TOOTH GRINDING IN PREVENTIVE DENTISTRY.
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The authors studied the specific hardness, micromorphology, electric resistance and penetration by 22Na ions in teeth extracted from juvenile subjects with beginning abrasion of the enamel differentiating between tooth parts affected with attrition and tooth parts not affected. The structural or physicomechanical properties of the enamel and dentine were quantitatively evaluated with regard to their relation to caries disposition.
OBJECTIVES: To develop a reproducible method to measure tooth wear and assess the protection given by dentine bonding agents in an erosive/abrasive wear regime. METHODS: Seal and Protect (Dentsply, UK) and Optibond Solo (Kerr, UK) were each applied to 20 extracted teeth and subjected to 3000 cycles in a reciprocating erosion/abrasion wear machine. A further 20 teeth, without protection, were subjected to the same wear regime and were either brushed in water or immersed in acid. Impressions were taken by a standardised technique and were scanned with a non-contacting laser profilometer. The amount of erosion was measured at the same co-ordinates before and after erosion using 2mm diameter metal discs as reference points. RESULTS: The amount of wear on Seal and Protect had a mean 24.8 microm (SD 57.4 microm) and for Solo it was 1.4 microm (24.5 microm), and this difference was statistically significant (p=0.02). There was no statistically significant difference in the wear measured on the teeth brushed in water or immersed in acid. The wear measured on the unprotected teeth was 243 microm (SD 120 microm) and was statistically significantly different to the protected surfaces (p=0.001). CONCLUSION: Both Seal and Protect and Solo protected the teeth in this wear regime and the technique could be used clinically for patients with uncontrolled dental erosion.
There is increasing clinical awareness of erosion of enamel and dentine by dietary acids and the consequent increased susceptibility to physical wear. Enamel erosion is characterized by acid-mediated surface softening that, if unchecked, will progress to irreversible loss of surface tissue, potentially exposing the underlying dentine. In comparison, dentine erosion is less well understood as the composition and microstructure are more heterogeneous. Factors which affect the erosive potential of a solution include pH, titratable acidity, common ion concentrations, and frequency and method of exposure. Abrasion and attrition are sources of physical wear and are commonly associated with tooth brushing and tooth-to-tooth contact, respectively. A combination of erosion and abrasion or attrition exacerbates wear; however, further research is required to understand the role of fluoride in protecting mineralized tissues from such processes. Abrasive wear may be seen in a wide range of patients, whereas attritive loss is usually seen in individuals with bruxism. Wear processes are implicated in the development of dentine hypersensitivity. Saliva confers the major protective function against wear due to its role in pellicle formation, buffering, acid clearance, and hard tissue remineralization. This review focuses on the physiochemical factors impacting tooth wear.
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During tooth bleaching abrasive dentifrices might change the outer superficial enamel. The aim of this in vitro study was to evaluate the roughness of human enamel exposed to a 10% carbamide peroxide bleaching agent at different times and submitted to different superficial cleaning treatments. The study consisted of 60 sound human enamel slabs, randomly assigned to different treatment groups: G1--not brushed; G2--brushed with a fluoride abrasive dentifrice; G3--brushed with a non-fluoride abrasive dentifrice; and G4--brushed without a dentifrice. There were 15 enamel slabs per group. Slabs of molar teeth were obtained and sequentially polished with sandpaper and abrasive pastes. A perfilometer was used to obtain the mean of Ra value on the surface of each specimen to initial and experimental times. Bleaching was performed on the enamel surface for six hours daily. After that, each slab received a cleaning surface treatment and was stored in artificial saliva. Analysis of variance (ANOVA) and Tukey's HSD hoc analysis (alpha =0.05) revealed significant differences in roughness values over time for enamel bleached and treated with different superficial cleaning methods. G1 and G4 showed no significant differences in roughness over time, G2 and G3 showed a significant increase in the surface roughness values. This in vitro investigation showed the sole use of 10% carbamide peroxide did not alter the enamel surface roughness, but the cleaning treatments that employed the use of brushing with abrasive dentifrices resulted in a significant increase of enamel surface roughness.
Of 64 burials at the Schönstedt common burial-ground which dates from the neolithic age, 49 well-preserved dentitions were examined for caries incidence, periodontal disease, abrasion, hypodontia and polydontia, tooth alignment and occlusal position. The results obtained are discussed with regard to contemporaneous and modern conditions.
We investigated 322 patients, 20 and 40 old to find connections between the occurrence and localisation of facets, malocclusion and dynamic occlusion and estimated special aspects of periodontal reactions. The symptoms "anterior crowding", "increased overbite and overjet" didn't effect an increasing of frequency of facets in comparison with eugnathic denture. We found, that the facets decreased in lateral segments if the overbite became deeper and on the other hand number of facets increased with advancing years. The localisation of facets and occlusal guidance of dynamic occlusion coincided only in one third of investigated cases. Balancing and hyperbalancing teeth showed frequent facets. There was a direct relationship between increasing frequency and intensity of gingival retraction and the level of the abrasion of the hard tooth substance.
The characteristics of the air-powder abrasive device (APAD) was reviewed from the current dental literature and found to be an excellent alternative to traditional methods for stain and plaque removal. Access to crowded teeth, grooves and involved furcation areas are easily obtainable with less operator fatigue. The APAD slurry produces different root surface abrasiveness, depending on the method of use. Extended maintenance periods of exposed root surface using the APAD can result in an enormous loss of root structure. To avoid permanent damage of the root, the device should be used with overlapping strokes and root exposure to the APAD slurry should be minimized. The device can be used for total cementum removal with less operator fatigue and more reproducibility than with hand instruments, leaving smooth and clean surfaces. In addition, the device may be a valuable tool in the detoxification of root surfaces during periodontal surgery.
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A study was made to determine the efficacy of a new jet abrasive tooth-polishing device and its effect on enamel surfaces. Extracted teeth with extrinsic stain were polished with the jet abrasive. Smoothed enamel surfaces were polished with the jet abrasive, a rubber cup with paste, and an ultrasonic instrument. The surface alterations were then compared.
1. A long term (54 months) supervised, double-blind human clinical study has been conducted to ascertain whether the routine use of a commercially available cosmetic dentifrice, with purported stain removal and flavor impact characteristics, would cause adverse manifestations in the oral tissues, as compared to the similar use of a more conventional type of commercially available dentifrice. 2. One hundred and twenty male and female subjects (aged 12 to 70) were randomly assigned to the use of one of the two dentifrices under investigation, after which they used the assigned dentifrices twice daily (1 min each brushing) under supervised conditions for a period of 54 months. 3. Clinical examinations were conducted on all subjects initially (base line), and at 3-month intervals throughout the 54-month course of the study. This examination included a complete and thorough inspection of the oral soft and hard tissues. 4. The results after 54 months of continuous use of the dentifrices (representing a total dentifrice/oral tissues exposure time of approximately 45 hours per subject) indicated that neither of the two dentifrices caused any adverse reactions of the oral soft tissues and that both dentifrice groups had similar patterns and levels of cervical abrasion and/or erosion. 5. The results also indicate a lack of direct correlation between laboratory abrasivity values (as determined by a radioactive dentin abrasion procedure) and the clinical situation, thus suggesting that factors other than dentifrice abrasivity may play an important role with regard to tooth wear.
Tooth discoloration's may cause serious damage to the aesthetic appearance of the patients. These discoloration's can be treated in several ways but up to lately tooth structure had to be removed in an irreversible manner in order to provide sufficient bulk for the new restorative material. Nowadays thanks to the work of T. Croll and others a method has been established in a scientific way whereby tooth discoloration's confined to the outermost layer of enamel can be removed, through the application of an compound called PREMA which will simultaneous erode and abrade the enamel surface. If carefully selected the discoloration can be removed with only a limited loss of tooth structure. The authors describe the historical background of the method. Furthermore patient's selection, specific instruments and materials are described in detail. The clinical procedure is explained step by step, followed by a complete report of the effects of the procedure on the different tooth structures. Finally the long term results are discussed and the possibility to enhance the result by combining this method with home bleaching.
The purpose of this article is to present an acid-abrasion ("enamel microabrasion") technique which can eliminate superficial enamel discoloration. The technique provides a conservative alternative for some patients who might otherwise have received porcelain or composite resin veneer restorations.
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