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PubMed2003

Abfraction and anisotropy--effects of prism orientation on stress distribution.

This work discusses the effect of enamel anisotropy in the stress concentration at the cement-enamel junction (CEJ), a probable cause of fracture in enamel leading to abfraction. Usual simplifications when developing computer models in dentistry are to consider enamel isotropic, or that the direction of the prisms is orthogonal to either the dentine-enamel interface or the tooth outer surface. In this paper, a more refined model for the material behavior is described, based on laboratory observation and on the work of Fernandes and Chevitarese. The material description is used in a two-dimensional (2D) finite element model of the first upper premolar, and the analysis is performed for two different situations: vertical loads, typical of normal mastication and horizontal loads, dominant in bruxism. The analyses were performed using a unit load, which under the hypothesis of linear response of the tooth, allows the combinations described in the text to simulate different functional and parafunctional loads. The results indicate that a realistic enamel description in terms of mechanical properties and spatial distribution of its prisms alters significantly the resulting stress distribution. For all cases included in this study, the detailed description of prism orientation and resulting anisotropy led to improved response in terms of stress distribution, even when loading was horizontal.

Anisotropy↗
PubMed2000

Long-term follow-up of maxillary incisors with severe apical root resorption.

The purpose of the study was to analyse the mobility of teeth with severe orthodontically induced root resorption, at follow-up several years after active treatment, and to evaluate mobility in relation to root length and alveolar bone support. Seventy-three maxillary incisors were examined in 20 patients, 10-15 years after active treatment in 13 patients (age 24-32 years) and 5-10 years after active treatment in seven patients (age 20-25 years). All had worn fixed or removable retainers; seven still had bonded twistflex retainers. Total root length and intra-alveolar root length were measured on intra-oral radiographs. Tooth mobility was assessed clinically according to Miller's Index (0-4) and the Periotest method. Crestal alveolar bone level, periodontal pocket depth, gingival, and plaque indices, occlusal contacts during occlusion and function, and dental wear were recorded. There was a significant correlation (P < 0.05) between tooth mobility, and total root length and intra-alveolar root length. No correlation was found between tooth mobility and retention with twistflex retainers. None of the variables for assessment of periodontal status, occlusion and function were related to total root length or tooth mobility. It is concluded that there is a risk of tooth mobility in a maxillary incisor that undergoes severe root resorption during orthodontic treatment, if the remaining total root length is < or = 9 mm. The risk is less if the remaining root length is > 9 mm. Follow-up of teeth with severe orthodontically induced root resorption is indicated.

Adult↗
PubMed2006

Epidemiological evaluation of the multifactorial aetiology of abfractions.

The purpose of this study was to determine risk indicators for the aetiology of abfractions (cervical wedge-shaped defects) on teeth using dental and medical variables obtained in a population-based sample of the cross-sectional epidemiological 'Study of Health in Pomerania' (SHIP). Medical history, dental, and sociodemographic parameters of 2707 representatively selected subjects 20-59 years of age with more than four natural teeth were checked for associations with the occurrence of abfractions using a two-level logistic regression model on a tooth and a subject level. The estimated prevalence of developing abfractions generally increased with age. The following independent variables were associated with the occurrence of abfractions: buccal recession of the gingiva, odds ratio (OR) = 6.7; occlusal wear facets of scores 1, 2 and 3, OR = 1.5, 1.9, 1.9; tilted teeth, OR = 1.4; inlays, OR = 1.6; toothbrushing behaviour, OR = 1.9 to 2.0 (two and three times a day versus once a day). First premolars had the highest estimated risk for developing abfractions, followed by the second premolars. Maxillary and mandibular teeth behaved similarly in terms of abfractions, with the exception of mandibular canines, which had a much lower estimated risk of incurring abfractions than did maxillary canines. The results of this analysis indicated that abfractions are associated with occlusal factors, like occlusal wear, inlay restorations, altered tooth position and tooth brushing behaviour. This study delivers further evidence for a multifactorial aetiology of abfractions.

Adult↗
PubMed1997

[Comparison of two methods of age determination in teeth of known age from wild carnivores].

Two age-determining methods were conducted on representatives of known age from the Order Carnivora (4 red foxes, 3 tree martens, 3 stone martens, 2 racoons, 2 badgers, 2 polecat and one otter). Age determination employed with the aid of tooth wear nearly agrees with the real age of the animals. Dating based on the formation of the age-dependent cement zone coincided well with the known ages of the individual specimens. However, in real foxes the figure one must be added to the number of cementum layers counted determining the definitive age of individuals. For representation of the cementum layers transverse sections of the apical part of the tooth root of canini, P2 and P3, stained with methylene blue, should be used. It is important to note that the dentino-cemental line should not be considered when counting the year rings in the cement.

Age Determination by Teeth↗
PubMed1999

Oral rehabilitation of a child with primary failure of tooth eruption.

This article describes the prosthetic evaluation and treatment of a 10-year-old female patient with primary failure of tooth eruption. This case is unique in that the failure of eruption affected both the deciduous and permanent dentition in all quadrants, in the absence of any other systemic abnormalities. After diagnostic articulation and a thorough discussion of the treatment with the patient and her parents, complete maxillary and mandibular overdentures were fabricated. The process followed with this preadolescent patient to ensure maximum compliance, success, and encouragement toward a positive attitude in wearing complete dentures is reported.

Child↗
PubMed2001

Analyzing the etiology of an extremely worn dentition.

Patients requiring extensive restorative care frequently exhibit significant loss of tooth structure. Specific clinical findings in an extremely worn dentition may vary widely and are often confusing. Severe wear can result from a mechanical cause, a chemical cause, or a combination of causes. The location of the wear, the accompanying symptoms and signs, and information gained from the patient interview are essential components in determining the etiology. A diagnostic decision tree facilitates a systematic analysis and diagnosis of dental wear.

Decision Trees↗
PubMed2005

Evaluation of a profilometrical method for monitoring erosive tooth wear.

The in vivo monitoring of erosive wear is difficult because lesions mostly progress relatively slowly and reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of erosive loss have been described, which either require extensive equipment or do not provide sufficient sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable observation periods. The method is the profilometric measurement of erosive tissue loss using acid-resistant markers, which represent both a reference area and a structure for the defined retracing of a given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the precision was < 4 microm, and the repeatability was good (95% limits of repeatability ranging from -4.7 to 5.2 microm). The estimated detection threshold for erosive loss is 15 microm, which appears to be adequate for monitoring. The method is indicated for special dental care in cases of severe dental erosion (e.g. eating disorders) and for clinical studies.

Dental Enamel↗
PubMed1998

"The view" and the canine connection: an atlas of mandibular anterior tooth esthetics.

Restoring splinted mandibular incisors and canines with full crown restorations has always presented a challenge in creating an esthetic illusion of reality of normal individual teeth. This treatise is designed to present the rules for mandibular anterior esthetics that have been distilled from almost 4 decades of clinical practice of restoring dentitions that have been severely compromised by the deformities of disease or accident. The resultant formula systematically creates the desired results with a high degree of predictability.

Crowns↗
PubMed1999

Potential for load-induced cervical stress concentration as a function of periodontal support.

PURPOSE: The purpose was to determine, photoelastically, the locations of occlusal load-induced stress concentrations within a maxillary premolar as a function of degree of periodontal support. MATERIALS AND METHODS: Composite three-dimensional models of a maxillary first premolar were fabricated for quasi-three-dimensional photoelastic stress analysis. Individual materials were used to model enamel, dentin, periodontal ligament, and alveolar bone. Three levels of periodontal support reduction (0%, 20%, 25%) were simulated by varying the socket depth. Vertical loads of 10 lb were applied to: (1) tip of buccal cusp, (2) tip of lingual cusp, and (3) center of occlusal surface. The resulting stresses were monitored and recorded photographically in the field of a circular polariscope arrangement. RESULTS: Cuspal loading concentrated stress around the cervical region below the loaded cusp, being highest under buccal cusp loading. The location of the stress concentration shifted apically as periodontal support diminished. CLINICAL SIGNIFICANCE: Observed cervical stress concentration corresponded well to the common location of abfractions seen in clinical situations. Since the location of cervical stress concentration varied with occlusal conditions, occurrence of abfractions must be highly dependent upon each patient's occlusion. Periodontal support reduction shifted the location of highest stress away from the cementoenamel junction. Therefore, abfractions are less likely to occur on periodontally compromised teeth compared to stable teeth.

Alveolar Process↗
PubMed2006

Incidence of noncarious cervical lesions and their relation to the presence of wear facets.

PROBLEM: Noncarious cervical lesions are characterized by loss of tooth structure in the cervical area, compromising its integrity and resulting in esthetic problems for the patient. PURPOSE: The purpose of this study was to assess noncarious cervical lesions in young patients in an attempt to establish a possible relationship to the presence of wear facets. MATERIALS AND METHODS: First-year dental students of Bauru Dental School were studied to verify the prevalence of noncarious cervical lesions and their relationship to the presence of wear facets. After 3 years, the students were examined again to verify the incidence of new lesions, trying to establish a correlation to the previous existence of wear facets. RESULTS: Of the 1,131 teeth analyzed, 129 had noncarious cervical lesions. Twenty-nine of the 40 students had at least one tooth with one lesion. After 3 years, the incidence of new lesions was 57. Mandibular first molars (22.3%), mandibular first premolars (13.2%), mandibular second premolars (13.2%), and maxillary first molars (12.4%) showed the highest prevalence of lesions. On final analysis, 86.8% of all teeth presenting lesions showed wear facets. The identification of new lesions associated with the presence of wear facets identified during the first exam 3 years earlier was statistically significant (p < 0.01). CONCLUSIONS: The patterns of wear facets found in the study population examined were associated with an increased occurrence of noncarious cervical lesions. CLINICAL SIGNIFICANCE: Occlusal factors, especially the presence of wear facets, should be considered in the management of noncarious cervical lesions.

Adolescent↗
PubMed2003

A model for the prediction of tooth wear in individuals.

BACKGROUND: Easily applied, age-specific standards are useful in assisting clinicians to decide whether the extent of tooth wear observed in a given patient at a specific age is acceptable or whether intervention is indicated. METHOD: A simple method of scoring tooth wear and previously established mathematical relationships between tooth wear scores and age, provide the basis of a method for predicting tooth wear scores. In its most specific form, the method can be used to predict tooth wear scores for individual patients at subsequent ages. Alternatively, tables or graphs can be consulted to provide a less precise prediction of tooth wear that can assist clinicians to decide whether the amount of wear reflects high, moderate or low rates of wear at the specified age. CONCLUSION: In cases where there is no reason to believe that aetiological factors have changed significantly over time, data obtained from the methods described can assist clinicians to plan appropriate management for patients presenting with unacceptable levels of tooth wear.

Age Factors↗
PubMed2003

Non-carious cervical lesions in a Nigerian population: abrasion or abfraction?

OBJECTIVES: To determine the proportion of non-carious cervical lesions (NCCL) that were either abrasion or abfraction like and to test the validity of the assumption that right-handed patients cause more abrasion on the cervical surfaces of teeth on the left side of the mouth. SETTING: Ile-lfe, Southwestern Nigeria. PARTICIPANTS: 106 first time patients diagnosed as having any form of NCCL. DESIGN: Patients were subjected to intra-oral examination followed by the administration of a questionnaire. The cervical lesions were examined and scored using the tooth wear index designed by Smith & Knight 1984. NCCL was diagnosed as abrasion or abfraction like based on established clinical features plus positive history of possible associated aetiological factors. OUTCOME MEASURES: Abrasion and abfraction like lesions. RESULTS: Abrasion was the diagnosis in 630 (62.3%) of the 1,012 tooth sites with NCCL that had no associated occlusal surface wear facet. This constituted about two-thirds of the NCCL. Three hundred and eighty two (37.7%) of the NCCL occurred in association with an occlusal surface wear facet and presented the typical wedge shaped defects with sharp margins characteristic of abfraction. These abfraction like lesions constituted about one-third of the NCCL. 50.8% of abrasive NCCL in right-handed brushers were located on the left side of the mouth. CONCLUSIONS: About one-third of NCCL in the present study presents an abfraction component, and two-thirds abrasion. Although, right-handed brushers had more severe lesions on the opposite side of the mouth, the difference was not statistically significant.

Adult↗
PubMed2005

The worn dentition--pathognomonic patterns of abrasion and erosion.

Historically, the dental literature has revealed various causes of tooth wear, yet it has failed to provide a conclusive method of differentiation and diagnosis of the condition. The categories of tooth wear encountered most commonly in dental practice are abrasion and erosion. The major causes of wear from abrasion are bruxism and toothpaste abuse, and the major causes of wear from erosion are regurgitation, coke-swishing and fruit-mulling. Through in-depth clinical study of these causes, this paper provides a diagnostic system that will enable dental professionals to determine and differentiate the exact aetiology of the worn dentition simply by the recognition of the pathognomonic wear patterns on diagnostic casts, which are based upon the position and quantity of the non-carious loss of tooth structure.

Bruxism↗
PubMed2006

Tooth surface loss in adult subjects attending a university dental clinic in Trinidad.

OBJECTIVES: To determine the prevalence of tooth surface loss (TSL) in a sample of subjects attending a university dental clinic in Trinidad and to investigate the relationship to tooth brushing, medical history, parafunction and dietary habits. DESIGN: Tooth surface loss was measured clinically by the index used in the 1998 UK, Adult Dental Health Survey. SETTING: Trinidad, West Indies. PARTICIPANTS: Convenience sample of adult subjects attending The University of the West Indies Dental School Polyclinic, Mount Hope. METHODS: A questionnaire was administered and tooth surface loss measured clinically. MAIN OUTCOME MEASURES: mild, moderate and severe tooth surface loss. RESULTS: 155 subjects were examined (mean age 40.6 years) of whom 72% had some degree of TSL with the majority (52%), exhibiting mild, 16% with moderate and 4% with severe TSL. There were associations found between TSL and age (OR=3.14), reflux (OR=1.37), parafunction (OR=1.06), weekly consumption of citrus fruits (OR=1.31) and soft drinks (OR=1.78), daily consumption of alcohol (OR=1.40) and a vegetarian diet (OR=2.79). CONCLUSIONS: Tooth surface loss in this Trinidadian population group appears to be common. Data supports an association between TSL and age, reflux parafunction and certain dietary patterns.

Adolescent↗
PubMedDate not supplied

Thickness measurement of worn molar cusps by ultrasound.

This study aimed to evaluate the effectiveness of an ultrasonic system for in vitro measurement of cusp tips of human teeth. Each worn cusp of 12 molar teeth was measured with an industrial ultrasonic system. The teeth were sectioned and measured by polarized light microscopy. The ultrasonic measurements and histological readings were moderately correlated (r = 0.601, p < 0.01). The ultrasonic system used in this study seemed a promising method for measuring thickness of worn cusp tips of extracted human molar teeth.

Dental Enamel↗
PubMed2006

Tooth wear.

Explore the source record for details and available documents.

Dental Enamel↗
PubMed2006

Definition of erosion and links to tooth wear.

Erosive tissue loss is part of the physiological wear of teeth. Clinical features are an initial loss of tooth shine or luster, followed by flattening of convex structures, and, with continuing acid exposure, concavities form on smooth surfaces, or grooving and cupping occur on incisal/occlusal surfaces. Dental erosion must be distinguished from other forms of wear, but can also contribute to general tissue loss by surface softening, thus enhancing physical wear processes. The determination of dental erosion as a condition or pathology is relatively easy in the case of pain or endodontic complications, but is ambiguous in terms of function or aesthetics. The impact of dental erosion on oral health is discussed. However, it can be concluded that in most cases dental erosion is best described as a condition, with the acid being of nonpathological origin.

Dental Occlusion↗