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Noncarious cervical lesions in adults: prevalence and occlusal aspects.

BACKGROUND: The factors that induce the formation of noncarious lesions are not understood fully, particularly those that are related to occlusal aspects. The authors conducted a study to evaluate the prevalence of noncarious cervical lesions in adults and their association with occlusal aspects. METHODS: The authors examined 70 people (35 men and 35 women) aged 25 to 45 years to determine the presence and type of noncarious cervical lesions, wear facets, tooth contacts in maximal intercuspal position, and lateral and protrusive movements. The assessment involved a questionnaire and clinical examination. RESULTS: Among the teeth the authors evaluated, 17.23 percent had cervical lesions, 80.28 percent of which had wear facets (P < .01). The authors found a significant difference between the prevalence of noncarious lesions and the presence of wear facets (P = .0484). CONCLUSIONS: The authors found that cervical lesions were related significantly to wear facets. These findings strengthen evidence for the role of occlusal forces as an etiologic factor for noncarious lesions. CLINICAL IMPLICATIONS: The presence of wear facets should be considered in the treatment of noncarious cervical lesions.

Adult↗

Managing dentin hypersensitivity.

BACKGROUND: The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. TYPES OF STUDIES REVIEWED: The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. RESULTS: The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. CLINICAL IMPLICATIONS: DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.

Adhesives↗

Measuring periodontal disease in ancient populations: root and wear indices in study of American Indian skulls.

As an example of the collaboration of periodontologists and physical anthropologists, the skulls of two Indian populations were studied. A root index to assay periodontal disease and a wear index to evaluate occlusal wear, were developed. The first Indian population, living 400 years ago, had more decay, loss of teeth and caries; the second population, living 4,000 years ago, exhibited more periodontal disease. Starting with a sample of eight teeth, two from each quadrant, the statistical analysis showed that a smaller number of teeth would give a reliable assessment of past oral health. Based on our findings, the canines proved to be good indicators for general wear and the incisors for periodontal disease. A six-tooth index of varying teeth studied is proposed for the root index and the wear index in future studies of oral health of ancient populations.

Adolescent↗

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↗

Patterns of tooth wear associated with methamphetamine use.

BACKGROUND: Methamphetamine (MAP) abuse is a significant worldwide problem. This prospective study was conducted to determine if MAP users had distinct patterns of tooth wear. METHODS: Methamphetamine users were identified and interviewed about their duration and preferred route of MAP use. Study participants were interviewed in the emergency department of a large urban university hospital serving a geographic area with a high rate of illicit MAP production and consumption. Tooth wear was documented for each study participant and scored using a previously validated index and demographic information was obtained using a questionnaire. RESULTS: Forty-three MAP patients were interviewed. Preferred route of administration was injection (37%) followed by snorting (33%). Patients who preferentially snorted MAP had significantly higher tooth wear in the anterior maxillary teeth than patients who injected, smoked, or ingested MAP (P = 0.005). CONCLUSION: Patients who use MAP have distinct patterns of wear based on route of administration. This difference may be explained anatomically.

Administration, Inhalation↗

Y-shaped lower bilateral incisors. A previously undescribed oral malformation.

A case of Y-shaped lower bilateral central incisors found in an 18-year-old Japanese man is reported. Each of the central incisors had an abnormally high cusp located at the labial surface. The cause of this malformation of the lower central incisors is obscure, but we suspect that it was due to hyperplasia of the labial surface of the central lobe of the incisor during tooth development.

Adolescent↗

Predictors of non-carious loss of cervical tooth tissues.

This Predictor Variables study is designed to determine which one of 11 factors evaluated may be correlated to Non-carious Loss of Cervical Tooth Tissues (NLCTT) using subjects with and without NLCTT. The ultimate objective is to successfully predict the path toward risky behaviors and reduce the incidence of NLCTT.

Acids↗

A 24-month follow-up of flowable resin composite as an intermediate layer in non-carious cervical lesions.

This study compared the clinical performance of a microhybrid resin composite to lined Class V restorations or to those restorations without a flowable resin composite over a 24-month period. Nineteen patients with at least 2 pairs of equivalent cervical erosion/attrition/abfraction lesions, under occlusion, were enrolled in this study. A total of 74 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250 or Single-Bond + Filtek Z250). According to the manufacturers' instructions, 2 calibrated operators placed all restorations. Two other independent examiners evaluated the restorations at baseline and after 24 months, according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test (alpha=0.05). For each group, 8 restorations were lost after 24 months (retention rate of 89.2%). All the restorations showed a trend toward dark yellowing after 24 months (color match A2).

Adult↗

The effect of a partial bite raising splint on the occlusal face height. An x-ray cephalometric study in human adults.

20 patients (18 - 50 years) with pathological attrition of upper and/or lower anterior teeth were treated, as a temporary measure, by means of a partial chrome-cobalt splint covering the palatal surfaces of the six upper front teeth. Tantalum implants to provide reference points were placed in the basal portion of upper and lower jaw bones. Lateral cephalometric radiographs were taken with and without the splint at the beginning of treatment and thereafter every two months till the difference between measurements was as small as possible. Changes in the occlusal face height were evaluated. Measurement reliability proved to be very high. Continuous use of the splint caused intrusion of the front teeth and eruption of the others in all patients. The intrusion was on an average 1.05 mm and the eruption 1.47 mm after 6 - 14 months, indicating a possible potential for tooth eruption in human adults. More eruption than intrusion appeared to take place in the youngest age groups. Sexual differences could not be established. Use of the splint did not cause the common symptoms of mandibular dysfunction. Lisping was the most serious complaint.

Adolescent↗

Some aspects of dental health in young adult Indian vegetarians. A pilot study.

The effect of a vegetarian diet on oral health status could be manifold, but reports have so far mainly appeared from within Western populations. This study reports the oral health status of southeast Indian vegetarians, obtained by means of a questionnaire, clinical examination, and study cast evaluations. The material comprised 30 vegetarians and 25 sex- and age-matched non-vegetarian controls. Comparison between the samples included dietary and oral hygiene habits, health-related variables, caries prevalence, and dentoalveolar characteristics. The questionnaire showed significantly less consumption of between-meal sweets and more widespread use of a soft toothbrush by the vegetarians. The vegetarians had a significantly higher degree of tooth wear than the non-vegetarians, but no difference in the degree of wear between women and men in either group was found. The vegetarians had a significantly higher tendency towards crowding in the maxillary arch, numerically higher DMFT, and greater number of cervical buccal defects than the controls. The results of this study suggest that the Indian vegetarian diet may produce certain effects on the oral health, associations that need to be studied further.

Adolescent↗

Accelerated eruption of rat lower incisor. Relationship between impeded and unimpeded eruption rates, rate of attrition, tooth length, and production of dentin and enamel.

The present investigation studies the effects of persistently cutting one lower rat incisor out of occlusion. Within four days, the rate of eruption of the cut (unimpeded) incisor increased to 216% and that of the uncut (impeded) contralateral to 136% of the baseline rate. While the former remained high, the latter decreased gradually to about 90% within three weeks. The rate of attrition of the impeded incisor increased to 233% of the baseline rate within two days, then fell abruptly, and remained at a slightly lower level than the rate of eruption. Accordingly, the length of the erupted part of the impeded incisor decreased initially, but increased gradually after about four days. Measurements made on SEM micrographs of the series of transverse tooth segments obtained when cutting the incisor out of occlusion, showed that growth-related increase in mesiodistal tooth width was arrested from the 10th segment, dentin thickness decreased gradually to about 50% in the 12th segment, and enamel thickness, after an initial increase, decreased to about 80% in the 11th segment. The present study provides experimental evidence that accelerated eruption affects morphogenesis and histogenesis of the rat lower incisor. An impeded incisor, especially the contralateral, may not serve as an ideal control.

Animals↗

Aberrations of the tooth arcade and mandible in Dall's sheep from southwestern Yukon.

Nine Dall's sheep (Ovis dalli dalli) collected in the Ruby Mountains of southwestern Yukon were examined for aberrations of the tooth arcade and mandible. Missing and displaced teeth were common in older sheep (greater than or equal to 6 yr). Necrosis of the mandible was observed in five of eight rams and in one ewe. Corynebacterium pyogenes was cultured from exudates from two rams with enlarged fistulated mandibles. The sequence of events leading to lesions of the tooth arcade and to "lumpy jaw" is postulated to be associated with abnormal wearing of teeth and a disrupted alignment of the tooth arcade, impaction of vegetable matter between teeth and between the gingiva and the root of the tooth, and penetration of the traumatized gingiva membrane and alveolus by oral bacteria which induce a necrotizing infection.

Animal Feed↗