erosion in citric acid from 1.5 microm (SD 0.4 microm) to 2.5 microm (SD 0.9 microm) to 6.0 microm (SD 3.7 microm). At a fixed time of 30 min, attrition in saline was 5.2 microm (SD 3.6 microm) at 200 g and 8.1 microm (SD 1.5 microm) at 400 g and combined attrition/erosion in citric acid 2.8 microm (SD 1.2 microm) and 3.6 microm (SD 0.7 microm). Comparison between both environments revealed significant differences at fixed load at all time points (p < 0.01) and at fixed time between 400 and 600 g (p < 0.01). CONCLUSIONS: Load and time significantly influence enamel wear both in acid and neutral conditions but the effects were not linear.

Adolescent↗

Toothbrush abrasion, simulated tongue friction and attrition of eroded bovine enamel in vitro.

OBJECTIVES: Enamel erosion results in the formation of a softened layer that is susceptible to disruption by mechanical factors such as brushing abrasion, tongue friction and attrition. The aim of this study was to investigate the individual contribution of those mechanical insults to the enamel loss caused by dental erosion. METHODS: Forty two bovine enamel samples were randomly divided into seven groups (n=6 per group) that were submitted to 3cycles of one of the following regimes: erosion and remineralization (er/remin); toothbrush abrasion and remineralization (abr/remin); erosion, toothbrush abrasion and remineralization (er/abr/remin); attrition and remineralization (at/remin); erosion, attrition and remineralization (er/at/remin); simulated tongue friction and remineralization (tg/remin); erosion, simulated tongue friction and remineralization (er/tg/remin). Erosion took place in a demineralization solution (50mM citric acid, pH 3) for 10min under agitation. Brushing abrasion, tongue friction and attrition were simulated for 1min using a home-made wear device. Remineralization was carried out in artificial saliva for 2h. Enamel loss was quantified using optical profilometry. RESULTS: One-way ANOVA indicated a significant difference between the amounts of enamel lost due to the different wear regimes (p<or=0.001). Multiple comparisons with Bonferroni procedure showed that the wear depths found for the er/at/remin (p<or=0.001) and er/tg/remin (p<or=0.001) were significantly higher than the amount found for the er/remin group (4.4+/-0.7microm). This was not the case for er/abr/remin group (p=0.075). CONCLUSIONS: The results suggest that the three forms of mechanical insults remove to varying extent the softened layer formed by the erosion challenges.

Animals↗

Sites of dental erosion are saliva-dependent.

Acid demineralization of teeth causes occlusal erosion and attrition and associated non-carious cervical lesions at sites relatively unprotected by saliva. Associations of occlusal pathology and cervical lesions were looked for in 450 patients with toothwear, and 174 subjects with cervical lesions were identified. Associations of occlusal attrition, or erosion, or no wear, with cervical lesions at 72 buccal and lingual sites were recorded from epoxy resin replicas of the subjects' dentitions (3241 teeth). Criteria used to discriminate occlusal erosion from attrition; and shallow from grooved and wedge-shaped cervical lesions were delineated by scanning electron microscopy (SEM). In the absence of occlusal pathology, cervical lesions were very rare (<1%). In the presence of occlusal pathology, cervical lesions were present in 27.71% of buccal sites as opposed to 2.61% of lingual sites. The commonest site of cervical lesions was the facial of maxillary incisors (36% of sites). The least common site was the lingual aspect of mandibular molars (1.7% of sites). These differences may reflect the normal protective role of serous saliva and salivary pellicle in a site-specific manner, on the lingual surfaces of mandibular teeth particularly, and do not support abfraction as the prime aetiology of cervical lesions.

Adult↗

A microradiographic and electron microscopic study of tertiary dentin in human deciduous teeth.

This study deals with the structure of the inorganic phase of tertiary dentin, and is limited to dentin formation caused by mild or moderate stimuli, e.g., attrition or initial or shallow carious lesions. Ground sections were prepared from 20 human deciduous teeth extracted mainly because of orthodontic treatment, and contact microradiographs were produced. Based on visual inspection of the ground sections in reflected and transmitted light and microradiographic findings, small areas were dissected out and processed for electron microscopy. In the tertiary dentin formed in the pulp horns the number of tubules was reduced, while in that on the side walls of the pulp there was often no marked reduction in the number of tubules. Several tubules could be followed from the physiological (primary and secondary) dentin into the tertiary dentin, and a change in the direction of the tubules was often noted. Interglobular dentin was frequently observed, and in some teeth incremental lines with alternating high and low mineral content were seen, indicating that tertiary dentin, like other mineralized tissues, is subject to biological rhythms during formation. When studied in the electron microscope, tubules with varying size and distribution as well as occluded tubules with a high mineral content were seen. The tubules often had an irregular circumference with projections of mineralized tissue protruding into the lumen. Highly mineralized peritubular dentin was rarely observed. The present results show that orthodentin is formed when dentin in primary human teeth is exposed to mild or moderate stimuli.

Dental Cavity Preparation↗

Depressed eruption dental rate in rats with hemodynamically-mediated acute renal failure.

The effects of acute renal failure on the impeded (IER) and unimpeded (UER) eruption dental rate and attrition rate (AR) were investigated. Adult female Wistar rats were injected with 125 mg/kg b.w of human methemoglobin (M-Hb) in order to induce a first episode of hemodynamically-mediated acute renal failure (H-ARF). Ten days after the injection of M-Hb, other groups of rats received another equal dose of the drug in order to induce a second episode of H-ARF. A group of six animals was pair-fed daily and individually with rats of M-Hb groups. Evaluation of renal function, histopathology studies, IER, UER, food intake (FI), AR and body weight gains was performed at different times after the first and second injections, of M-Hb. Treatment induced transient increases in plasma urea concentration and urine volume, and significant depression in urine osmolality, body weight gains, IER, UER and AR. In every case, the maximal effect of the first injection of M-Hb on the individual parameters was always greater than that of the second injection. Histologic sections showed interstitial cellular infiltration, desquamation of the proximal tubular epithelium and collapse or dilation of the tubular lumen. The functional values of kidney, histologic findings, IER, UER and AR of the pair-fed rats were not significantly different from control values. The results of the present study indicate that dental eruption rate (IER and UER) is relatively low in uremic rats with kidney tubule lesions and that both parameters are related.

Acute Kidney Injury↗

The effects of dental wear on third molar eruption and on the curve of Spee in human archaeological dentitions.

The abrasiveness of food is a key determinant in the rate of physiological attrition (dental wear) in humans. With increasing food processing through time, the rate of physiological dental wear in human teeth has decreased markedly. Many consider such wear to be beneficial to oral health and that insufficient wear may result in impaction of the third molars. If enhanced extraoral food processing provides an evolutionary advantage, then it is possible that agenesis of the redundant third molar may follow. One of the aims here was to examine impaction and agenesis of the third molars in four populations of varying antiquity and hence varying dental-wear rates. Paradoxically, whilst there is a decrease in the rate of dental wear with modernity, there is also an increasing prevalence of advanced dental wear due to prolongation of the lifespan of the human dentition. As the effect of dental wear on the curve of Spee was unknown, a second aim was to examine it in an archaeological population with a high rate of dental wear. The results showed an increase in non-eruption and impaction of the third molars with modernity, but did not demonstrate a significant increase in the rate of agenesis. The time period over which impaction and agenesis could be discerned was of the order of 600 years and this may not be sufficient to observe adaptive changes at the genetic level in humans. In molar teeth there was no clear indication of maintenance of the curve of Spee with dental wear. This has potential implications on the design of prostheses for the worn dentition.

Adult↗

[Current terminology for tooth wear].

In general dental practice the "abrasion" diagnosis is universally used for the loss of any tooth structure irrespective of its etiology. The author's aim was to summarize and classify the types of non-caries-related tooth wear (i.e. attrition, abrasion and erosion) based on their etiology and clinical features. All dental practitioners should be aware of the criteria of differentiation and the principles of differential diagnoses because only the elimination of the etiologic factors can ensure permanent therapeutic effect. On he other hand dental practitioners should also be familiar with this field to be able to recognize the early symptoms of certain general diseases that can initially be diagnosed in he dental office. Besides the elimination of the causative factors other specialist should also be involved in the comprehensive treatment to provide long-term success and arrest the progression of the disease.

Humans↗

Oral health in alcohol misusers.

One hundred and seven chronic alcohol misusers (mean age 42.9 years; range 21-65 years; 80 males) attending four centres in South East London were interviewed on their current and past alcohol consumption. Their nutritional status (body mass index (BMI) and mid arm muscle circumference) was also recorded. Each subject completed a dental and oral mucosal examination. Ninety four per cent of the sample consumed greater than 50 units of alcohol per week and 80 per cent greater than 100 units of alcohol per week. Smoking and alcohol misuse were found to be related, 81 per cent reporting both habits. Neither plaque index scores or mean subject pocket depths were correlated with alcohol consumption but both were positively correlated with the frequency and duration of smoking. Overall mean DMFT was 15.4; age specific mean DMFT and tooth loss of the sample were closely similar to the 1988 United Kingdom adult dental health survey data. The prevalence and severity of tooth wear and attrition were greater in the sample than levels described in the literature and these dental features may prove useful markers to the practitioner. Trauma to teeth and oral mucosae was noted in 25 per cent of the sample. Seven oral mucosal lesions (including one treated carcinoma) were detected; mucosal trauma could have acted as a co-factor. Furthermore, 21 per cent of the alcoholics were malnourished (BMI < 20). It is concluded that, unlike several reports from the United States, dental health in this sample of alcoholics is not compromised; however mucosal health is a cause for concern.

Adult↗