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Thegosis--a critical review.

The evidence for tooth sharpening has been examined and it has been concluded that there is no evidence for a posterior tooth sharpening mechanism which is independent of masticatory function and improves the efficiency of that function. Anterior tooth sharpening may occur in some species as behavioural activity but it is not accepted that this sharpening is directed towards the production of new incisiform weapons as distinct from the improvement of existing caniniform weapons, or more efficient tools for the manipulation of food. Thegosis (from the Greek, thego to whet or sharpen) is a term which could be used to describe the sharpening of anterior teeth under specific often socially context driven situation. Stress is accepted as a cause of non-masticatory tooth to tooth contact as is the suggestion that excessive tooth grinding and clenching is pathological and stress related. Bruxism and pathological thegosis are suggested synonymous terms for this activity.

Animals↗

Dental erosion and bruxism. A tooth wear analysis from south east Queensland.

Tooth-tissue loss from erosion and attrition from bruxism were associated findings in 104 patients with excessive toothwear from South East Queensland. Approximately one-third of these subjects had been given a diagnosis of bruxism prior to referral. After a structured interview and clinical examination, the prevailing diagnosis was tooth erosion associated with occupational or sports-related dehydration, and one-third of the subjects were provisionally classified as bruxers. Eight items of clinical history and examination, designed to differentiate bruxers from non-bruxers, were analysed retrospectively from their records. These clinical items, by which the diagnosis of bruxism might be made, segregated the subjects into three groups of equal size, 'bruxers, possible bruxers and non-bruxers,' by a notional score for bruxism. The presence of occlusal attrition or erosion on the sextants of the dentitions was determined by scanning electron microscopic criteria on epoxy resin dental casts. The incidence of attrition versus erosion was compared between the three groups. The hypothesis was that attrition would be found on more sextants of bruxers than non-bruxers. Erosion predominated in virtually all sextants in all three groups, to the virtual exclusion of attrition in the molar sextants. The exception was the mandibular anterior sextant, where more sextants in bruxers were affected by attrition. Thus extrinsic or intrinsic acid erosion was strongly associated with occlusal tooth wear found in bruxers. Conversely, tooth-wear patterns were unreliable indicators of a bruxing habit, for attrition alone was often found on acid-exposed teeth. Thus, even if a patient is suspected of having bruxism, dental erosion is more likely the cause of tooth-tissue loss than attrition, especially in the dehydrating environment of South East Queensland.

Adult↗

Clinical evaluation of EBS dentine bonding agent: one year results.

There are numerous dentine bonding agents currently on the market, the majority of which adhere by means of infiltration of a hydrophilic polymerizable diacrylate into dentinal collagen exposed by acid treatment. The purpose of the present study was to evaluate the clinical performance of one such product, EBS dentine bonding, in non-undercut caries-free cervical lesions. Forty cavities were restored in eight patients of mean age 53 years. The manufacturer's instructions were followed, which involved essentially etching the enamel and dentine for 20 seconds with 32 per cent phosphoric acid, application and evaporation of EBS Primer, followed by placement and curing of EBS Bond, and restoring the cavity with Pertac II (ESPE) hybrid resin composite. Restorations were photographed at base line and one year for evaluation of marginal discolouration on a continuous linear rating scale. At six months, one patient with four restorations was not available; the remaining 36 restorations were all present. At one year, one restoration was missing, giving a cumulative retention rate of over 97 per cent. One of the 36 restorations exhibited very mild marginal discolouration.

Acid Etching, Dental↗

Tooth wear in children with Down syndrome.

BACKGROUND: Several studies have described the impact that dental caries and periodontitis may have on the dentitions of individuals with Down syndrome, but there are few reports about the effects of tooth wear. This investigation aimed to compare the aetiology, prevalence and severity of tooth wear in 49 cytogenetically confirmed Down syndrome children with 49 non-Down syndrome controls. METHODS: This study involved three aspects: an oral examination, including obtaining dental impressions; a dietary analysis spanning three days; and a questionnaire seeking information about habits, medical problems and medications. Tooth wear severity was scored on a 4-grade scale (none-to-little; moderate; severe; very severe), while aetiology was classified as being due to attrition mainly, erosion mainly, or a combination of both. Double determinations established scoring method reliability and chi-square tests assessed associations between samples. RESULTS: Tooth wear was significantly more frequent (p<0.01) in the Down syndrome than the non-Down syndrome sample (67.4 per cent cf 34.7 per cent), with more of the Down syndrome children showing severe to very severe wear (59.2 per cent cf 8.2 per cent). Significantly more Down syndrome children (p<0.05) displayed a multifactorial aetiology of tooth wear, i.e., both attrition and erosion (46.7 per cent cf 28.6 per cent), although no particular dietary link was established. Gastric reflux and vomiting were reported in over 20 per cent of the Down syndrome sample. CONCLUSIONS: Given the potential consequences of high levels of tooth wear, associated with tooth grinding and an acidic oral environment in Down syndrome children, educational programmes aimed at increasing awareness of carers and health professionals are needed urgently.

Adolescent↗

A model for the prediction of tooth wear in individuals.

BACKGROUND: Easily applied, age-specific standards are useful in assisting clinicians to decide whether the extent of tooth wear observed in a given patient at a specific age is acceptable or whether intervention is indicated. METHOD: A simple method of scoring tooth wear and previously established mathematical relationships between tooth wear scores and age, provide the basis of a method for predicting tooth wear scores. In its most specific form, the method can be used to predict tooth wear scores for individual patients at subsequent ages. Alternatively, tables or graphs can be consulted to provide a less precise prediction of tooth wear that can assist clinicians to decide whether the amount of wear reflects high, moderate or low rates of wear at the specified age. CONCLUSION: In cases where there is no reason to believe that aetiological factors have changed significantly over time, data obtained from the methods described can assist clinicians to plan appropriate management for patients presenting with unacceptable levels of tooth wear.

Age Factors↗

Prevalence and side preference for tooth grinding in twins.

BACKGROUND: Estimates of the prevalence of tooth grinding in children range considerably, reflecting different methods of recording. The main aims of this study were to determine the prevalence of tooth grinding in monozygotic (MZ) and dizygotic (DZ) twin pairs by assessing wear faceting on the primary canines, and to compare the faceting on the right and left to determine whether children have a side preference for grinding. METHODS: The sample consisted of 116 MZ twin pairs and 124 dizygous DZ twin pairs, all participants in an ongoing study of dento-facial development at the dental schools in Adelaide and Melbourne. Evidence of wear faceting on primary maxillary and mandibular canine tips was recorded from dental casts, and the side with the larger wear facet recorded. Types of occlusal relationship, handedness, zygosity and gender were also recorded, and associations between variables analysed statistically. RESULTS: Canine tip wear facets were found in 100 per cent of the sample, and grinding was lateralized in 59 per cent of children. MZ twin pairs showed a higher discordance for grinding side preference than DZ twin pairs (33.8 per cent compared with 16.8 per cent), providing evidence of a mirror-imaging effect for grinding side preference. There was no strong evidence that individuals had the same preference for grinding side and handedness, although right-handers (RH) showed a preference for a grinding side more often than non-right-handers (NRH) (63.6 per cent compared with 51.2 per cent), consistent with previous findings that RHs display more cerebral lateralization than NRHs. CONCLUSIONS: Tooth grinding appears to be a universal phenomenon in children and is commonly expressed more on one side than the other. The significantly higher discordance for grinding side preference in MZ twin pairs compared with DZ twin pairs may reflect a mirror-imaging effect in the former. However, at present we have no evidence to suggest that handedness and preferred tooth grinding side are associated.

Adolescent↗

Tooth surface loss in adult subjects attending a university dental clinic in Trinidad.

OBJECTIVES: To determine the prevalence of tooth surface loss (TSL) in a sample of subjects attending a university dental clinic in Trinidad and to investigate the relationship to tooth brushing, medical history, parafunction and dietary habits. DESIGN: Tooth surface loss was measured clinically by the index used in the 1998 UK, Adult Dental Health Survey. SETTING: Trinidad, West Indies. PARTICIPANTS: Convenience sample of adult subjects attending The University of the West Indies Dental School Polyclinic, Mount Hope. METHODS: A questionnaire was administered and tooth surface loss measured clinically. MAIN OUTCOME MEASURES: mild, moderate and severe tooth surface loss. RESULTS: 155 subjects were examined (mean age 40.6 years) of whom 72% had some degree of TSL with the majority (52%), exhibiting mild, 16% with moderate and 4% with severe TSL. There were associations found between TSL and age (OR=3.14), reflux (OR=1.37), parafunction (OR=1.06), weekly consumption of citrus fruits (OR=1.31) and soft drinks (OR=1.78), daily consumption of alcohol (OR=1.40) and a vegetarian diet (OR=2.79). CONCLUSIONS: Tooth surface loss in this Trinidadian population group appears to be common. Data supports an association between TSL and age, reflux parafunction and certain dietary patterns.

Adolescent↗

Thickness measurement of worn molar cusps by ultrasound.

This study aimed to evaluate the effectiveness of an ultrasonic system for in vitro measurement of cusp tips of human teeth. Each worn cusp of 12 molar teeth was measured with an industrial ultrasonic system. The teeth were sectioned and measured by polarized light microscopy. The ultrasonic measurements and histological readings were moderately correlated (r = 0.601, p < 0.01). The ultrasonic system used in this study seemed a promising method for measuring thickness of worn cusp tips of extracted human molar teeth.

Dental Enamel↗

Tooth wear.

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Dental Enamel↗

Definition of erosion and links to tooth wear.

Erosive tissue loss is part of the physiological wear of teeth. Clinical features are an initial loss of tooth shine or luster, followed by flattening of convex structures, and, with continuing acid exposure, concavities form on smooth surfaces, or grooving and cupping occur on incisal/occlusal surfaces. Dental erosion must be distinguished from other forms of wear, but can also contribute to general tissue loss by surface softening, thus enhancing physical wear processes. The determination of dental erosion as a condition or pathology is relatively easy in the case of pain or endodontic complications, but is ambiguous in terms of function or aesthetics. The impact of dental erosion on oral health is discussed. However, it can be concluded that in most cases dental erosion is best described as a condition, with the acid being of nonpathological origin.

Dental Occlusion↗

The cheek teeth of the rabbit: morphology, histology and development.

A detailed anatomic and histologic description of the cheek teeth of the rabbit, both deciduous and permanent, is presented, together with the chronology of their pre- and postnatal development. The deciduous teeth are of limited growth, while the permanent ones grow continuously. Certain aspects of cementogenesis in these teeth are discussed.

Animals↗

Cranial and dental anomalies in three species of platyrrhine monkeys from Nicaragua.

This paper presents information on the cranial and dental anomalies observed in the crania of three species of platyrrhine monkeys collected in Nicaragua. Cranial anomalies that are discussed include plagiocephaly, bregmatic fontanelle bones, Wormian bones, cranial trauma, and heterotopic bones. Among the dental anomalies that were studied were the following: crazing caries, periodontal and pulpal disorders, alveolar thinning, mechanical loss, excessive attrition, shear bite, impacted molars, supernumerary teeth, congenital agencies, congenital crown aberration, and irregular placement.

Alouatta↗

Demineralization of human dentine compared with enamel in a pH-cycling apparatus with a constant composition during de- and remineralization periods.

A comparison was made between the demineralization of enamel and dentine with and without abraded surfaces. This was done in a pH-cycling experiment for different demineralization/remineralization ratios--in the range from 1:1 to 1:4--and for different fluoride additions (up to 2 ppm) in solution. A new automatic pH-cycling system, in which the de- and remineralization solutions have a constant composition during the de- and remineralization cycles, was used to create mineral loss in human dentine and enamel. Changes in mineral content were monitored by means of longitudinal microradiography. A linear correlation was found between the amount of mineral lost and the total demineralization time for both dentine and enamel. The demineralization rates were comparable for abraded enamel and dentine and for polished enamel and dentine, and this rate was roughly doubled by the removal of the outer surface for both tissues. This showed that the presence of the outer surface is equally important to dentine and enamel. Under the pH-cycling conditions used, a logarithmic relation was found between the addition of fluoride and the decrease in demineralization for both enamel and dentine. The inhibitory effect of fluoride on demineralization was most pronounced on abraded enamel, followed by pumice-polished enamel, abraded dentine and pumice-polished dentine. About 2 ppm fluoride was needed under the conditions used to stop enamel demineralization completely; in the case of dentine, however, this amount of added fluoride did not inhibit demineralization.

Analysis of Variance↗