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An in vitro investigation into the wear effects of selected restorative materials on dentine.

Wear testing of five restorative materials was carried out against plates of human dentine using a wear machine specifically designed to simulate the masticatory cycle. The results showed that dentine is substantially less wear resistant than enamel when compared to previous findings. Amalgam produced no measurable wear of dentine, conventional composite produced extreme destruction and porcelain produced the greatest amount of wear. Great care should be taken with the choice of restorative material when opposing dentine.

Analysis of Variance↗

The face height in adult dentate humans. A discussion of physiological and prosthodontic principles illustrated through a case report.

The adaptability of the stomatognathic system to alterations in the vertical dimension is discussed based on scientific reports and clinical experience. A case is reported demonstrating the stability of a therapeutically induced increase in the occlusal vertical dimension over a 10 year period. In conclusion, it is stated that moderate alterations in the occlusal vertical dimension of patients are generally well tolerated if necessary for therapeutic measures.

Adult↗

The prevalence of toothwear in 1007 dental patients.

The dental profession is becoming increasingly concerned about unacceptable levels of toothwear and there is an impression that the condition is becoming more prevalent. There is, as yet, little epidemiological evidence to illuminate the question and so this study is therefore intended to provide baseline data on the prevalence of toothwear in a sample of the dental attending population of South East England. A degree of toothwear is normal and progresses throughout life. Toothwear which is acceptable in an older age group would not be so with younger patients. It is therefore necessary to designate threshold values of acceptable levels of toothwear for different age groups to reach realistic conclusions about the prevalence of unacceptable levels of toothwear. Of the 1007 patients examined only nine had completely unworn dentitions. More than 93,500 tooth surfaces were examined and of these 5.1% had wear which exceeded the threshold values. Despite increasing the threshold values for the older age groups from those proposed in an earlier study by Smith & Knight (1984), these patients still had higher levels of unacceptable toothwear. There was a slight tendency for men to have more wear than women, but there was no clinically significant relationship between the number of missing posterior teeth and wear of the anterior teeth.

Adult↗

Prediction of demand for treatment of temporomandibular disorders based on a 20-year follow-up study.

The purpose was to test the hypothesis that signs and symptoms characteristic of temporomandibular disorders (TMD) at age 15 would predict demand for treatment during a 20-year follow-up period. Of originally 135 examined 15-year-old subjects, 103 completed a questionnaire and 84 were examined clinically at the 10-year follow-up (at age 25). After 20 years (at age 35), 114 completed a questionnaire and 100 were also examined clinically. During the 20-year follow-up period, 21 subjects received some kind of treatment of TMD. At baseline (age 15), the treated group reported tooth grinding at night more often than the non-treated group (P = 0.0042). At the 10-year follow-up (at age 25), the treated group reported more symptoms of TMD and oral parafunctions than the non-treated group. Among the clinical registrations, there was only one significant difference between the groups: anterior tooth wear was more extensive in the treated group. At the 20-year follow-up (at age 35), the treated group reported significantly more symptoms of TMD and oral parafunctions than the non-treated group. The clinical dysfunction index was also higher in the treated group. Logistic regression revealed tooth grinding at night as a significant predictor of received treatment of TMD. However, the positive predictive value was low whereas the negative predictive value was high (90%). The findings indicate that nocturnal tooth grinding is related to demand for treatment of TMD.

Adolescent↗

Vertical height loss: an investigation of four restorative materials opposing enamel.

PURPOSE: The objective of this in vitro investigation was to compare the vertical wear produced by cone-shaped styli of three ceramic restorative materials and a Type III gold alloy opposing flattened human enamel. Vertical wear was measured as enamel height loss, material stylus height loss, and total vertical height loss (the sum of the enamel height loss and the restorative material height loss). MATERIALS AND METHODS: Ten cone-shaped styli were fabricated from each of four restorative materials, which included two machined ceramics, a pressed ceramic, and a Type III gold alloy. To maintain the standardized shape, styli were not polished or glazed. Specimens were subjected to wear in the presence of water for 100,000 cycles at 1.2 Hz under a load of 75 N using a wear simulation device. Enamel wear was evaluated by profilometry, and stylus wear was evaluated by computer imaging. Vertical wear was reported as enamel height loss, material stylus height loss, and total vertical height loss (the sum of the enamel height loss and material height loss). Data were compared using one-way analysis of variance and Scheffe's analysis (alpha = 0.05). RESULTS: Significant differences existed among materials based on material height loss (p = .0001), enamel height loss (p = .0001), and total vertical height loss (p = .0118). No significant difference among the three ceramics was found in mean total height loss, which ranged from 0.280 to 0.305 mm. However, the Type III gold exhibited less mean total wear (0.231 +/- 0.082) than the pressed and one machineable ceramic. This machined ceramic exhibited the most material height loss (0.249 +/- 0.044 mm). With the other ceramics, mean enamel wear was significantly more (0.211 and 0.216 mm, respectively). CONCLUSIONS: During wear simulation, pressed or machineable ceramics opposing flattened enamel exhibited a similar degree of total vertical height loss. One machined ceramic material wore significantly more than the other materials. The other machineable ceramic and the pressed ceramic wore the opposing enamel significantly more.

Aluminum Silicates↗

An in vitro investigation on the loss of root substance in scaling with various instruments.

There are differing opinions as to the extent to which root cementum has to be removed during root surface instrumentation over and above that of the debridement of plaque and calculus. Similarly, the amount of tooth material removed by individual instruments is also unclear, but a trend towards less damaging methods of root surface debridement has evolved in recent years. The purpose of this in vitro study was to determine the amounts of root substance removed by 4 different methods of instrumentation, hand curette, ultrasonic scaler, airscaler and fine grit diamond bur. Measurement of tooth substance loss was carried out with a specially constructed measuring device at 360 sites on 90 mandibular incisors following 12 working strokes with a clinically appropriate force of application. Only a thin layer of root substance (11.6 microns) was removed by the ultrasonic scaler, compared to the much greater losses sustained with the airscaler (93.5 microns), the curette (108.9 microns) and the diamond bur (118.7 microns).

Dental Cementum↗

On the relationship between crown form and clinical features of the gingiva in adolescents.

The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary front tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. 108 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, thickness of the free gingiva, width of the keratinized gingiva and the contour of the marginal gingiva. From clinical photographs of the maxillary front tooth region, the width (at the apical third--CW) and the length (CL) of the crowns of the 6 front teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. After correction for incisal attrition, the 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow (group N) or a short-wide (group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Control of supragingival calculus. Scaling and polishing and anticalculus toothpastes: an opinion.

The removal of supragingival calculus by scaling and polishing of the teeth is only one aspect of a dental prophylaxis. However in many countries, a large number of individuals only require and receive, at regular intervals, a supragingival scale and polish. The association of supragingival calculus to gingival and periodontal disease is unclear, however, it is logical to assume a plaque retention role. Moreover, for the individual, supragingival calculus may pose cosmetic problems. Regular calculus removal is both time consuming and exacting for dental professionals and has important financial implications to patients and/or health schemes. The benefits of regular supragingival calculus removal are not established, yet potential detrimental effects for the patient are known, and certain groups are susceptible to systemic disease consequent on scaling and polishing of the teeth. The oral hygiene habits of most individuals appear insufficient to prevent the reformation of supragingival calculus once removed and for this reason chemical inhibition is an attractive proposition. Most success to date has been with agents which inhibit crystal growth, notably pyrophosphates, and toothpaste products are available containing such agents. Clinical studies support efficacy for some products and indicate that the magnitude of calculus inhibition would reduce the need for or frequency of scaling and polishing of teeth in a proportion of individuals. Anticalculus toothpastes would appear to be proven worthy of recommendation for those individuals in whom supragingival calculus formation is a problem.

Bacteremia↗

Molar tooth attrition in a selected group of Nigerians.

A study of the degree and gradient of attrition was undertaken on 352 molar teeth of 88 selected Nigerian subjects. A method for the quantification of attrition experience per molar tooth is described. There is a close correlation between age and the degree of attrition of the first molar. This finding may be of value in age determination in forensic odontology. The wear on the first molar is about two stages ahead of that on the second and third molars. It is suggested that the degree of tooth attrition may be an index of masticatory activity.

Adult↗

Prevalence of oral soft and hard tissue lesions related to mechanical toothcleansing procedures.

The prevalence of oral soft and hard tissue lesions related to mechanical oral hygiene procedures was recorded and correlated to toothbrushing habits and oral hygiene status in two selected samples. Fifty-one percent of 533 persons examined exhibited gingival retractions and 45% had wedge-shaped defects in the cervical area of one or several teeth. Both types of lesions were often seen in the same area, indicating a common etiologic factor. The subjects with a good oral hygiene status, as well as those who brushed more than twice daily, showed a high frequency of lesions. The various toothbrushing techniques did not, however, seem to influence the development of such lesions in the present material. Subjective symptoms were reported in a few cases only.

Adolescent↗

Longitudinal study of functional conditions in the masticatory system in Flemish children.

A 5-yr longitudinal study on occlusal and functional parameters has been made in 75 children aged 8-11. They were selected at random from an original group of 510 studied 5 yr earlier. The following parameters were measured: frequency of frontal open bite lateral and frontal crossbite, the attrition on molars and on front teeth, the contacts on lateral excursion, pain on condyle palpation, TMJ clicking, deviations in the opening and lateral movement, and the maximal interincisal distance. There was an increase in the percentage of deep bite and crossbite. Attrition on molars was seen in 41% and on front teeth in 13% of the children. No real pattern could be observed as a function of age. The mean maximal opening range was 43.7 mm, varying between 23 and 52 mm. Restricted opening was found in one girl. In 60% a deviation in the opening has been found. In 26% TMJ sounds were observed and 28% had pain on condyle palpation. In most of the children the symptoms were very mild to moderate. No significant correlation could be found between dysfunctional signs and occlusal parameters. The present results did not provide any conclusive answer to the tremendous increase in dysfunctional signs over this 5-yr period. The treatment need is, however, low and should not be overestimated.

Belgium↗

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↗