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[The comparative study of the effect of silica and calcium carbonate based dentifrice on dentine abrasives in vitro].

PURPOSE: To evaluate the effect of Silica (SiO(2)) and Calcium Carbonate (CaCO(3)) based dentifrice on their dentine abrasives. METHODS: Microscope, environmental electron scanning electron microscope (SEM) and radioactive Dentine Abrasion (RDA) assay were used to quantitatively measure the wear of dentine. RESULTS: The mechanical brushing assay showed severe dentine abrasion with CaCO(3) based dentifrices. There were only minor scratches on the specimens brushed with SiO(2) dentifrices. Analysis of the thin section by SEM after exposure to dentifrices showed that NaF/SiO(2) produced significant remineralization whereas MFP/CaCO(3) system resulted in little remineralization. RDA values were 86.17 and 98.61 for SiO(2) based dentifrices and 222.85 and 253.84 for CaCO(3) based dentifrices, respectively. The morphology of the irregular shaped CaCO(3) with sharp points/edges further explained the brushing and RDA results. CONCLUSION: These results indicate that abrasive in dentifrice, e.g. CaCO(3), can cause severe abrasion of dentine in vitro.

Calcium Carbonate↗

[Fracture resistance of human premolar with regard to morphological factors].

173 extracted human upper and lower premolars were tested for their fracture resistance with regard to the morphological factors proximal vertical fluting and occlusal abrasion. Upper and lower premolars revealed a comparable fracture strength. The proximal groove did not influence the fracture resistance. Markedly abraded teeth showed a higher fracture strength than premolars without or with only a moderate occlusal abrasion. But these differences were not significant statistically. In total the morphological factors, which were considered in this study, should not influence the fracture resistance.

Bicuspid↗

[Dental examination of skulls of the early Middle Ages in Bial-Mett].

UNLABELLED: A systematic dental examination was made on 43 skulls from the 6th/7th and 8th/9th centuries which were excavated by the archeological service of the canton of Berne in the church of Biel-Mett. The examination consisted of the following parameters: Count, loss of teeth, caries (instrumental and radiological), calculus deposits, bone loss. The skulls were classified after age and compared with other findings. Generally speaking the results were comparable to findings of other excavations, but they are more detailed owing to more exact methods of examination. CONCLUSIONS: The examined population had lost about 23% of their teeth, had a relatively high caries incidence (30%) and a high caries morbidity. Most of the individuals had suffered from periodontal disease. High abrasion values point to the abrasive food then consumed.

Adolescent↗

Noncarious cervical lesions: the decision to ignore or restore.

A variety of unusual noncarious cervical lesions (NCL) are depicted that appear to negate W.D. Miller's toothbrush/dentifrice abrasion theory and demonstrate that other factors may be involved in their etiology. Confusion exists in the designation of NCL ever since G.V. Black stated in 1908 that toothbrush/dentifrice abrasion is an erosive effect. Since abrasion and erosion are two distinct activities, it is suggested that dentistry adopt the same terminology as chemical engineering in order to foster improved communication between the sciences. The term "abfraction" has been used to supplant erosion because it seems more appropriate when describing the loss of tooth substance attributable to effects of occlusal loading forces as well as the physiochemical breaking that occurs during stress corrosion. Numerous reasons, based on accepted engineering principles, indicate that NCL should be restored. It is incumbent on dentists to become cognizant of these reasons, since this would help them inform patients of the benefits to be gained by restoring such deficient areas.

Composite Resins↗

Use of variable remineralization periods to improve the abrasion resistance of previously eroded enamel.

The objective of the study was to evaluate the period of remineralization needed to re-establish the resistance of eroded enamel against brushing abrasion. Enamel specimens were prepared from 84 polished bovine incisors. The samples were evenly distributed among 7 groups (A-G) and submitted to ten alternating de- and remineralization cycles which included abrasion by toothbrushing. Demineralization was accomplished by immersing the specimens in the erosive soft drink Sprite Light((R)) for 1 min. Remineralization was performed by storing the samples in artificial saliva for either 0 min (A), 10 min (B), 60 min (C) or 240 min (D). After each remineralization, the specimens were brushed in an automatic brushing machine. Group E (erosion and 240 min remineralization, but no brushing) group F (erosion, but no remineralization and no brushing), and group G (brushing, but no erosion and no remineralization) served as controls. After performing the cycles, loss of enamel was determined by profilometry. The following values (mean +/- SD) were obtained and statistically analyzed (p<0.05): group A (5.16+/-1.26 microm), B (2.47+/-0.68 microm), C (1.72+/-0.75 microm), D (1.11+/-0.42 microm), E (0.81+/-0. 23 microm), F (1.04+/-0.31 microm), G (0.22+/-0.15 microm). Only the differences between groups D, E, and F were statistically not significant. Under the chosen in vitro conditions, it is concluded that abrasion resistance of eroded enamel continuously increases with remineralization time. However, even after a period of 1 h of remineralization, abrasion of previously eroded enamel is increased

Analysis of Variance↗

Influence of fluoride dentifrice on brushing abrasion of eroded human enamel: an in situ/ex vivo study.

This in situ/ex vivo study assessed the effect of fluoride dentifrice on eroded enamel subjected to brushing abrasion. In a crossover study performed in 2 phases, 10 volunteers wore acrylic palatal appliances, each containing 3 human enamel blocks. Dentifrice was used to brush the volunteers' teeth and the specimens subjected to abrasion. In phases A and B the dentifrices used had the same formulation, except for the absence or presence of fluoride, respectively. The blocks were subjected to erosion by immersion of the appliances in a cola drink for 5 min, 4 times a day. Then the blocks were brushed, and the appliance was replaced into the mouth. Enamel alterations were determined using profilometry and percentage change in surface microhardness (%SMHC) tests. The data were tested using the paired t test. The mean wear values (+/-SD, microm) were: group A 6.84 +/- 1.72 and group B 5.38 +/- 1.21 (p = 0.04). The mean %SMHC values (+/-SD) were: group A 54.6 +/- 16.2 and group B 45.7 +/- 6.8 (p = 0.04). Fluoride dentifrice had a protective effect on eroded enamel subjected to brushing abrasion.

Adult↗

Clinical methods for determining dentifrice-cleaning ability. American Dental Association Health Foundation Research Institute.

This collaborative study of dentifrice-cleaning methodology and function was conducted to compare three dental stain-grading methods among 300 adults who brushed their teeth for 8 weeks with three specially formulated calcium phosphate dentifrices, which differed in dentin abrasivity. In general, with some difference in sensitivity, use of the three stain-grading methods distinguished among different groups of the population using these three dentifrices. By using the method with the greater level of magnification, a significant difference was detected earlier. The data indicate that there is a linear correlation between dentin abrasivity as measured in vitro and observed clinical stain cleaning. As the dentifrices used in this study were custom-designed and limited to the chemical family of calcium ortho-phosphates, the linear relation between abrasivity and cleaning in this study cannot necessarily be related to other abrasive systems or other abrasion levels. Either of the two study designs, that is, testing after a prophylaxis (stain accumulation) or non-prophylaxis (stain removal), is appropriate for future investigations. However, in this study, greater examiner sensitivity was observed with the design that utilized preformed pellicle stain of known history as the substrate for cosmetic tooth-cleaning.

Adolescent↗

Enamel loss during orthodontic bonding and subsequent loss during removal of filled and unfilled adhesives.

1. The techniques required in the removal of highly filled composite adhesives at the end of orthodontic treatment on an average cause more loss of enamel than removal of an unfilled polymethylmethacrylate adhesive. 2. The amount of enamel lost during the removal of either adhesive may be of clinical significance because of the removal of a major part of the protective fluoride-rich layer of enamel. 3. The use of zirconium silicate on a rotating bristle brush may cause considerable abrasion of enamel.

Acid Etching, Dental↗

Dental erosion: diagnostic-based noninvasive treatment.

Lesions that result from dental erosion can be difficult to recognize--particularly when abrasion and attrition are also present. Consequently, dental erosion is often misdiagnosed and mistreated by radical restorative modalities that compromise the vitality of the pulp. This article provides clinicians with knowledge concerning the diagnosis of the complex lesions of dental wear and demonstrates the conservative treatment of this condition. Two cases that exhibit marked tooth wear in anterior teeth and their subsequent restoration utilizing occlusal principles and composite resin are presented.

Acid Etching, Dental↗

Preventive measures and caries progression: an in vitro study on fissures and smooth surfaces of human molars.

The aim of this study was to compare pit-and fissure sealants with fluoride treatments in their effectiveness to inhibit or reduce the progression of enamel lesions, particularly in the fissure region. The effects of fissure probing as used in diagnosis were compared with in the same protocol. Using a combination of image analysis of X-ray pictures of full crowns and a light microscopic evaluation of cross-sections provided information on the three dimensional spread of enamel demineralization. Pit-and-fissure sealants were superior in protecting enamel against progression of demineralization, as long as the walls of the fissures were well covered. The protection against demineralization offered by fluoride was mainly restricted to the smooth enamel surfaces; in fissures no protection could be measured. Surface defects of the enamel caused by probing or abrasion aided the progress of the lesion.

Amines↗

In vitro evaluation of toothbrushing abrasion of differently bleached bovine enamel.

PURPOSE: To evaluate in vitro, the effect of different external bleaching agents on the susceptibility of enamel against toothbrushing abrasion. METHODS: 96 bovine enamel specimens were embedded in acrylic resin, polished and covered with tape except for a 1.4 x 10 mm window. The samples were divided into eight groups (A-H), 12 specimens each (A-G) were treated with seven different home-bleaching (A: Whitestrips, B: Rapid White, C: Opalescence 10%, D: Opalescence PF 15%) and in-office-bleaching agents (E: Opalescence Extra, F: Opalescence Quick, G: Opalescence Extra Boost) according to manufacturers' instructions. Before and after each individual bleaching treatment the samples were brushed 40 times in an automatic brushing machine using a slurry containing artificial saliva and fluoridated toothpaste. The control group (Group H) was not bleached, but also brushed. After each cycle the specimens were stored in artificial saliva for 24 hours. RESULTS: After 20 cycles loss of enamel was determined by profilometry, resulting in the following values (mean +/- standard deviation) which were statistically analyzed: Group A: (0.169 microm +/- 0.035), Group B (11.108 microm +/- 0.655), Group C (0.207 microm +/- 0.042), Group D (0.154 microm +/- 0.028), Group E (0.081 microm +/- 0.015), Group F (0.084 microm +/- 0.018), Group G (0.087 microm +/- 0.014), Group H (0.076 microm +/- 0.012). Group B differed significantly from the other groups (r = 0.001). Samples of Groups C, D and A showed a significant difference compared to the control H (r = 0.001). Statistical analysis revealed no significant difference between enamel loss of Groups E, F, G and the Control H. It could be proven that toothbrushing abrasion of bleached enamel may be increased depending on the bleaching agent and application form used. Nevertheless, with the exception of bleaching treatment with Rapid White, toothbrushing abrasion of bleached enamel seems to be clinically less relevant.

Animals↗

Effects of irradiation on in situ remineralization of human and bovine enamel demineralized in vitro.

The objective of this study was to evaluate the effects of irradiation and surface condition on in situ remineralization of demineralized human and bovine enamel. Specimens (n=96) obtained from 24 human molars and 24 bovine incisors were prepared. The surfaces of half of the specimens were abraded while the others remained natural. Each of the 12 human and bovine abraded and sound specimens was irradiated fractionally up to 46.5 Gy (3.1 Gy/day, 5 days/week), while the remaining samples were not irradiated. Prior to and following the demineralization (pH 5.0; 14 days) all specimens were partly covered with nail varnish (control). After in vitro demineralization 2 irradiated and 2 nonirradiated specimens were inserted into both buccal aspects of 12 intraoral appliances, which were worn by 12 persons for a period of 6 weeks. All samples were brushed twice a day with a fluoride-containing toothpaste. Mineral analyses revealed a significant influence on mineral loss (DeltaZdemin), mineral gain (DeltaDeltaZ), lesion depth (LDdemin), and lesion depth reduction (DeltaLD) of the variables 'material' and 'irradiation' (p<0.05; ANOVA). Reciprocal interactions could be observed between these two variables for DeltaZdemin, DeltaDeltaZ, and LDdemin, due to significantly reduced values found for the irradiated, abraded bovine specimens compared to the nonirradiated ones (p<0.05; Bonferroni post hoc test). It can be concluded that neither irradiation nor abrasion influenced in vitro demineralization or in situ remineralization of the human specimens, whereas abrasion hampered demineralization in irradiated, bovine specimens.

Adult↗

Interproximal grooving in the Atapuerca-SH hominid dentitions.

The dental sample recovered from the Sima de los Huesos (SH) Middle Pleistocene cave site of the Sierra de Atapuerca (Spain) includes 296 specimens. Interproximal wear grooves have been observed in 20 maxillary and mandibular posterior teeth belonging to at least five of the 32 individuals identified so far in the SH hypodigm. Interproximal grooving affected only the adults, and at an age between 25 and 40 years. The appearance, morphology, and location pattern of the SH wear grooves are similar to those reported in other fossil hominids and in more recent human populations. Two alternative proposals, the toothpicking and the fiber or sinew processing hypotheses, compete for explaining the formation of this anomalous wear. The characteristics observed in the wear grooves of the SH teeth are compatible only with the habitual probing of interdental spaces by means of hard and inflexible objects. Dietary grit may also have contributed to the abrasion of the root walls during the motion of the dental probes.

Adult↗

Abrasion of eroded root dentine brushed with different toothpastes.

This study evaluated the surface roughness change and wear provided by different dentifrices on root dentine previously exposed to erosive challenges. According to a randomized complete block design, 150 slabs of bovine root dentine (6 x 3 x 2 mm) were ground flat and polished. In an area of 4 x 3 mm on the dentine surface, specimens were submitted to five erosive/abrasive events, each one composed by: exposure to Sprite Diet or distilled water for 5 min, then to a remineralizing solution for 1 min, and simulation of 5,000 brushing strokes. Four dentifrices--regular (RE), baking soda (BS), whitening (WT) and tartar control (TC)--and distilled water (CO), used as control, were compared. Final texture and the wear depth were evaluated using a profilometer. ANOVA did not show significant interaction, indicating that the effect of dentifrices on both surface roughness change and wear did not depend on whether or not the dentine was eroded ( p>0.05). There was no difference between abrasion of eroded and sound dentine. The Tukey's test revealed that WT, BS and TC provided the highest increase in surface roughness differing from RE and CO. TC yielded the deepest wear of root dentine, whereas RE and CO, the shallowest. No significant difference in wear among BS, TC and WT were observed. Within the limitations of this study, the data showed that abrasion of both eroded and sound root dentine was dependent on the dentifrice used.

Analysis of Variance↗

Prevention of progression of dental erosion by professional and individual prophylactic measures.

The key elements for the establishment of a preventive program for patients suffering from erosion are described on pathophysiologic grounds. These elements aim 1) to diminish frequency and severity of acid challenge, 2) enhance salivary flow, 3) to enhance acid resistance, remineralization and rehardening by fluoride application, 4) to offer chemical protection by buffering substances, 5) to minimize abrasion, 6) to offer mechanical protection. Recommendations for prophylactic measures are made as a conclusion and summarized in the form of check-lists.

Buffers↗

Influence of acidified fluoride gel on abrasion resistance of eroded enamel.

The objective of the study was to evaluate the abrasion resistance of eroded enamel brushed with an acidified fluoride gel. Each enamel specimen was prepared from one of 64 bovine incisors. The specimens were embedded in acrylic resin, ground flat, polished and subsequently covered with a tape exposing an area of 1.8x10.0 mm in the center of the enamel specimens. The samples were alternatingly stored in a demineralizing solution (5 min) and a remineralizing solution (1min) four times. An acidic soft drink (Sprite Light(R)) served as a demineralizing solution and artificial saliva was used as a remineralizing solution. After each remineralization the specimens were brushed in an automatic brushing machine (2,000 strokes, 2.5 N load) and subsequently stored again in saliva (1 min). A mixture of artificial saliva (5 ml) with a gel (1 ml) based on the formulation of Elmex(R) gelée (Wybert, Lörrach, Germany) served as an abrasive slurry. Thirty seconds after brushing, the slurry was removed from the specimens by rinsing with destilled water. For each of 16 specimens the following gels (A-D) were used: gels A (pH 7.0) and B (pH 4.5) were unfluoridated; gels C (pH 7.0) and D (Elmex gelée; pH 4.5) contained 1.25% F-. After two cycles the specimens were kept in the saliva for 8 h. Finally the tape was removed and the abrasion was determined profilometrically. The following values (mean +/- SD) were obtained and statistically analyzed by analysis of variance and Wilcoxon two-sample tests (p</=0.01): gel A, 0.96+/-0.24 microm; B, 1.58+/-0.32 microm; C, 0. 71+/-0.23 microm; D, 0.25+/-0.08 microm. The differences between all experimental groups were statistically significant. It is assumed that treatment of enamel erosions with an acidified fluoride gel results in a higher abrasion resistance compared to gels which are either unfluoridated or neutral.

Amines↗

Soft tissue root coverage as treatment for cervical abrasion and caries.

Root exposure caused by gingival recession may result in cervical abrasion, root caries, root sensitivity, and compromised esthetics. Although cervical root lesions can be treated with Class V restorations, there may be advantages in treating them with soft tissue grafts for root coverage since they restore the dento-gingival unit to its prerecession condition. The rationale for root coverage with soft tissue grafts is reviewed and two cases are presented of successful root coverage procedures in which gingival recession associated with cervical abrasion and caries was present.

Adult↗