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PubMed2003

Non-occlusal dental microwear variability in a sample of Middle and Late Pleistocene human populations from Europe and the Near East.

Non-occlusal, buccal tooth microwear variability has been studied in 68 fossil humans from Europe and the Near East. The microwear patterns observed suggest that a major shift in human dietary habits and food processing techniques might have taken place in the transition from the Middle to the Late Pleistocene populations. Differences in microwear density, average length, and orientation of striations indicate that Middle Pleistocene humans had more abrasive dietary habits than Late Pleistocene populations. Both dietary and cultural factors might be responsible for the differences observed. In addition, the Middle Paleolithic Neanderthal specimens studied show a highly heterogeneous pattern of microwear when compared to the other samples considered, which is inconsistent with a hypothesis of all Neanderthals having a strictly carnivorous diet. The high density of striations observed in the buccal surfaces of several Neanderthal teeth might be indicative of the inclusion of plant foods in their diet. The buccal microwear variability observed in the Neanderthals is compatible with an overall exploitation of both plant and meat foods on the basis of food availability. A preliminary analysis of the relationship between buccal microwear density and climatic conditions prevailing in Europe during the Late Pleistocene has been attempted. Cold climatic conditions, as indicated by oxygen isotope stage data, seem to be responsible for higher densities of microwear features, whereas warmer periods could correspond to a reduced pattern of scratch density. Such a relationship would be indicative of less abrasive dietary habits, perhaps more meat dependent, during warmer periods.

Animals↗
PubMed2002

Potential countersample materials for in vitro simulation wear testing.

OBJECTIVES: Any laboratory investigation of the wear resistance of dental materials needs to consider oral conditions so that in vitro wear results can be correlated with in vivo findings. The choice of the countersample is a critical factor in establishing the pattern of tribological wear and in achieving an efficient in vitro wear testing system. This research investigated the wear behavior and surface characteristics associated with three candidate countersample materials used for in vitro wear testing in order to identify a possible suitable substitute for human dental enamel. METHODS: Three candidate materials, stainless steel, steatite and dental porcelain were evaluated and compared to human enamel. A variety of factors including hardness, wear surface evolution and frictional coefficients were considered, relative to the tribology of the in vivo situation. RESULTS: The results suggested that the dental porcelain investigated bore the closest similarity to human enamel of the materials investigated. SIGNIFICANCE: Assessment of potential countersample materials should be based on the essential tribological simulation supported by investigations of mechanical, chemical and structural properties. The selected dental porcelain had the best simulating ability among the three selected countersample materials and this class of material may be considered as a possible countersample material for in vitro wear test purposes. Further studies are required, employing a wider range of dental ceramics, in order to optimise the choice of countersample material for standardized in vitro wear testing.

Analysis of Variance↗
PubMed1996

Considerations for modeling.

There has been a great growth in the biophysical knowledge base of the human masticatory system, which increases the chances of success in numerical and experimental modeling of the oral environment. The chief advances in understanding are in the areas of the dentino-enamel complex, the force-movement cycle of the mandible, mastication, comminution and salivary lubrication. These areas are reviewed, and suggested average clinical conditions are offered as a starting point for experiments in laboratory clinical simulation as it relates to the studies in biomaterials and biomechanics in dental research.

Biomechanical Phenomena↗
PubMed2003

Relative wear of enamel opposing low-fusing dental porcelain.

PURPOSE: This study evaluated the wear of human enamel opposing 5 low-fusing dental porcelains and a traditional feldspathic control. In a second experiment, the repeatability of the test method and the effect of ceramic overfiring on enamel wear were also evaluated. MATERIALS AND METHODS: Five low-fusing dental porcelains--Finesse (FI), Rhapsody (RP), IPS d.Sign (DS), Omega 900 (OM), and Duceram LFC (LFC)--and 1 traditional feldspathic porcelain--VMK 68 (VMK)--were formed into disks (n = 10) and used as substrate for the wear test. Enamel was harvested from extracted human molars and machined into cusps with a 5-mm spherical radius (n = 60). The Oregon Health Sciences University oral wear simulator was used to simulate chewing and the size of the resulting enamel wear facets (in mm(2)) were evaluated after a specified number of chewing cycles. A portion of the experiment was duplicated to assess the repeatability of the data and determine the effects of overfiring on enamel wear. Data were subjected to analysis of variance and post hoc tests to determine significant differences. After wear testing, scanning electron micrographs were made using representative ceramic samples from each group. RESULTS: The results indicate that none of the low-fusing ceramics resulted in significantly less wear than the VMK control. In fact, 3 of the low-fusing porcelains (OM, RP, LFC) resulted in significantly greater enamel wear than VMK. Enamel wear was not significantly affected (p = 0.29) by the increased ceramic firing temperature. Wear data were repeatable, with no significant difference (p = 0.56) between the enamel wear from 2 separate experiments. The results from both experiments indicated that ceramic material significantly affected enamel wear (p <0.001). There was significantly less enamel wear opposite DS than LFC. CONCLUSIONS: This work suggests that variations in ceramic composition and microstructure may affect the opposing enamel wear, but that low-fusing temperatures do not necessarily guarantee low enamel wear. Although the clinical relevance of this testing apparatus may be questioned, the testing method was repeatable.

Aluminum Silicates↗
PubMed2000

Using partial recording to assess tooth wear in older adults.

OBJECTIVES: To establish whether partial recording can be used for the measurement and reporting of tooth wear data in samples of adult populations, whilst maintaining the usefulness of the index. METHODS: Using whole mouth coronal tooth wear data from a large random population sample of 1200 dentate older adults in England, several different partial recording systems were investigated to establish which teeth would maintain a high level of sensitivity for the most economic use of codes and index teeth. Tooth wear data were recorded on a surface-by-surface basis on all teeth in the sample using the tooth wear index. RESULTS: Five different partial mouth recording systems were assessed, including half-mouth scoring, assessment of just upper or just lower anterior teeth, assessment of all anterior teeth and use of six index teeth. The 12 anterior teeth were the ones most often affected by moderate or severe wear, and when all 12 teeth were used as the index teeth few wear cases were missed, and all the most extensive and severe cases of coronal wear were classified as having some wear. A limited index of only six anterior teeth (three uppers and three lowers) was almost as sensitive, but allowed less flexibility when reporting the extent of coronal wear. Other systems for partial recording were less sensitive. CONCLUSIONS: Partial recording using six or 12 anterior teeth is appropriate for measuring and reporting tooth wear data in large population surveys.

Age Distribution↗
PubMed1999

Occlusion and splint therapy.

Control of occlusal contacts is important to the success of restorative dentistry. Tooth surface loss can contribute to a loss of stability in the occlusion. An occlusal splint is often part of pre-restorative management and can also have a valuable role in protecting both teeth and restorations from excessive loads and further wear.

Dental Materials↗
PubMed1996

A personal, historical view of the management of tooth wear.

The management of caries, periodontal disease and tooth wear has followed similar patterns over the last 30 years but at different rates. The reduced emphasis on surgery in the treatment of periodontal disease has now caught up with minimum interventive treatment of caries. Tooth wear is still, in my opinion, often over-treated and it is time that the management of tooth wear followed the same pattern.

Humans↗
PubMed1997

The clinical evolution of the 'Dahl Principle'.

The restorative management of patients with localised tooth wear is a major challenge to the dental profession. There is rarely adequate interocclusal space available to place restorations without the need for extensive tooth preparation or the involvement of many unaffected teeth. In 1975, a method was described which created interocclusal space by the use of a partial coverage appliance made of cobalt chromium alloy. The technique reduced the need for more invasive palatal reduction. This paper, with the aid of clinical case examples, highlights the development and evolution of the original removable appliance. However, there remains a need for further clinical studies to evaluate fully these techniques.

Adolescent↗
PubMed2003

The survival and clinical performance of resin-based composite restorations used to treat localised anterior tooth wear.

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.

Adolescent↗
PubMed2005

An audit of study casts used to monitor tooth wear in general practice.

OBJECTIVE: To assess the outcome of compliance of advice sent to patients and dentists about monitoring tooth wear in general practice. METHOD: Postal questionnaires were sent to 70 patients and their dentists requesting information on the outcome of letters of advice sent to general dental practitioners regarding monitoring tooth wear with study casts. They also requested information about the reasons for the patients' referral, the outcome of treatment and whether study models had been taken. RESULTS: Replies were received from 60 dentists (87%) and 53 patients (75%). Of these, 16 patients and 16 dentists had moved from their recorded address. Study casts were reported as having been taken by 23 dentists (38%) and reported by 18 patients (34%). The most common reason for referral was advice about monitoring the wear and the appearance of their teeth. CONCLUSIONS: The compliance of the patients and dentists in monitoring tooth wear by using study casts in general practice was not successful. It raises issues regarding the value of consultant advice letters to this common clinical problem.

Adult↗
PubMed2006

A cephalometric comparison of skulls from the fourteenth, sixteenth and twentieth centuries.

OBJECTIVES: To evaluate changes in the size and shape of the skull and jaws in British populations between the thirteenth and twentieth centuries. METHOD: Lateral cephalometric radiograms were obtained from skulls of three groups of subjects: 30 skulls were from the remains of those who died in the London Black Death epidemic of 1348, 54 skulls were recovered from the wreck of the Mary Rose which sank in 1545 and 31 skulls were representative of modern cephalometric values. RESULTS: Horizontal measurements in the base of the anterior cranial fossa and in the maxillary complex were greater in the modern group than in the medieval skulls. Cranial vault measurements were significantly higher (P=0.000) in the twentieth century skulls, especially in the anterior cranial fossa. CONCLUSION: Results suggest that our medieval ancestors had more prominent faces and smaller cranial vaults than modern man.

Adolescent↗
PubMed1999

Craniofacial morphology and tooth wear: a longitudinal study of orthodontic patients.

Previous research has suggested that a relationship exists between craniofacial morphology and tooth wear. The primary objective of this study was to determine whether an individual's craniofacial morphology during childhood is related to the degree of tooth wear that occurs in that same individual's adult dentition. Pretreatment orthodontic records taken during the mixed dentition (T1) and follow-up records taken an average of 20 years later (T2) were available for 165 orthodontic patients. Incisal/occlusal tooth wear was measured on a tooth-by-tooth basis from T1 and T2 casts using a four-category scoring system. Measures of craniofacial morphology were made from the T1 lateral cephalometric radiograph. Multiple regression analysis indicated that adult wear was associated with the T1 cephalometric measures of ANB (p = 0.017) and the interaction between ramal height and sex (p = 0.039). These results suggest that the craniofacial morphology observed during childhood has a small but significant relationship to adult tooth wear.

Adult↗
PubMed2002

Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development.

A sample of 4724 children (2353 girls and 2371 boys) (5-17 years old) were grouped not only by chronological age but also by stage of dental development (deciduous, early mixed, late mixed, and permanent dentition). The registrations included functional occlusion (anterior and lateral sliding, interferences), dental wear, mandibular mobility (maximal opening, deflection), and temporomandibular joint and muscular pain recorded by palpation. Headache was the only symptom of temporomandibular dysfunction (TMD) reported by the children. The results showed that one or more clinical signs were recorded in 25% of the subjects, most of them being mild in character. The prevalences increased during the developmental stages. Girls were in general more affected than boys. Significant associations were found between different signs, and TMD was associated with posterior crossbite, anterior open bite, Angle Class III malocclusion, and extreme maxillary overjet.

Adolescent↗
PubMed1998

An association between the regular use of 3,4 methylenedioxy-methamphetamine (ecstasy) and excessive wear of the teeth.

AIMS: This study was established to determine if users of ecstasy had greater tooth wear than a comparison group of non-users. DESIGN: The study involved a direct comparison between two groups of young people gathered by a peer information network and divided by the response to the question "Do you take ecstasy?" SETTING: The information network was established at the Maryland Centre in Liverpool (UK). Besides offering advice on drug and sex-related problems this centre distributes free condoms and is therefore visited by many young people who would not consider themselves to have these problems. PARTICIPANTS: There were 30 users and 28 non-users with no significant difference in the gender ratio. Age was not recorded to maintain absolute confidentiality, but all the participants appeared to be of student age. MEASUREMENTS: Tooth wear was measured using the index of Smith & Knight. The social and drug-taking profile of the two groups was ascertained by questionnaire. FINDINGS: It was found that the mean (+/- STD) tooth wear score for the back teeth was 0.96 +/- 0.16 in the users compared with 0.12 +/- 0.08 for the comparison group. These values were significantly different (p < 0.001). The values for the front teeth were not significantly different. Many users were aware of clenching their teeth 12 or even 24 hours after taking the drug. CONCLUSION: Taking ecstasy results in an increased likelihood of tooth wear on the back teeth. This is likely to result from clenching the teeth in the acidic environment caused by carbonated (fizzy) drinks.

Drinking↗