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PubMed1992

Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis.

The purpose of the present study was to determine the reliability of several selected signs of trauma from occlusion and their relations with severity of periodontitis. 32 moderate to advanced chronic periodontitis patients participated in the study. All teeth present were evaluated for various abnormal occlusal contacts, signs of trauma from occlusion, and the severity of periodontitis. Standardized periapical radiographs were also taken for each tooth. The results demonstrated that: (1) no significant difference occurred in probing pocket depth (PD), clinical attachment loss (AL), or percentage of alveolar bone height (BH) between teeth with and without various abnormal occlusal contacts, i.e., premature contacts in centric relation occlusion, non-working contacts in lateral excursions, premature contacts of anterior teeth or posterior protrusive tooth contacts; (2) teeth with either significant mobility, functional mobility, or radiographically widened periodontal ligament space (PDLS) had deeper PD, more AL and lower BH than teeth without these signs, while teeth with pronounced wear or radiographically thickened lamina dura had less AL than teeth without these findings; (3) 2 combined indices, i.e., the trauma from occlusion index (TOI) and the adaptability index (AI), were proposed for the identification of occlusal trauma and the response of periodontium to excessive biting forces in heavy function, respectively; TOI-positive teeth exhibit deeper PD, more AL and less osseous support than TOI-negative teeth; however, AI-positive teeth had less AL and more osseous support than AI-negative teeth; (4) with identical attachment level, TOI-positive teeth had less osseous support than TOI-negative teeth while the magnitude of difference became greater with an increase of attachment loss.

Adult↗
PubMed1992

Comparative in vitro studies of sonic, ultrasonic and reciprocating scaling instruments.

Flat root surface areas of formalin-stored mandibular incisors with plaque and calculus were scaled by sonic (PHATELUS SONIC SCALER, SONIC FLEX 2000, TITAN-S SONIC SCALER) or ultrasonic instruments (HYGIENIST ULTRASONIC SCALER, CAVITRON) or by a new reciprocating scaling insert for the EVA/PROFIN system. The test areas were photographed by SEM and coded micrographs were independently graded by three examiners using the RCI (Remaining Calculus Index) and the RLTSI (Roughness Loss of Tooth Substance Index). The findings revealed that the sonic scalers as a group removed calculus more completely but also left significantly more roughness and loss of tooth substance than the other instruments tested. No difference was seen between the two ultrasonic scalers. The reciprocating insert gave results similar to those of the ultrasonic except for the scaling time which was significantly longer for the new "cleansing principle".

Dental Calculus↗
PubMed2004

Surface wear on cervical restorations and adjacent enamel and root cementum caused by simulated long-term maintenance therapy.

BACKGROUND: In an in vitro study, the surface wear on cervical restorations and adjacent enamel and root cementum caused by different tooth-cleaning methods in simulated long-term therapy was investigated. METHODS: Cervical restorations of amalgam (Oralloy), modified composite resin (Dyract), glass-ionomer cement (ChemFill Superior), and composite (Tetric) were instrumented by POL (polishing), CUR+POL (curette and polishing), US+POL (ultrasonic device with polishing) and the polishing agents Cleanic and Proxyt in a computer-controlled test bench. Treatment time corresponding to a real-time period of 5 or 10 years. Substance loss from instrumented surfaces was measured with a digital gauge. A three-way anova was used in the statistical evaluation. RESULTS: The results showed that POL led to slight substance loss, which was greater using Cleanic (27 microm) than Proxyt (5 microm). CUR+POL produced a significantly greater substance loss than did US+POL, with 186 microm versus 35 microm on glass-ionomer cement, respectively, and 123 microm versus 18 microm, respectively, on root cementum, followed by composite (111 microm versus 27 microm, respectively), polyacid modified composite resin/compomer (89 microm versus 36 microm), amalgam (75 microm versus 19 microm), and enamel (32 microm versus 23 microm). CONCLUSIONS: As opposed to the use of US+POL or POL, substance loss on cervical restorations and especially root cementum must be expected to result from tooth-cleaning during long-term maintenance treatment using CUR+POL.

Analysis of Variance↗
PubMed1984

Epidemiologic survey of functional conditions of the masticatory system in Belgian children aged 3-6 years.

In this epidemiologic survey 510 children aged 3-6 yr were investigated. Several occlusal and functional parameters were measured: the maximal interincisal distance, the frequency of lateral and frontal crossbite, open bite, the number of tooth contacts on lateral excursions of 3 mm, the wear facets, deviations in opening, pain in muscles and in the TM-joints, TMJ sounds, parafunctional habits. The interincisal distance varied between 25 and 55 mm. This distance increased with age. Only five children had a hypermobility of the mandible (opening more than 55 mm) and 11 a restricted opening movement (less than 30 mm). 7.2% showed a lateral crossbite on the right, and 8.9% on the left, side. The percentage of an open bite decreased with age from 66.7% in the 3-yr-olds to 20.0% in the 6-yr-olds. 33% of the children had only one contact on the working side. As reported by the parents 7.7% had regularly bruxism but 21.8% showed wear facets on the molars and 40.7% on the front teeth. Only in three girls were the TMJ painful to palpation. Dysfunction only occurred in 3.5% of the sample.

Belgium↗
PubMed1991

Oral conditions among German battery factory workers.

The purpose of the study was to evaluate the oral health situation of workers in a modern battery factory; in particular, to describe the prevalence and the severity of dental erosion and attrition in relation to exposure of airborne acids in the work environment. Measurements of the work environment at a German battery factory showed that the workers were exposed to sulfuric acids (0.4-4.1 mg/cm3). All workers at the factory were included in the survey and a total of 61 dentate individuals completed a questionnaire on their work environment, dental health, and symptoms from the mouth, nose, and throat. Information on oral health status, erosion, and attrition was collected by clinical examinations. Nearly all workers reported exposure to etching substances in their work environment: 56% complained of sharp and thin teeth and 29% of short teeth. Poor dental health conditions were observed (e.g. mean D-T = 3.8); the mean number of teeth with crown restoration was 5.3. The prevalence of erosion was 31% and 92% were affected by attrition. Erosion was found only in front teeth while attrition also occurred in posterior teeth. Due to the high level of crown restorations a rather moderate dose-effect relationship was observed. In conclusion, severe erosion and attrition due to sulfuric acid mists should be recognized as an occupational disease.

Acids↗
PubMed1992

An epidemiological study of temporomandibular disorders in university students of Taiwan.

A total of 2033 university students were surveyed for the prevalence of TMD in Taiwan. It was found that 42.9% of the students had one or more signs related to TMD, and females were slightly more frequently found. Clicking of the joint was the most common sign. Occlusal factors such as balancing contact, dental restoration, molar guidance in eccentric movement, etc., were more often found in the TMD group. Scores on stress, general anxiety, emotion and anger were higher in the TMD group while tension, ambition, depression, competition and test anxiety were not as significant. Although the prevalence of TMD in this population is high, the severity and treatment demands are low.

Adolescent↗
PubMed1993

CPITN, DMFT, and treatment requirements in a Nicaraguan population.

WHO basic methods were used to assess CPITN, DMFT, and treatment requirements in a population of 178 persons aged 12-64 yr living in urban and rural areas of Nicaragua. Two groups were examined: individuals presenting for dental treatment at health clinics (30%) and subjects chosen randomly at other locations (70%). Mean ages of both groups were similar although females were found in higher percentages among those presenting for dental care. With the exception of one young individual, all subjects had calculus in at least one sextant. About 26% of the subjects who presented for treatment had a > or = 6 millimeter pocket compared to about 14% of the remainder of subjects. The mean DMFT for health clinic subjects was 16.1 compared to 10.3 for subjects from other locations. Subjects presenting for treatment had twice as many missing teeth and a mean of 0.5 filled teeth compared to 2.4 filled teeth for other subjects. Subjects at the clinics were in greater need of restorative care and extractions, while subjects from other locations were found to have more teeth that did not require any treatment. Health clinic subjects reported more visits to the dentist in the last year than other subjects. Only 80% of those presenting for treatment owned a toothbrush compared to 97% of those examined in other locations, and the latter group reported brushing their teeth more frequently. Attrition was a commonly encountered tooth disorder with 53% of all subjects exhibiting this condition.

Adolescent↗
PubMed1996

The tooth wear index: a flawed epidemiological tool in an ageing population group.

With a greater number of people living longer and tending to retain many natural teeth, the problems associated with tooth wear are likely to place greater demands upon dental professionals in the future. Several attempts have been made to develop an index to measure tooth wear, for use at both the individual and population level. A review of these indices is undertaken, and difficulties experienced with the tooth wear index (TWI) of Smith & Knight (1984) in a large adult dental health survey is discussed. In the elderly population the scoring criteria of the TWI proved to be difficult to apply without additional qualification, and in cases of extreme wear a five-point ordinal scale was found to be inadequate to describe the range of wear observed. The concept of "pathological" levels of wear proposed by the TWI are challenged and modification to the index suggested for use among the elderly population.

Adult↗
PubMed1999

The occurrence of toothwear in users of Ecstasy (3,4-methylenedioxymethamphetamine).

UNLABELLED: Ecstasy users have reported that dry mouth, jaw tension and tooth grinding were common side effects of its use although the influence of these effects upon toothwear have not been previously investigated. OBJECTIVE: This study aimed to compare incisal and occlusal toothwear in Ecstasy users and a group of non-users of Ecstasy but users of other drugs. METHODS: Groups were established by a snowball peer information network from visitors to the "drop-in" Maryland Centre in Liverpool. Volunteers completed a questionnaire about social life, drug use and diet. Clinical examination for wear on the incisal edges and on canine tips was conducted with a mirror and probe, whereas occlusal wear was recorded in impressions and subsequently scored from stone replica casts. The degree of toothwear was scored according to the criteria of the Tooth Wear Index (Smith & Knight, Br Dent J 1984;157:16). RESULTS: Ecstasy users (n = 30) were compared with non-users (n = 28). Toothwear through the enamel into the underlying dentine occurred in 18 (60%) Ecstasy users but in only three (11%) non-users. The overall mean toothwear score in Ecstasy users was 0.63 compared with 0.16 in non-users (t = 4.34, P < 0.001). Dry mouth was reported by 93% of Ecstasy users whilst 89% stated that they clenched or ground their teeth after taking the drug. Tooth grinding commonly continued into the following morning. Carbonated (acidic) beverages were consumed by 93% of the users with a mean of three cans per "trip". CONCLUSION: The severity of toothwear and the number of teeth affected were greater in Ecstasy users than in a group of non-users. The occlusal surfaces were more commonly affected than the incisal, which may indicate jaw clenching rather than grinding as a feature of Ecstasy-induced muscle hyperactivity.

England↗
PubMed1981

Absence of enamel matrix on root-analogue surfaces of rabbit permanent incisors.

Permanent incisors from fetal New Zealand white rabbits aged 27-29 in utero from offspring of New Zealand white rabbits until the 4th d after parturition were processed for scanning electron microscopy. Macroscopic examination and measurements on standardized scanning electron micrographs revealed that the lingual surface of unerupted teeth was covered with developing enamel extending about 2.1 mm from the incisal end as evidenced by the presence of typical Tomes' pits. Such structures were not observed more apically where the lingual tooth surface appeared to be covered by cementum. The permanent incisors erupted into the oral cavity at birth and attrition was initiated within a few hours after parturition, leading to an inverse correlation between attritional loss of tooth substance and extension of lingual enamel. The findings indicate that the enamel-covered, linguoincisal part of the rabbit permanent incisors is not a root-analogue surface. The results are discussed in the light of recent studies on rabbits and rodents.

Animals↗
PubMed1990

A 3-year evaluation of Gluma and Gluma/Scotchbond for restoration of cervical erosions.

Gluma and Gluma/Scotchbond were used in cervical abrasion/erosion lesions mediating a bond between a resinous restorative material and dentin. The lesions were restored without acid etching of enamel and without use of an intermediary layer of an enamel bonding agent. 142 restorations were placed. The restorations were evaluated clinically using the USPHS-system at the baseline and every half year during a 3-yr period. After 36 months the Gluma and Gluma/Scotchbond restorations showed a 14.3% and 7.4% cumulative loss of retention respectively. No secondary caries was observed during the evaluation period.

Adult↗
PubMed1992

Five-year study of cervical erosions restored with resin and dentin-bonding agent.

The cumulative retention rate of a microfilled resin in non-undercut cervical abrasion/erosion lesions was studied over a 5-yr period. The enamel was etched and the dentin was pretreated with either Gluma (n = 75) or the first marketed version of Scotchbond (n = 30). The cumulative 5-yr retention rate of the Gluma fillings was 90% and that of the Scotchbond fillings 47% (the 95% confidence limits were 83-98% for Gluma fillings and 27-67% for Scotchbond fillings). The retention rate with both bonding agents was significantly higher in the maxillary arch than in the mandibular arch.

Acid Etching, Dental↗
PubMed1993

Exaggerated abrasion/erosion of human dental enamel surfaces: a case report.

An atypical, rapidly proceeding abrasion/erosion of the labial enamel surfaces of the maxillary and mandibular incisors and canines in a 27-yr-old man is reported. Ultrastructural examination of a replica of the teeth showed a practically structureless enamel surface both at the initial examination and after 12 months. However, at the end of the period, minor areas of dentin tubules became visible, indicating that a substantial loss of the tooth substance had taken place. The patient's occupation involved daily environmental contact with proteolytic enzymes. In vitro study of enamel exposed to one of the actual proteolytic enzymes showed dissolution of enamel substance, and it cannot be excluded that enzymatic decomposition of the organic enamel matrix is a contributing cause of the observed exaggerated loss of tooth substance.

Adult↗
PubMed1993

An investigation of some factors associated with occlusal tooth wear in a selected high-wear sample.

The aim of the present study was to investigate the influence of some factors associated with occlusal tooth wear in a selected high-wear Swedish sample. The material comprised 59 persons having a mean age of 35 yr within the range 16-70 yr, the criteria for selection being a full or near-full complement of natural teeth, and the presence of definite clinical signs of occlusal wear. A dentition wear index, in addition to anterior, posterior, and arch subindices, was derived from a tooth-by-tooth evaluation of casts. Factors which were found to correlate significantly with increased occlusal wear were age, sex, self-perception of wear, number of teeth, and general health, as well as a number of variables from study-cast analysis. On the basis of the findings, not only is the multifactorial etiology of occlusal tooth wear a reality, but so, too, is the complex interdependence of these factors in the severity of wear.

Adolescent↗
PubMed1996

Four-year evaluation of the effect of 10% polyacrylic acid or water rinsing pretreatment on retention of glass polyalkenoate cement.

To optimize the bonding of glass polyalkenoate (ionomer) cement to dentin, different conditioning methods have been suggested. The effect of two easily applied conditioning methods, a 10-15 seconds cleaning with a 10% polyacrylic acid or rinsing with copious amounts of water, was compared in class V abrasion/erosion lesions. The cervical lesions were restored, without any form of mechanical cavity preparation, with an anhydrous glass ionomer cement. During a 4-yr period, 137 restorations were evaluated every 6 months. Cumulative loss rates after 4 yr were 15.6% for the polyacrylic acid group and 21.9% for the water rinsing group. The difference was not significant. No secondary caries was registered.

Acid Etching, Dental↗
PubMed2004

Undermining of enamel as a mechanism of abfraction lesion formation: a finite element study.

Many workers have suggested that abfraction lesion formation is caused by the physical overloading of enamel. However, an alternative mechanism, involving undermining of the cervical enamel along the amelodentinal junction (ADJ), may be a more realistic explanation. The aim of this study was to examine what effect undermining of the buccal cervical enamel would have on the stress distribution in upper teeth. Two-dimensional plain strain finite element meshes of an upper incisor, canine and first premolar and the supporting periodontal ligament and alveolar bone were developed. Each tooth was loaded with an oblique 100 N load, and the nodal maximum principal stresses (MPS) along a buccal horizontal sampling plane 1.1 mm above the amelo-cemental junction was measured. A discontinuity between the cervical enamel and dentine elements was then introduced (0.1 mm wide) using gap elements. The vertical extent of this defect varied from 0.1 to 0.5 mm. The value of the MPS varied from 1.8 to 209 Mpa, and the lowest values were found for the intact teeth (range 0.6-30.3 MPa). The discontinuity caused a dramatic increase in the numerical values of the MPS, and in many instances these exceeded the known failure stress for enamel.

Bicuspid↗