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Facet pattern in intact and restored dentitions of young adults. A comparative study.
The attritional dental pattern was studied clinically and on plaster casts in a group of individuals, 17-22 years old, with intact teeth and in a control group with a 'normal' distribution of dental restorations. The following observations were made: 1) all contact areas between occluding teeth exhibited facets; 2) most facets were located on inclines; 3) facets in the fossa bottom occurred oftenest in the control group and often involved fillings; 4) attritional facets on the distal marginal crest of the lower second molars were oftenest found in the control group; 5) denuded dentin in facets occurred oftenest in the control group; and 6) the number of facets and the worn areas were on an average largest in the control group. The findings in this study indicate a difference in the functional activity between the groups and support the hypothesis that dental fillings can induce changes in the neuromuscular pattern of the masticatory system.
Relationship between occlusal factors and signs and symptoms of mandibular dysfunction. A clinical study of 48 dental students.
Forty-eight young adults answered a questionnaire and were examined clinically for determination of symptoms and signs of mandibular dysfunction in accordance with the Helkimo indices. Occlusal conditions recorded included contacts in centric and excentric mandibular positions in accordance with specified criteria for registration of "ideal occlusion', various occlusal patterns, occlusal interferences, and dental attrition. Relatively frequent but mainly mild signs and symptoms of mandibular dysfunction were found. The occlusal conditions were extremely varied and did not show any significant correlations with signs and symptoms of mandibular dysfunction.
Occlusal wear. A follow-up study of 18 subjects with extensively worn dentitions.
Eighteen patients with moderate to severe dental wear were re-examined 6-10 years after a treatment period that included use of occlusal splints at night. The splints were used with various intensities for an average of 2 years. The methods of evaluation comprised a questionnaire, clinical examination, comparison of dental casts, salivary analysis, and bite force measurements. The changes in dental wear during the follow-up period were small, the typical finding being an increase of facets but no measurable reduction of tooth length. The results indicate that many variables apart from occlusal parafunctions, such as acid regurgitation and salivary and dietary factors, may contribute to loss of tooth substance diagnosed as dental wear. In most patients, the continuing wear process was slow after long-term treatment with occlusal splints.
An index for evaluating wear of teeth.
An index for evaluation of dental wear based on Ryge's system comprising three satisfactory and two not acceptable categories was tested in two different age groups of individuals with brain damage. Group 1 consisted of 12 individuals, 3 women and 9 men, with a mean age of 34.5 years. Group 2 consisted of 13 individuals, 4 women and 9 men, with a mean age of 45.1 years. The wear was evaluated by three examiners, two dentists and one dental hygienist. The examiners worked independently, having available at all times the written criteria and a photographic guide illustrating the lowest limit of each category. Each tooth was given a rating in accordance with the index, and the interexaminer agreement of 612 such evaluations was approximately 85%. Each person was given an individual wear rating corresponding to the most severe category comprising 90% of the tooth ratings. The difference in the distribution of individual ratings between the two groups was tested for significance by the ridit method. Significantly greater wear was observed in group 2 than in group 1, indicating a good sensitivity of the index.
Mandibular dysfunction and periodontitis. A comparative study of patients with periodontal disease and occlusal parafunctions.
Fifty-one patients (mean age, 47.3 years) with moderate to severe periodontal disease and 40 patients (mean age, 48.9 years) with symptoms related to bruxism (occlusal parafunctions such as grinding and/or clenching of the teeth) were compared with regard to periodontal conditions and signs and symptoms of mandibular dysfunction. The bruxists reported more symptoms of pain and dysfunction of the masticatory system than the periodontal patients. The clinical dysfunction index was significantly higher among the bruxists, while there was a similarity between the groups in the variation of occlusal conditions, except for occlusal wear, which was more pronounced in the bruxist group. Attrition was in general positively correlated to alveolar bone height. This correlation was stronger (and statistically significant) for the canines than for other teeth. Attrition was negatively correlated to tooth mobility. It is concluded that patients with moderate to severe periodontal disease and patients with bruxism/occlusal parafunctions are distinctly different with regard to signs and symptoms of mandibular dysfunction. The results support the opinions that there is no or only weak correlation between periodontal disease and bruxism, and between bruxism and occlusal status.
Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population.
The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.
Differences in functional variables, fillings, and tooth wear in two groups of 19-year-old individuals.
Fifty-one individuals (28 girls and 23 boys) who had received orthodontic treatment were compared with 47 subjects (19 girls and 28 boys) without such treatment as to maximal mandibular mobility, chewing muscle tenderness, morphologic occlusion, occlusal/incisal state, and degree of tooth wear. All were 19 years old. There were no statistically significant differences between the groups except for the number of teeth present and maximal mouth opening, which were both smallest in those who had received treatment. The first finding is evident, extraction of premolars being an accepted mode of orthodontic treatment. The reduced mouth opening capacity was related to an increased number of individuals with four or more palpably tender muscle sites in that group of individuals.
The suitability of a new index for the evaluation of dental wear.
The suitability of a new index for rating dental wear by different observers was tested. Four dentists, who were first calibrated using the scoring system and then subjected to an inter-examiner agreement test before and after a field study, rated 167 individuals in total in their private dental practices. The incisal/occlusal state of the teeth with regard to restorations and dental wear was recorded. The inter-examiner agreement test proved satisfactory when rating main groups of wear but not so good when rating subcategories. However, a marked improvement in agreement developed between the first and the second test. The individuals composing the field study group are probably not representative of Scandinavian populations in general. Relatively few teeth were missing, and the teeth were well restored. Only the highest age group (80-89 years) displayed the most severe degree of wear to any extent. However, wear into the dentin was observed in 20% of the teeth already in the youngest age group (20-29 years). These teeth were solely incisors and canines of both jaws. In conclusion, we found that the index should be well suited for the evaluation of dental wear in large groups of people by different investigators after adequate training in use of the system has been provided and that tooth wear may be a relatively small problem in urban Scandinavian populations with regular dental care.
Prevalence and severity of occlusal tooth wear in a young Saudi population.
An epidemiologic investigation of the prevalence and severity of occlusal wear was carried out in a young Saudi population. Occlusal wear was evaluated on a tooth-by-tooth basis on study casts made for 206 dental students, using an ordinal scale. The reliability of the scale was assessed by percentage inter- and intra-observer concordance. The mean occlusal wear was high for the population studied. The sample presented the highest wear scores in the incisor region, maxillary canines, and mandibular molars. Comparison with other studies of similarly aged Western populations showed a more extensive pattern of wear in the present sample, pointing to the possible role of environmental influences.
An individual tooth wear index and an analysis of factors correlated to incisal and occlusal wear in an adult Swedish population.
The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.
Five-year longitudinal recordings of functional variables of the masticatory system in adolescents with intact and restored dentitions. A comparative anamnestic and clinical study.
Recordings of functional variables of the masticatory system were made in 184 subjects, 18-20 years old, 5 years after the first examination. One hundred and six subjects had restored dentitions at both examinations (group F), 35 subjects with previously intact dentitions had received fillings during the follow-up period (group FI), and 43 subjects had intact dentitions at both examinations (group I). In conformity with the first examination 5 years earlier, the subjects in group F had higher scores for dentin facets on the first lower molar. Together with the finding of more frequent attrition on the distal part of the occlusal surface of the second lower molar, this finding indicates more functional or parafunctional activity in restored dentitions. Unilateral contacts in the retruded contact position (RCP) were equally common in all three groups, but the contacts in RCP were more often located in the molar region in group F. The finding at the first examination that interference causing a lateral slide of the mandible between RCP and the intercuspal position (ICP) was commoner in restored dentitions was not confirmed in the present study. Nor did the correlation analysis show any relationship between occlusal factors and signs and symptoms of mandibular dysfunction. However, the differences found between subjects with intact and restored dentitions indicate that the iatrogenic effect of dental filling therapy merits more consideration and more extensive research.
The clinical performance of two groups of functioning class-II cast gold inlays.
The length of service and the clinical performance of two groups of functioning class-II cast gold inlays in patients attending a private practice were assessed by conventional clinical and radiographic examination. In one group all inlays were older than 25 years (median age, 34 years), and they had an extended outline form. The impression technique was based on a thermoplastic material in a copper ring. In the other group, comprising inlays inserted during the past 25 years (median age, 16.5 years), the outline form was minimal and an elastic impression material in a copper ring was used. The inlays in the older group appeared to perform better than those in the younger group. In both groups recurrent caries appeared to be the predominant reason for repair.
Longitudinal relationship between incisal occlusion and incisal tooth wear.
The purpose of the study was to evaluate the longitudinal relationship between incisal wear of central incisors and the size of vertical overbite (OB) and horizontal overjet (OJ). Stone casts of 51 subjects were used for the determinations. Casts were obtained when the subjects were 15 and 27 years old. Statistical analysis was performed with the t test for paired samples, the chi-square test of association. Pearson's product moment correlation coefficient, and Spearman's rank correlation coefficient. Both overbite and overjet diminished after 12 years, and incisal wear increased. It was concluded that increase in age, incisal wear, vertical overbite and incisal occlusion (OB/OJ) are clinical predictors of wear of maxillary and mandibular central incisors in adolescents.
Prevalence, pattern, and severity of incisal wear in dental students.
This paper describes the prevalence, pattern, and severity of incisal wear of anterior teeth in 64 dental students at an average age of 23 +/- 1.7 years with a high number of permanent teeth present. The index used to assess wear on stone casts (IwI) was shown to have good reproducibility. The results indicated that about 98% of the anterior teeth had been worn to various degrees. In both jaws central incisors were most commonly affected by incisal wear, canines followed next in order, and lateral incisors were least commonly affected. Wear of identical teeth on the right and left side tended to be bilaterally symmetrical in both jaws. The results of these initial observations suggest that data from re-examination of this study group will lend themselves to detecting possible changes of the pattern and severity of incisal wear of permanent anterior teeth.
Prevalence of occlusal tooth wear and its relationship to lateral and protrusive contact schemes in a young adult Indian population.
The aim of the present study was to investigate the prevalence and severity of occlusal tooth wear and their interrelationships with lateral and protrusive occlusal contact schemes in a young adult Indian population. The material comprised 64 individuals (age: mean = 19 years; range, 17-24 years). Assessment of wear was performed by means of a tooth-by-tooth evaluation of casts. Lateral excursive and protrusive contact relationships were recorded at the clinical examination. There was no difference in the degree of wear between women and men. Mean occlusal wear was low for the population studied compared with similarly aged Scandinavians and Saudis. No differences in the severity of wear were found in relation to lateral excursive and protrusive contact schemes. Whereas the low wear experience in the present Indian sample may be related to dietary factors, more must be understood about the various other causes of occlusal tooth wear before its functional interdependence becomes clear.
A 2-year follow-up study of incisal tooth wear in dental students.
This report was derived from cross-sectional and longitudinal analyses of prevalence, pattern, and severity of incisal wear in 64 dental students who had virtually complete dentitions at the first examination and unchanged dentitions at the re-examination. They were first examined in 1991 and re-examined after 24 months in 1993. The average age of the students in 1991 was 23 +/- 1.7 years. Assessment of incisal wear was made on stone casts based on silicone impression material in accordance with the Incisal wear Index (IwI). The results showed that the prevalence of incisal wear had not changed during the observation period. The severity of incisal wear for maxillary and mandibular central and lateral incisors had remained essentially the same, whereas the severity of wear of maxillary and mandibular canines had increased during the observation period. There was no statistically significant relationship between age and IwI. The wear pattern found for anterior teeth is discussed in relation to the cuspid protection and the group function theories of occlusion.
Sliding wear of various composite resins and bovine enamel.
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