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PubMed2006

Risk assessment and preventive measures.

A prerequisite for preventive measures is to diagnose erosive tooth wear and to evaluate the different etiological factors in order to identify persons at risk. No diagnostic device is available for the assessment of erosive defects. Thus, they can only be detected clinically. Consequently, erosion not diagnosed in the early stage may render timely preventive measures difficult. In order to assess the risk factors, patient should record their dietary intake for a distinct period of time. Then a dentist can determine the erosive potential of the diet. Particularly, patients with more than four dietary acid intakes have a higher risk for erosion when other risk factors (such as holding the drink in the mouth) are present. Regurgitation of gastric acids (reflux, vomiting, alcohol abuse, etc.) is a further important risk factor for the development of erosion which has to be taken into account. Based on these analyses, an individually tailored preventive program may be suggested to the patients. It may comprise dietary advice, optimization of fluoride regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for nondestructive toothbrushing habits with a low abrasive toothpaste. The frequent use of fluoride gel and fluoride solution in addition to fluoride toothpaste offers the opportunity to reduce somewhat abrasion of tooth substance. It is also advisable to avoid abrasive tooth cleaning and whitening products, since they may remove the pellicle and may render teeth more susceptible to erosion. Since erosion, attrition and abrasion often occur simultaneously all causative components must be taken into consideration when planning preventive strategies.

Acids↗
PubMed2004

A new 3-d approach to determine functional morphology of cercopithecoid molars.

Functional relationships between diet and tooth morphology form an integral part of primatological and paleontological research. Previously, mostly two-dimensional parameters have been used to compare and interpret the complex crown morphology of cercopithecine and colobine molars. However, as teeth are three-dimensional objects, any dimensional reduction in describing their morphology must result in loss of information. In the current study we use a high resolution optical topometric system to record crown morphology in different wear stages in order to extract three-dimensional (3-d) parameters from virtual 3-d models. Structural parameters such as relief index, occlusal surface area, enamel area and strike and dip of cusp slopes as well as wear facets can be calculated, reflecting the changing occlusal topography of molars due to attrition and abrasion. By comparing mostly fruit-eating cercopithecines and leaf-eating colobines, functional implications of tooth wear, occlusal jaw movement and resulting relief can be inferred. Our analyses show that the main differences in occlusal relief between these genera do not change with wear. Colobines maintain higher occlusal relief, whereas in cercopithecines all cusps wear flat quite rapidly. Detailed models of wear for cercopithecoid molars will be used to reconstruct diet and will enhance our knowledge of the paleoecology of Cercopithecoidea.

Animals↗
PubMed1990

Scanning electron microscopic observations of microcanals and continuous zones of interglobular dentin in human deciduous incisal dentin.

Scanning electron microscopic (SEM) observation of the coronal dentin of deciduous incisors revealed microcanals and continuous zones of interglobular dentin (CID) in the labio-lingual central portion of dentin beneath the incisal edge. The microcanals, which were clearly larger than dentinal tubules, extended from the incisal edge to the vicinity of the pulp cavity. They were located essentially in the labio-lingual central portion of the dentin and were arranged linearly in the mesio-distal direction. Inside the microcanals, collagen fiber bundles were arranged almost in parallel with the canal long axis: spherical bodies 1.0-2.5 microns in size made up of assemblies of regular parallelpipedal crystals and granulated crystals were also seen. In some instances, bacteria had invaded incisal dentin that had been exposed by attrition. The CID were made up of interglobular dentin aligned with the long axis of the tooth. As was true in the case of the microcanals, several zones were arranged irregularly in the mesio-distal direction, generally in the labio-lingual central portion of the coronal dentin. The CID were confined to about half the width of the incisal edge dentin on the incisal edge side and did not appear in the vicinity of the pulp cavity. Within the interglobular dentin itself, which was surrounded by calcospherites, were longitudinal collagen fibers connected with dentinal tubule walls inside calcified dentin and collagen bundles forming a network with those fibers. Spherical bodies 1.0-1.5 microns in size were observed attached to the surfaces of the bundles or distributed among these fibers. In some instances, the microcanals penetrated the CID.

Child↗
PubMed1998

Radiographic study of the broadbeach aboriginal dentition.

This study forms part of a larger anthropological investigation of the Ngaraangbal Aboriginal Tribe's ancestral burial ground at Broadbeach, Australia. It examines the dentition, records the associated pathology in a noninvasive manner, and relates this to the likely subsistence diet of the tribe. The Broadbeach osteological collection was returned for reburial in 1985; however, radiographic and photographic records of 36 adult males were available. These form the basis of our study. The pathology noted in the study sample was compared with a representative sample (n = 38) of pre-European Aboriginal remains from throughout Queensland for verification purposes only. Rates of dental pathology and injury were calculated from the radiographic and photographic records. There was a significant rate of tooth-wear related intra-bony pathology (4.0%), moderate to severe alveolar bone loss, and heavy dental attrition, of which the mandibular posterior teeth were the most severely affected. Caries prevalence (0.8%) was low for hunter-gatherer populations. A large number of molar pulp chambers had a distinctive "cruciate" morphology resulting from the formation of secondary dentine and pulp stones. Injuries and abnormalities included upper central incisor avulsion (58.3%) and taurodontism. These results support the proposal that the Ngaraangbal tribe was a hunter-gatherer population subsisting on an abrasive diet that included marine foods.

Adolescent↗
PubMed1992

Chronic rhinitis and dental disease.

Whenever an animal is examined because of chronic rhinitis, the dentition should be carefully examined to rule out the possibility of a primary dental problem. Oral examination under heavy sedation or general anesthesia is necessary to diagnose many of these cases. A periodontal probe is used in detecting deep periodontal pockets that extend into the nasal cavity or maxillary sinus. A dental explorer is used to reveal pulpal exposure secondary to dental fractures or rapid dental wear or attrition. Careful oral examination is used to localize any oronasal or oroantral fistula from a previously lost tooth. Dental radiographs help to reveal the extent of alveolar bone pathology. An assessment of all these findings will result in an accurate diagnosis of the primary cause of the chronic rhinitis, which will in turn facilitate appropriate treatment.

Animals↗
PubMed1989

Craniomandibular disorders in adult populations of West Bothnia, Sweden.

A randomly selected sample of 1992 adults (995 men and 997 women) representing four equally sized age groups of 25-, 35-, 50-, and 65-years-old inhabitants of West Bothnia were studied for prevalence of symptoms and clinical signs of mandibular dysfunction. Of the sample 79% completed a questionnaire and a clinical examination. The chewing inability increased with age. Recurrent headaches (once a week or more often) were reported to occur in 11% to 15% of the four age groups, and the duration of headaches was generally more than 2 years. Tooth-clenching, which was the most frequent oral parafunction, was reported significantly more often in women, whereas attrition was more severe in men. The commonest clinical finding was temporomandibular joint clicking, which varied between 13% and 35% in the different age groups. Crepitation was observed more often in women and increased with age. The jaw muscles were more frequently tender to palpation in women and the elderly. The mean maximal mouth opening capacity varied between 55 mm and 44 mm, decreasing with age, and was for the whole sample significantly higher among men. Since signs and symptoms of craniomandibular disorders were common findings in all age groups, routine dental examination should always include functional evaluation of the stomatognathic system.

Adult↗
PubMed1990

Chairside evaluation of salivary parameters in patients with tooth surface loss: a pilot study.

In cases of tooth surface loss, the possibility of an erosive component should be considered, even when the lesions have the characteristic clinical appearance of abrasion or attrition. Individual susceptibility or resistance to erosive damage has been attributed to variations in the quality of saliva. Two recent studies have indicated that rate of flow of saliva and buffer capacity may be important determinants in erosion susceptibility. These parameters may be readily assessed using the chairside kits developed in Scandinavia for assessing caries susceptibility. In eight consecutive patients referred to the University of Queensland Dental School for investigation of tooth surface loss, six had no measurable quantities of resting whole saliva, four had low values for stimulated saliva flow rates, and only two patients had buffer capacities within the normal range. The results indicate the need for a larger scale study of salivary parameters in this patient group. The chairside kits provide a simple, rapid, hygienic means of assessing salivary values.

Adolescent↗
PubMed2006

Erosive tooth wear: diagnosis, risk factors and prevention.

PURPOSE: To provide an overview on diagnosis, risk factors and prevention of erosive tooth wear, which is becoming an increasingly important factor when considering the long- term health of the dentition. RESULTS: Awareness of dental erosion by the public is still not widespread due to the cryptic nature of this slowly progressing condition. Smooth silky-glazed appearance with the absence of perikymata and intact enamel along the gingival margin, with cupping and grooving on occlusal surfaces are some typical signs of enamel erosion. In later stages, it is sometimes difficult to distinguish between the influences of erosion, attrition or abrasion during a clinical examination. Biological, behavioral and chemical factors all come into play, which over time, may either wear away the tooth surface, or potentially protect it. In order to assess the risk factors, patient should record their dietary intake for a distinct period of time. Based on these analyses, an individually tailored preventive program may be suggested to patients. It may comprise dietary advice, optimization of fluoride regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for non-destructive tooth brushing habits. The frequent use of fluoride gel and fluoride mouthrinse in addition to fluoride toothpaste offers the opportunity to minimize abrasion of tooth substance.

Acids↗
PubMed2002

Middle Pleistocene human remains from the Bau de l'Aubesier.

Excavations in later Middle Pleistocene levels at the Bau de l'Aubesier, Vaucluse, France yielded a maxillary molar (M(1) or M(2); Aubesier 10) and a partial mandible from the left C(1) alveolus to the right condylar base lacking the coronoid process (Aubesier 11). Dentally they are similar to other later Middle Pleistocene Europeans in dental dimensions and variable taurodontism (Aubesier 10 but not Aubesier 11). The small Aubesier 11 mandible exhibits a retreating symphyseal profile with a minimal tuber symphyseos, an anterior marginal tubercle at P(4)/M(1), the mental foramen at P(4)/M(1)-M(1), a modest retromolar space, no lingular bridging of the mandibular foramen, an enlarged superior medial pterygoid tubercle, a modest lateral condylar tubercle, and a mandibular notch crest that intersects the middle third of the condylar margin. All of these features fall within the ranges of variation of later Middle Pleistocene Neandertal lineage humans, and some are characteristic of Middle Pleistocene human mandibles in general. In addition, Aubesier 11 exhibits pervasive ante mortem alveolar resorption with apical abscesses, alveolar bone destruction, universal labial/buccal bone loss, ante mortem tooth loss (for > or =81.8% of preserved alveoli), a lingual alveolar fenestration, and two broken root apices with masticatory attrition. These lesions indicate significantly impaired masticatory function, the oldest specimen currently known with such a reduced degree of dental function but one of several Middle Pleistocene human remains with indications of serious abnormalities.

Alveolar Bone Loss↗