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PubMed2002

Dental erosion caused by silent gastroesophageal reflux disease.

BACKGROUND: Gastroesophageal reflux disease, or GERD, is a relatively common condition, in which stomach acid may be refluxed up through the esophagus and into the oral cavity, resulting in enamel erosion. Symptoms such as belching, unexplained sour taste and heartburn usually alert the patient to the condition. In silent GERD, however, these symptoms do not occur, and enamel erosion of the posterior dentition may be the first indication of GERD. CASE DESCRIPTION: A 30-year-old man came to a dental clinic with enamel erosion on the occlusal surfaces of his posterior teeth and the palatal surfaces of his maxillary anterior teeth. He reported no history of gastrointestinal disease or heartburn. CLINICAL IMPLICATIONS: Enamel erosion may be a clinical sign of silent GERD that allows the dentist to make the initial diagnosis. Referral to a physician or gastroenterologist is necessary to define the diagnosis; however, dental expertise may be essential in distinguishing between differential diagnoses such as bulimia, attrition and abrasion. Successful treatment of this medical condition is necessary before dental rehabilitation can be initiated successfully.

Adult↗

PubMed1993

The degree to which attrition characterizes differentiated patient groups of temporomandibular disorders.

Dental attrition severity as the cumulative record of parafunctional and functional wear was graded from study cast analysis using established methodology. Attrition severity was compared in anterior, posterior mediotrusive, and posterior laterotrusive segments. Attrition scores in 48 female and 100 male totally asymptomatic controls were compared to 239 female and 31 male patients differentiated into five patient groups of temporomandibular disorders: (1) disc displacement with reduction, (2) disc displacement without reduction, (3) osteoarthrosis with a history of prior derangement, (4) osteoarthrosis without a history of prior derangement, and (5) myalgia only. All the male patients were in the myalgia-only group. Age was controlled in the analysis to control for functional wear. Comparisons between patients and controls were made according to 10-year age intervals. Analysis included ANCOVA confirmed by a Games-Howell post-hoc test, with P < .01 interpreted as a significant difference in the attrition score. Only 1 of 112 ANCOVAs showed a significant difference, with younger men from 20 to 29 years of age in the myalgia-only group having lower mediotrusive attrition than the male controls. It would therefore be difficult if not impossible to differentiate patients from nonpatients based on the severity of dental attrition. Consequently, a major peripheral occlusal etiologic role for attrition in TMD is questioned. Some clinical implications are elaborated.

Adult↗

PubMed1997

Five-year incidence of coronal and root caries in 60-, 70- and 80-year-old Swedish individuals.

The 5-year incidence of caries was studied in a random sample of 60-, 70- and 80-year-old inhabitants of Göteborg, with 69, 51 and 28 individuals in the different age groups. One aim of the study was to introduce a root caries index (DMFRS%) in which the missing root surfaces are taken into account. This study, as well as other recent studies, has shown that dental caries is the main reason for tooth extraction. The study also revealed that coronal and root caries occurred more frequently in elderly than younger people and the incidence of root caries was positively correlated with coronal caries (r = 0.3, p < 0.001) and negatively correlated with the number of remaining teeth (r = 0.4, p < 0.0001). The 5-year DMFRS% increment values increased with advancing age from 2.7 involved root surfaces per 100 susceptible ones in the 60-year-olds to 4.8 in the 70-year-olds and 10.7 in the 80-year-olds. It should be mentioned, however, that only people able to come to the clinic were enrolled in the study and an analysis of the attrition bias indicated that oral health may be worse in those who are too ill to participate. The frequent utilization of dental care among the participants was reflected in the finding of several new fillings and prosthetic crowns. Most of the very elderly people with carious lesions at baseline, however, had developed new lesions at the margins of the newly made restorations.

Aged↗

PubMed1989

[Clinical evaluation of the GaALAs laser treatment for hypersensitive dentin].

The methods available for treatment of hypersensitive dentin include the application of heavy metal salts such as diamine silver fluoride to the tooth, iontophoresis, Hyper-Band patching and restoration with various filling materials following cavity lining. Laser beam therapy, which has recently been used in dental treatment, is also expected to be applied to the treatment of hypersensitive dentin. In the present study, we obtained interesting results from the clinical use of a GaAlAs semiconductor Laser (Semilaser Nanox LX-800, GC Co.). The subjects were 63 patients with hypersensitive dentin: 8 patients without the exposed root, 40 with the exposed root, 21 treated with filling materials, 5 given Hyper-Band treatment, 14 with wedge-shaped defect, attrition or abrasion, and one with primary caries. Twenty-six fell into two or more categories. The effect of treatment was assessed by a single examiner in order to minimize error of estimates. Each lesion was directly irradiated for less than 3 minutes, and assessment of the result was conducted according to the criteria and method of Suzuki and Ishikawa. The results were as follows: The treatment was markedly effective in 44 (69.8%), effective in 12 (19.0%) and not effective in 7 (11.1%) of 63 patients. No case of exacerbation was found. The efficacy rate was 88.9%.

Dental Caries↗

PubMed1986

Posteruptive tooth age and severity of dental fluorosis in Kenya.

The purpose of the present study was to assess whether the degree of severity of enamel changes in a population exhibiting rather severe dental fluorosis may be related to posteruptive tooth age and to describe the clinical manifestations of the enamel destructions. All permanent teeth in 102 children aged 10-15 yr who were born and reared in a 2 ppm fluoride area of Kenya were examined for dental fluorosis using the TF-Index. Clinically, at time of eruption all teeth appeared chalky white, but already prior to coming into occlusion discrete pits had formed. A variety of more extensive damages to the surface enamel was found in teeth already in occlusion. In particular, the maxillary incisors exhibited extensive artificial attrition for cosmetic reasons, which make these teeth unreliable for accurate scoring of severity in the present population. An analysis of the proportion of teeth exhibiting TFI-scores 4+, 5+ and 6+ showed that children aged 13-15 yr had a significantly greater proportion of teeth with TFI-scores greater than or equal to 6 compared to children aged 10-12 yr (Wilcoxon, P less than 0.0001). This finding is unlikely to be a result of different fluoride exposures in the two age groups and indicates that even several years after eruption there is a trend towards an increasing severity of enamel surface destructions in children exhibiting pronounced degrees of subsurface enamel hypomineralization at time of eruption.

Adolescent↗

PubMed2005

Flexural strength and modulus properties of carbamide peroxide-treated bovine dentin.

BACKGROUND: The effects of carbamide peroxide bleach on tooth structure are uncertain. PURPOSE: The purpose of this study was to investigate the effects of direct or indirect carbamide peroxide application on dentin flexural strength and modulus in vitro. MATERIALS AND METHODS: Dentin bars were machined from bovine incisors and treated with 10% carbamide peroxide for 6 h/d for 14 days. Four groups were created, with eight bars in each group: group 1-direct bleach application only; group 2-indirect bleach application only; group 3-direct bleach application followed by a 2-week storage in artificial saliva; group 4-direct bleach application followed by a 2-week storage in artificial saliva and daily topical fluoride treatments. The specimens' flexural strength and modulus were tested after 24 hours, and the results were compared with water controls using independent t-tests (p < .05). RESULTS: Flexural strength results (in megapascals) for bleached versus control dentin (1=205+/-26 vs 215+/-14, 2=257+/-25 vs 261+/-14, 3=180+/-22 vs 193+/-36, 4=157+/-18 vs 184+/-11) were significantly lower in group 4 (p=.005). Modulus results (in gigapascals) for bleached versus control dentin (1=10.7+/-1.4 vs 12.2+/-0.6, 2=14.2+/-1.7 vs 14.4+/-1.6, 3=10.0+/-2.0 vs 10.9+/-1.3, 4=9.0+/-1.2 vs 11.1+/-1.0) were significantly lower in groups 1 and 4 (p=.013 and p=.003, respectively). There were no significant differences in strength and modulus results between the bleached and control dentin in groups 2 and 3. A direct application of carbamide peroxide to bovine dentin significantly decreased some dentin mechanical properties in vitro. An indirect application of carbamide peroxide to dentin did not significantly decrease dentin strength and stiffness. CLINICAL SIGNIFICANCE: This in vitro study suggests that a bleaching treatment, when applied to the enamel of intact teeth, does not significantly affect the mechanical properties of the underlying dentin. However, when applied directly to dentin in clinical situations such as root exposure or occlusal attrition, the bleaching treatment may result in altered mechanical properties of dentin. The clinical consequences of this observation are, however, unknown.

Animals↗

PubMed1997

Methodological problems in assessing health-related, neuropsychological effects of lead absorption in a very low-level exposed area.

Methodological problems in the low level lead studies are reviewed using the Aarhus lead study as an example. It is shown that a lead effect can be found in an area where the background blood lead level is as low as 37 micrograms/l (geometric mean). Even in such an area it is worthwhile looking for populations at risk. It is shown that attrition causes confounding with a directional bias towards the null-hypothesis. Longitudinal studies are associated with this type of bias. Misclassification as for past exposures will also have a bias of this type. Studies depending on blood-lead measures are liable to have this type of bias. This is the case to a lesser degree in studies using cumulated indices. Subsamples of tooth dentin (circumpulpal dentin) satisfies the requirement for an index for cumulated lead absorption. Since lead absorption requires motor abilities, medical factors that are risk factors for motor development as well as for the other developmental outcome are also confined with a directional bias towards the null-hypothesis. It is suggested to exclude for such factors. Lead seems to be a ubiquitous noxious substance. Any community should have a strategy to minimize its effects.

Child↗

PubMed1991

Oral conditions among German battery factory workers.

The purpose of the study was to evaluate the oral health situation of workers in a modern battery factory; in particular, to describe the prevalence and the severity of dental erosion and attrition in relation to exposure of airborne acids in the work environment. Measurements of the work environment at a German battery factory showed that the workers were exposed to sulfuric acids (0.4-4.1 mg/cm3). All workers at the factory were included in the survey and a total of 61 dentate individuals completed a questionnaire on their work environment, dental health, and symptoms from the mouth, nose, and throat. Information on oral health status, erosion, and attrition was collected by clinical examinations. Nearly all workers reported exposure to etching substances in their work environment: 56% complained of sharp and thin teeth and 29% of short teeth. Poor dental health conditions were observed (e.g. mean D-T = 3.8); the mean number of teeth with crown restoration was 5.3. The prevalence of erosion was 31% and 92% were affected by attrition. Erosion was found only in front teeth while attrition also occurred in posterior teeth. Due to the high level of crown restorations a rather moderate dose-effect relationship was observed. In conclusion, severe erosion and attrition due to sulfuric acid mists should be recognized as an occupational disease.

Acids↗

PubMed2004

Hereditary opalescent dentin--a case report.

A female patient aged 6 years reported with brown coloured small sized teeth that were continuously wearing out. The teeth were badly attrited upto the gingival margins. The occlusal surfaces were flattened. The clinical and radiographical examination confirmed the case as Hereditary opalescent Dentin. The rationale for early diagnosis and treatment has been discussed.

Child↗

PubMed1991

Orthodontic aspects on a skull collection from the Carmelite monastery in New Varberg.

During an excavation of the Carmelite monastery in New Varberg, 178 skeletons were found. Many of the skulls were in a bad condition. Thus, the material in the present study consists of 12 complete and 47 partial skulls (maxilla and/or mandible) of 22 monks and 37 ordinary inhabitants. The information collected involved direct inspection of the skulls, segments of the jaws and radiographic examination of the complete skulls. Malocclusion, attrition, temporomandibular joints and arch dimensions were analysed. From the results it is tempting to assume that lack of forceful masticatory function and consequent absence of evenly distributed attrition and observed differences in craniofacial morphology can be a major explanation to the high prevalence of severe malocclusion in modern man.

History, 15th Century↗

PubMed1995

Case report: an unusual cause of toothwear.

Dental practitioners often have to treat cases of toothwear, which may be caused by a number of factors including dietary erosion, physical attrition and abrasion due to friction against a foreign body. The authors encountered a young patient with a very unusual cause of toothwear, details of which are reported here.

Child↗

PubMed1978

Vital staining of coronal dentin in monkey teeth.

Vital staining of monkey incisor teeth with the incisal dentin exposed to the oral environment by attrition was carried out, with the use of a number of dyes (pH and redox indicators). There was a distinct staining of the coronal dentin, regardless of which dye was introduced into the pulpal cavity. The exposed dentin was stained like the unaffected dentin, with the exception of a narrow centrally located zone that extended from the tip of the original pulp horn to the incisal edge of the tooth. The suggestion is that this zone is not unstained because of exposure of the dentin to the oral environment, but because it coincides with an area of the tissue where the pulpal ends of the dentinal tubules are blocked by atubular hard tissue normally laid down in the pulp horn of incisor teeth.

Animals↗

PubMed1990

Five-year follow-up caries study among Nigerian children.

Eighty-five children (age in 1981, 3-9 yr) examined in the 1981 survey in Ile-Ife, Nigeria, were seen again in 1986. In addition cross-sectional caries data in a small sample of 6-14-yr-olds were compared with data obtained in 1986. Results show that caries prevalence rate and the average number of DMFT increased slightly in the urban area, but was still very low. Both caries prevalence and the average number of DMFT decreased in rural areas because attrition proceeded faster than did caries.

Adolescent↗

PubMed1990

An acoustically investigated case of phonetic change in higher vertical dimension.

This report presents the phonetic changes of a patient whose occlusal vertical dimension is extended. His chief complaint is esthetic restoration of his anterior teeth, but his occlusal vertical dimension is abnormally shortened by long-time attrition. Therefore we extended his occlusal vertical dimension, and reconstructed his occlusion, and carried out acoustic observations.

Aged↗

PubMed1998

[The study on the attrition of molars with occlusal hypersensitivity molars in elderly people].

OBJECTIVE: To investigate the attrition of molars in old people who suffered from occlusal hypersensitivity. METHODS: 113 maxillary and mandibular molars of old people (47-74 years old) who had dentine hypersensitivity caused by attrition were studied. The Lavelle's criteria were used. RESULTS: When the attrition reached to the e type, the rate of lesion rose up quickly (19.47%), the highest incidence was seen in g type (41.59%). The hypersensitivity occurred as 48.67% in the first molar, 51.33% in the second molar, 53.10% in enamel-dentin junction, and 38.05% in dentine concave site. CONCLUSION: The rate of hypersensitivity rises with the severity of attrition. There is no significant difference between the first molar and the second molar, but the incidence of hypersensitivity in enamel-dentin junction is significantly higher than in dentine concave site (P < 0.05).

Aged↗

PubMed1997

A reconsideration of the Archi 1 Neandertal mandible.

A reassessment of the early last glacial immature Neandertal mandibular corpus from Archi indicates a series of features in which it closely resembles other pre-adolescent Neandertal mandibles and contrasts with those of similarly aged recent humans. These are in the context of a re-aging of the specimen to ca. 3 years on the basis of deciduous dental eruption and attrition and permanent dental calcification. The Archi 1 mandible resembles other immature. Neandertals in having a "retreating" symphyseal profile in the context of moderate development of mental trigone features. It is relatively robust in the development of lateral and basilar corpus features and some increased symphyseal and lateral corpus thickness. And it exhibits, along with other Middle Paleolithic immature mandibles, anteriorly wide dental arcades, probably due to large developing anterior permanent tooth crowns.

Age Factors↗

PubMed1999

Dental findings in three siblings with Morquio's syndrome.

Three siblings with Morquo's syndrome are described. Cultured fibroblasts from the youngest sibling demonstrated a total absence of N-acethylgalactosamine-6-sulphate-sulphatase whereas beta-galactocidase activity was normal, thus verifying the diagnosis of MPS-IV A. Dental features such as pointed cusps, spade-shaped incisors, thin enamel and pitted buccal surfaces were observed in all three children. Furthermore, in all three siblings the TMJ was affected with severe resorption of the head of the condyle. Histological examination of exfoliated primary molars showed a band of increased porosity following the striae of Retzius in the outer part of the enamel. These developmental disturbances were occasionally associated with minor localized defects in the enamel surface. The importance of close monitoring of dental development and regular dental care in order to prevent attrition of the teeth, loss of vertical face height and subsequent risk of TMJ dysfunction is emphasized.

Adolescent↗

PubMed1993

Five-year study of all-porcelain veneer fixed partial dentures.

Improvements in enamel-dentinal bonding systems combined with the introduction of new ceramics have encouraged replacement of missing anterior teeth in specific patients with porcelain veneer fixed partial dentures. Metal substructures are not needed, and more natural tooth structure can be preserved because the preparation of abutments is conservative. Twelve porcelain veneer fixed partial dentures were monitored for 5 years, and fractures attributed to degradation of the gingival margins occurred in the veneer surface of the fixed partial dentures. The success rate of 75% was dependent on rigid patient selection criteria, strength of the major connectors, and precise adjustment of occlusion to prevent overloading. The failing margins were attributed to the degeneration, attrition, and deterioration of the composite resin cements. Despite these limitations, patients were extremely satisfied with the esthetics. Improvement in the mechanical properties of composite resin cement will ameliorate the prognosis with this approach.

Composite Resins↗