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Dental erosion in children.

Erosive tooth wear in children is a common condition. The overlapping of erosion with mechanical forces like attrition or abrasion is probably in deciduous teeth more pronounced than in permanent teeth. Early erosive damage to the permanent teeth may compromise the dentition for the entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of the condition and adequate preventive measures are of importance. Knowledge of the etiological factors for erosive tooth wear is a prerequisite for such measures. In children and adolescents (like in adults) extrinsic and intrinsic factors or a combination of them are possible reasons for the condition. Such factors are frequent and extensive consumption of erosive foodstuffs and drinks, the intake of medicaments (asthma), gastro-esophageal reflux (a case history is discussed) or vomiting. But also behavioral factors like unusual eating and drinking habits, the consumption of designer drugs and socio-economic aspects are of importance.

Adolescent↗

Composite resins in the 21st century.

Human enamel and dentin should be used as the physiologic standards with which to compare composite resins, especially in the posterior region. The intrinsic surface roughness of composite resins must be equal to or lower than the surface roughness of human enamel on enamel-to-enamel occlusal contact areas (Ra = 0.64 microns). Roughness determines the biologic strength of composite resins. The nanoindentation hardness value of the filler particles (2.91 to 8.84 GPa) must not be higher than that of the hydroxyapatite crystals of human enamel (3.39 GPa). Composite resins intended for posterior use should have a Young's modulus at least equal to, and preferably higher than, that of dentin (18.500 MPa). The compressive strength of enamel (384 MPa) and dentin (297 MPa) and the fracture strength of a natural tooth (molar = 305 MPa; premolar = 248 MPa) offer excellent mechanical standards to select the optimal strength for posterior composite resins. The in vivo occlusal contact area wear rate of composite resins must be comparable to the attritional enamel wear rate (about 39 microns/y) in molars. Differential wear between enamel and composite resin on the same tooth is a new criterion for visualizing and quantifying the wear resistance of composite resins in a biologic way. Posterior resins must have a radiographic opacity that is slightly in excess of that of human enamel (198% Al). Based on these standard criteria, it can be concluded that in the 21st century the ultrafine compact-filled composite resins may be the materials of choice for restoring posterior cavities.

Analysis of Variance↗

Identifying causes of dental erosion.

Erosion is a chemical process in which an intrinsic or extrinsic source causes a loss of tooth structure. The damage caused by erosion can be accelerated when it occurs in combination with attrition or abrasion. It is important to recognize erosion and determine the source of insult so that destructive behaviors or systemic conditions contributing to the erosive process are terminated.

Bulimia↗

Dental and skeletal relationships to attritional occlusion.

Dental attrition has been investigated in depth. Besides alterations in arch length due to attrition, skeletal and intra-arch differences were discovered. It is felt that these findings do have value in helping us realize that present-day concepts of proper occlusion cannot necessarily be applied to dentitions that existed at another time. A more thorough knowledge of occlusions exhibiting dental attrition provides information that is helpful in understanding more fully the nature of tooth eruption and associated dental arch occlusion and the interrelationships of these factors with supporting skeletal structures.

Cephalometry↗

Restoring the worn dentition.

Strong dental materials and dental porcelains are providing dentists with restorative opportunities that are more conservative because they require less destruction of healthy tooth structure and yield a more esthetic result. In cases of severe wear due to attrition, abrasion, and erosion, this process can be stopped, restoring the esthetics and function by using proper techniques and materials. The case report described in this article demonstrates the conservative restoration of severe wear due to attrition and erosion. Teeth were lengthened, wear was restored, and further wear was ceased by using a combination of bonded porcelain, a heat, light, and self-cure resin system, and a new glass-ionomer restorative material. The result was a strong, durable restoration (that required no anesthesia) with high esthetics.

Adult↗

Dental paleopathology in a Serbian Medieval population.

Analysis of the pattern of dental disease in two Late Medieval populations from cemeteries excavated at archaeological sites in western Serbia was based on the study of tooth wear, ante-mortem tooth loss, caries, dental enamel hypoplasia, alveolar resorption, abscesses and calculus. The findings reported here show a high prevalence of attrition, alveolar resorption and caries, which suggest an abrasive diet and poor oral hygiene.

Adult↗

Regional variation in tooth size and pathology in fossil hominids.

Tooth size and dental pathology in fossil hominids were studied to test for regional differences in these parameters. The results showed little regional variation in tooth size for the Middle and Upper Pleistocene sites compared (except for Krapina) but considerable differences in the severity of attrition and dental pathology. These differences were considered indicative of regional differences in the functional load borne by the teeth, and in view of the similar technological status of the groups studied, were attributed to environmental differences in the diet. Since, in all regions, reduction in tooth size appeared to continue at the same rate for the periods investigated, no association can be established between presumed selective pressures related to differences in functional demands made on the dentition, and tooth reduction.

Adult↗

Continuous tooth eruption in Australian aboriginal skulls.

Increases in the distance from the cemento-enamel junction to the alveolar crest (CEJ-AC) have often been attributed to senile atrophy of the bone or to the effects of periodontitis, without reference to the condition of the alveolar crest. This study investigated the relationship between CEJ-AC distance, tooth wear, gender, site of the CEJ-AC measurements, and age in 161 pre-white-contact Australian aboriginal skulls. Individual teeth were included in the study when there was no evidence of dehiscence, periodontitis, or abscess cavity formation in the supporting alveolar bone. The CEJ-AC distances increased as the severity of attrition increased; in male skulls, CEJ-AC distances were greater than in female skulls for all categories of tooth wear. In general, CEJ-AC distances measured on the mesial aspects of teeth were greater than those recorded distally; lingual distances generally exceeded buccal recordings. The best explanation of these findings and similar reports in the anthropological literature is that continuous tooth eruption occurred without the concomitant coronal movement of alveolar bone. This conclusion has significant ramifications for anthropological, epidemiological, and clinical studies which use the CEJ and AC as reference points when measuring periodontal attachment loss (periodontitis).

Age Factors↗

Facial cellulitis arising from dens evaginatus: a case report.

Dens evaginatus is a developmental anomaly that produces a tubercle on the occlusal surface of a tooth. It is found most frequently in the mandibular premolars. The occlusal tubercle easily causes occlusal interferences. Attrition or fracture of the tubercle can lead to pulpitis, pulp necrosis, periapical pathosis, and periapical infection. This case report illustrates the treatment of facial cellulitis arising from dens evaginatus with open apex. Calcium hydroxide was used for the apexification procedure. One year after canal obturation, radiography revealed no apical pathosis and the apical seal was evident.

Adult↗