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PubMed1998

Restoring palatal tooth loss with composite resin, aided by increased vertical height.

Loss of palatal enamel and dentine of maxillary anterior teeth often leads to fractures of incisal edges. This phenomenon has always presented dentists with a demanding challenge. An ultraconservative approach using composite resin onlays together with an increase in vertical height is presented. Three cases illustrating the technique are reported.

Adult↗
PubMedDate not supplied

Aesthetic restoration with full-coverage porcelain veneers and a Ceromer/fiber-reinforced composite framework: a case report.

Due to the recent evolution of dental materials and procedures, the restoration of a particular clinical condition can be accomplished by various alternatives. While the use of integrated treatment modalities permit the restoration team to utilize the benefits of each material simultaneously, it requires the development of a comprehensive preoperative treatment plan to address the specific concerns of each region or material utilized. This article describes the use of a multidisciplinary approach to restore proper occlusion, function, and aesthetics in a patient with worn dentition.

Aluminum Silicates↗
PubMed1998

Tooth wear and temporomandibular joint morphology in a skull material from the 17th century.

Skeletal remnants from the skulls of 69 subjects from the 17th century have been studied focusing on TMJ morphology and tooth wear. Several of the skulls were damaged and altogether 68 condyles and 28 temporal components of the TMJ, and 97 dentate jaws could be examined. Tooth wear was extensive and most of the first molars in both jaws had lost most of their occlusal morphology. This is remarkable with respect to the fact that the great majority of the subjects had died before the age of 35 years, according to the age determination performed. The TMJs showed frequent remodelling but only rarely deformative changes. The frequent observation of a broken up compact bone layer on the condyle was interpreted as a post-mortem artefact. The results indicate adaptive response of the TMJs to the probably heavy masticatory function but do not support the suggested relationship between tooth wear and TMJ osteoarthrosis.

Age Determination by Teeth↗
PubMedDate not supplied

Bruxing patterns in children compared to intercuspal clenching and chewing as assessed with dental models, electromyography, and incisor jaw tracing: preliminary study.

The purpose of the present study was to compare bruxing patterns in children with chewing and maximum intercuspal clenching as defined in a clinical and laboratory environment. Six non-bruxing controls and six children who actively bruxed according to parent reports were evaluated. Both control and experimental subjects were assessed by an initial questionnaire, intraoral examination, extraoral examination, dental study models, incisor mandibular tracking, and bilateral surface electromyographic recordings (e.g., EMG). Bruxing was defined as grinding, clenching, or both in combination. The clinical examination consisted of an intraoral examination of the dentition, number of occlusal contacts, and wear facets. Dental study models were used to substantiate the intraoral findings for occlusal contact and wear facets. The mandibular incisors position was tracked during opening, closing, laterotrusion, protrusion, and chewing and compared to the bruxing movements in the experimental subjects. Bilateral surface EMG signals from the temporalis and masseter muscles were recorded in three maximum intercuspal clenches, ten chewing cycles on sugarless gum, and during simulated bruxing. The dental contacts were equal in number bilaterally in both control and bruxing subjects. Both groups demonstrated wear facets, but the bruxing subjects had more facets. The wear facets indicated lateral excursions but not clenching. Only the incisor jaw tracking and bilateral EMG differentiated the bruxing patterns. In those subjects (n = 4) who clenched during bruxing, the EMG pattern was not similar to that of intercuspal clenching and demonstrated its own unique muscle recruitment for the temporalis and masseter muscles. In the subjects who exhibited lateral excursions for bruxing (n = 2), the pattern of muscle recruitment of the two-closing muscles in terms of amplitude was similar for both the bruxing and chewing gum. Our findings support a concept that bruxing may depend upon factors that modify coactivation of muscle recruitment and do not depend upon occlusal contacts.

Analysis of Variance↗
PubMed1999

Understanding wear in dentistry.

Tooth wear is an increasing problem in dentistry. Traditionally, it has been divided into three categories: abrasion, attrition, and erosion. However, most clinical cases of tooth wear involve more than one of these processes. It is often easier to make a diagnosis by looking for the signs of the fundamental wear processes rather than trying to categorize the individual case. Wear can be caused by direct surface-to-surface wear, an intervening slurry, or a corrosive environment. Wear occurs during mastication, but also at other times, often at night. Although it may be possible to institute a preventive regimen, this will not always help the patient if his or her prime concern is esthetics. The same processes that cause tooth wear will cause wear to restorative materials. To diagnose and prevent wear, its processes must be understood.

Adult↗
PubMed1991

Relationships between age and dental attrition in Australian aboriginals.

Tooth wear scores (ratios of exposed dentin to total crown area) were calculated from dental casts of Australian Aboriginal subjects of known age from three populations. Linear regression equations relating attrition scores to age were derived. The slope of the regression line reflects the rate of tooth wear, and the intercept is related to the timing of first exposure of dentin. Differences in morphology between anterior and posterior teeth are reflected in a linear relationship between attrition scores and age for anterior teeth but a logarithmic relationship for posterior teeth. Correlations between age and attrition range from less than 0.40 for third molars (where differences in the eruption and occlusion of the teeth resulted in different patterns of wear) to greater than 0.80 for the premolars and first molars. Because of the generally high correlations between age and attrition, it is possible to estimate age from the extent of tooth wear with confidence limits of the order of +/- 10 years.

Adolescent↗
PubMed2001

Presentation, diagnosis and initial management of patients referred to a hospital tooth wear clinic.

Information on presenting complaints, diagnosis and initial management strategy was recorded on a proforma for 114 consecutive patients referred to a hospital tooth wear clinic over a two-year period. Over twice as many male patients were referred as females. Twenty percent of patients had no presenting complaint and the others shared the common complaints concerning appearance, sensitivity and their deteriorating dentitions. The assessment of aetiology identified attrition as the most common cause of tooth wear in the subject group studied. About half the group were prescribed preventative treatment only and the other half were deemed to require restorative dental treatment.

Adolescent↗
PubMedDate not supplied

Application of a computer assisted image analyzer to the assessment of area and number of sites of dental attrition and its use for age estimation.

A simple method was devised to assess dental attrition in terms of its area and number of sites by using dental plaster casts and a computer assisted image analyser. The changes presented on the occlusal surfaces of teeth were investigated for age estimation using these criteria. The area of attrition on each tooth demonstrated a significant positive correlation with age, but a wide individual variation was observed in the values for each tooth. Therefore, this method was unsuitable for accurate age estimation of a single tooth. A strong negative correlation with age was observed in the number of sites of attrition. A multiple stepwise regression analysis using the variables 'attrition area' and 'attrition number' revealed multiple correlation coefficient values of 0.93. The quantitative assessment of both horizontal and vertical factors of dental attrition would be essential to improve the accuracy of this method.

Adolescent↗
PubMedDate not supplied

An up to 3-year randomized clinical study comparing indirect and direct resin composites used to restore worn posterior teeth.

PURPOSE: To compare a developmental indirect resin composite with an established, microfilled directly placed resin composite used to restore severely worn teeth. The cause of the tooth wear was a combination of erosion and attrition. MATERIALS AND METHODS: Over a 3-year period, a total of 32 paired direct or indirect microfilled resin composite restorations were placed on premolars and molars in 16 patients (mean age: 43 years, range: 25 to 62) with severe tooth wear. A further 26 pairs of resin composite were placed in 13 controls (mean age: 39 years, range 28 to 65) without evidence of tooth wear. The material was randomly selected for placement in the left or right sides of the mouth. RESULTS: Sixteen restorations were retained in the tooth wear group (7 indirect and 9 direct), 7 (22%) fractured (4 indirect and 3 direct), and 9 (28%) were completely lost (5 indirect and 4 direct). There was no statistically significant difference in failure rates between the materials in this group. The control group had 21 restorations (80%) that were retained (10 indirect and 12 direct), a significantly lower rate of failure than in the tooth wear patients (P = .027). CONCLUSION: The results of this short-term study suggest that the use of direct and indirect resin composites for restoring worn posterior teeth is contraindicated.

Acrylic Resins↗
PubMed1990

Dental attrition in a south Indian skull.

The skull of a twentieth-century man presented by chance and was recognised as an example of attritional occlusion. It was photographed and x-rayed and seemed to be a worthy supplement to Begg's classic work. It demonstrates severe loss of tooth structure from attrition, both occlusally and interproximally, resulting in reduction of tooth width and height. Interproximal loss of tooth substance results in a mesial inclination of the posterior teeth. 'X-occlusion' is found to be functional in origin, rather than hereditary, and caused by the reverse bucco-lingual obliquity of the occlusal plane. The arches accommodate all the teeth, including the third molars, without crowding or protrusion. A study of this case sheds additional light on the causes of Modern Man's anomalous occlusion. Relevance to orthodontic analysis and treatment is noted.

Adult↗
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↗
PubMed2006

Tooth wear and dental pathology at the advent of agriculture: new evidence from the Levant.

Differences in patterns of diet and subsistence through the analysis of dental pathology and tooth wear were studied in skeletal populations of Natufian hunter-gatherers (10,500-8300 BC) and Neolithic populations (8300-5500 BC, noncalibrated) from the southern Levant. 1,160 Natufians and 804 Neolithic teeth were examined for rate of attrition, caries, antemortem tooth loss, calculus, periapical lesions, and periodontal processes. While the Natufian people manifest a higher rate of dental attrition and periodontal disease (36.4% vs. 19%), Neolithic people show a higher rate of calculus. Both populations manifested low and similar rates of caries (6.4% in the Natufian vs. 6.7% in the Neolithic), periapical lesions (not over 1.5%), and antemortem tooth loss (3.7% vs. 4.5%, respectively). Molar wear pattern in the Neolithic is different than in the Natufian. The current study shows that the dental picture obtained from the two populations is multifactorial in nature, and not exclusively of dietary origin, i.e., the higher rate and unique pattern of attrition seen in the Natufian could result from a greater consumption of fibrous plants, the use of pestles and mortars (which introduce large quantities of stone-dust to the food), and/or the use of teeth as a "third hand." The two major conclusions of this study are: 1) The transition from hunting and gathering to a food-producing economy in the Levant did not promote changes in dental health, as previously believed. This generally indicates that the Natufians and Neolithic people of the Levant may have differed in their ecosystem management (i.e., gathering vs. growing grains), but not in the type of food consumed. 2) Changes in food-preparation techniques and nondietary usage of the teeth explain much of the variation in tooth condition in populations before and after the agricultural revolution.

Agriculture↗
PubMed2001

A review of taurodontism with new data on indigenous southern African populations.

The prevalence and degree of taurodontism (enlargement of the pulp cavity) in the mandibular permanent molars of two recent population samples from southern Africa were investigated quantitatively from lateral radiographs. The degree of occlusal wear was scored and two measures of relative pulp cavity size were recorded for each tooth. There was a significant association between increased attrition and a reduction in the size of the pulp cavity when all of the teeth were considered together, but no correlation among individual molar types within each sample. In both the Zulu (n=68 individuals) and Khoisan (n=28 individuals) samples, third molars had the highest prevalence of taurodontism and first molars the lowest. The data for Zulus are similar to those recorded for other modern populations (e.g. white and black Americans, and Israelis), whereas the Khoisan data exhibit significantly higher frequencies. An increased appreciation of the distribution of this variant in modern human populations would contribute to an understanding of its possible evolutionary significance in the human fossil record.

Africa, Southern↗
PubMed1987

[The respective roles of occlusal abrasion and bacterial plaque in the etiology of alveolar lysis in periodontitis in hamsters].

This study was designed to determine the respective roles of occlusal attrition and subsequent tooth egression, and bacterial plaque accumulation on bone loss (or radicular denudation) during hamster periodontitis. Seventy young male animals were separated into 7 groups. Occlusal attrition was compared on 3 different diets (standard in pellet form, standard in powder form, and Keyes 2000 in powder form), thought to have different abrasiveness. The role of bacterial plaque wad evidenced by inhibiting it with Penicillin V in animals fed the same 3 diets. Compared to animals killed at the beginning of the experimental period (absolute controls), 3 months later bacterial plaque was slightly increased in hamsters fed the standard diet, very markedly increased in 2000 diet-fed animals and, decreased in the 3 antibiotic treated groups. Occlusal attrition was increased in the 2 groups fed the standard diets but not in the 2000 diet-fed animals. Radicular denudation was slightly increased in the standard diet groups, very markedly increased in the 2000 diet group, and unchanged in the antibiotic treated animals. Thus, the less abrasive diet was associated with the greatest plaque accumulation and bone loss; conversely, with the most abrasive diets, radicular denudation had slightly progressed with only small amounts of plaque. This suggests that in hamster periodontitis, bone loss is not influenced by occlusal attrition but is completely dependent on the direct action of bacterial plaque.

Alveolar Process↗