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Clinical Oral Investigations Mar 2008The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is... (Review)
Review
The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is essential in order to assess the extent of this clinical phenomenon, both on an individual level and in the population, and for the adequate provision of preventive and therapeutic measures. Well-established erosion indices have been used in most of these studies, although in many cases modifications have been made to suit the different research aims. This use of different indices is one reason why it still cannot be claimed that there is enough current knowledge on this clinical phenomenon. This article summarises the proceedings of a workshop to discuss the topic of dental erosion indices. The result of the workshop is the proposal for a new scoring system (Basic Erosive Wear Examination, BEWE) designed for use both within the research field and for dental clinicians, with the aims of standardising assessment of erosion for international comparisons, raising awareness and providing guidelines for treatment of erosive tooth wear in dental practice.
Topics: Dental Enamel; Diagnosis, Differential; Humans; Odontometry; Prevalence; Reproducibility of Results; Severity of Illness Index; Tooth Abrasion; Tooth Attrition; Tooth Erosion
PubMed: 18228058
DOI: 10.1007/s00784-007-0180-6 -
Journal of Dentistry Jul 2022To assess the level of agreement between the simplified Tooth Wear Index (S-TWI) and the Basic Erosive Tooth Wear Examination (BEWE).
AIM
To assess the level of agreement between the simplified Tooth Wear Index (S-TWI) and the Basic Erosive Tooth Wear Examination (BEWE).
METHODS
Data from 477 adult participants in the Adult Dental Health Survey were analysed. They were examined at home using the S-TWI and the BEWE, in that order. Agreement in the highest score at person, segment and sextant levels was measured with Gwek's agreement coefficient. The impact of the threshold used to define tooth wear (any [mild/moderate/severe] vs no wear, moderate/severe vs no/mild wear and severe vs no/mild/moderate wear) on their agreement was also evaluated.
RESULTS
The prevalence of any, moderate/severe and severe tooth wear was 93.1%, 36.1% and 4.6% according to the S-TWI and it was 98.9%, 70.9% and 21.4% according to the BEWE, respectively. The agreement in the highest score between both indices was 0.745 (95% CI: 0.715, 0.775) at person level, 0.771 (95% CI: 0.746, 0.796) at the anterior segment level, 0.795 (95% CI: 0.766-0.824) for the upper anterior sextant and 0.905 (95% CI: 0.895-0.915) for the lower anterior sextant. The agreement between indices was higher for any wear than for severe wear at person, segment and sextant level. However, it was the weakest for moderate/severe wear regardless of the assessment level.
CONCLUSION
The agreement between indices was high, especially when focusing on specific parts of the mouth (lower anterior teeth) and when using specific thresholds of tooth wear severity (any wear and severe wear). Agreement was constantly low when using the moderate/severe wear threshold.
CLINICAL SIGNIFICANCE
When used as an epidemiological tool, the BEWE may report higher levels of tooth wear than the S-TWI. The BEWE may be a better screening tool whereas the S-TWI may be a better tool to use when determining secondary or tertiary care referral.
Topics: Adult; Humans; Mouth; Prevalence; Tooth Attrition; Tooth Erosion; Tooth Wear
PubMed: 35430318
DOI: 10.1016/j.jdent.2022.104126 -
British Dental Journal Mar 2023Gastro-oesophageal reflux disease (GORD) is a relatively common condition that occurs in adults and less commonly in children. It develops when the reflux of stomach...
Gastro-oesophageal reflux disease (GORD) is a relatively common condition that occurs in adults and less commonly in children. It develops when the reflux of stomach contents into the oesophagus causes troublesome symptoms and/or complications. Signs and symptoms include heartburn, retrosternal discomfort, epigastric pain and hoarseness, dental erosion, chronic cough, burning mouth syndrome, halitosis and laryngitis. A proportion of patients will, however, have silent reflux. Strongly associated risk factors include family history, age, hiatus hernia, obesity and neurological conditions, such as cerebral palsy. There are different treatment options which may be considered for GORD, consisting of conservative, medical and surgical therapy. Dentists should be aware of the symptoms of GORD and dental signs of intrinsic erosion indicative of possible GORD so that they can question patients about this and, if appropriate, initiate a referral to a general medical practitioner.
Topics: Adult; Child; Humans; Gastroesophageal Reflux; Tooth Wear; Risk Factors; Tooth Attrition
PubMed: 36964375
DOI: 10.1038/s41415-023-5677-0 -
International Journal of Environmental... Sep 2021Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues...
Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues throughout life, termed secondary dentin (SD). The effect of attrition on SD formation was considered to be confined to the area subjacent to attrition facets. However, due to a lack of three-dimensional methodologies to demonstrate the structure of the SD, this association could not be determined. Therefore, in the current study, we aimed to explore the thickening pattern of the SD in relation to the amount of occlusal and interproximal attrition. A total of 30 premolars (50-60 years of age) with varying attrition rates were evaluated using micro-computerized tomography. The results revealed thickening of the SD below the cementoenamel junction (CEJ), mostly in the mesial and distal aspects of the root ( < 0.05). The pattern of thickening under the tooth cervix, rather than in proximity to attrition facets, was consistent regardless of the attrition level. The amount of SD thickening mildly correlated with occlusal attrition ( = 0.577, < 0.05) and not with interproximal attrition. The thickening of the SD below the CEJ coincided with previous finite element models, suggesting that this area is mostly subjected to stress due to occlusal loadings. Therefore, we suggest that the SD formation might serve as a compensatory mechanism aimed to strengthen tooth structure against deflection caused by mechanical loading. Our study suggests that occlusal forces may play a significant role in SD formation.
Topics: Bicuspid; Bite Force; Child, Preschool; Dentin, Secondary; Female; Finite Element Analysis; Humans; Tooth Cervix
PubMed: 34639261
DOI: 10.3390/ijerph18199961 -
International Dental Journal Aug 2012This study aimed to appraise, within the context of tooth caries, the current clinical evidence and its risk for bias regarding the effects of xylitol in comparison with... (Comparative Study)
Comparative Study Review
OBJECTIVES
This study aimed to appraise, within the context of tooth caries, the current clinical evidence and its risk for bias regarding the effects of xylitol in comparison with sorbitol.
METHODS
Databases were searched for clinical trials to 19 March 2011. Inclusion criteria required studies to: test a caries-related primary outcome; compare the effects of xylitol with those of sorbitol; describe a clinical trial with two or more arms, and utilise a prospective study design. Articles were excluded if they did not report computable data or did not follow up test and control groups in the same way. Individual dichotomous and continuous datasets were extracted from accepted articles. Selection and performance/detection bias were assessed. Sensitivity analysis was used to investigate attrition bias. Egger's regression and funnel plotting were used to investigate risk for publication bias.
RESULTS
Nine articles were identified. Of these, eight were accepted and one was excluded. Ten continuous and eight dichotomous datasets were extracted. Because of high clinical heterogeneity, no meta-analysis was performed. Most of the datasets favoured xylitol, but this was not consistent. The accepted trials may be limited by selection bias. Results of the sensitivity analysis indicate a high risk for attrition bias. The funnel plot and Egger's regression results suggest a low publication bias risk. External fluoride exposure and stimulated saliva flow may have confounded the measured anticariogenic effect of xylitol.
CONCLUSIONS
The evidence identified in support of xylitol over sorbitol is contradictory, is at high risk for selection and attrition bias and may be limited by confounder effects. Future high-quality randomised controlled trials are needed to show whether xylitol has a greater anticariogenic effect than sorbitol.
Topics: Cariostatic Agents; Clinical Trials as Topic; Dental Caries; Evidence-Based Dentistry; Humans; Outcome Assessment, Health Care; Sorbitol; Sweetening Agents; Xylitol
PubMed: 23016999
DOI: 10.1111/j.1875-595X.2011.00113.x -
Progress in Orthodontics Jan 2018Gingival recession in dentitions with otherwise healthy periodontium is a common occurrence in adults. Recession is clinically measured using a periodontal probe to the...
BACKGROUND
Gingival recession in dentitions with otherwise healthy periodontium is a common occurrence in adults. Recession is clinically measured using a periodontal probe to the nearest millimeter. The aim of this study is to establish quantitative measures of recession, the clinical crown height, and a new measure the gingival margin-papillae measurement. The latter is seen as the shortest apico-coronal distance measured from the depth of the gingival margin to a line connecting the tips of the two adjacent papillae.
METHODS
Measurements on all teeth up to and including the first molar were performed on pretreatment study models of 120 adult Caucasian and African-American subjects divided into four groups of 30 by gender and race.
RESULTS
Both the clinical crown height and the gingival margin-papillae measurements gave a true positive result for changes associated with gingival recession. Tooth wear shortens the clinical crown, and therefore, the measure of clinical crown height can give a false negative result when gingival recession is present. However, the gingival margin-papillae measurement was not affected by tooth wear and gave a true positive result for gingival recession. Tooth wear (attrition) was not associated with an increase in gingival recession. These measures are also useful in detecting recession prior to cemental exposure. Measures for recession and tooth wear were different for the four demographic groups studied.
CONCLUSIONS
These measures can be used as quantitative standards in both clinical dentistry, research, and epidemiological studies.
Topics: Adult; Black or African American; Age Factors; Female; Gingival Recession; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Sex Factors; White People
PubMed: 29376198
DOI: 10.1186/s40510-017-0199-4 -
Clinical Oral Investigations Mar 2008Tooth wear--attrition, erosion and abrasion-is perceived internationally as an ever-increasing problem. Clinical and epidemiological studies, however, are difficult to... (Review)
Review
Tooth wear--attrition, erosion and abrasion-is perceived internationally as an ever-increasing problem. Clinical and epidemiological studies, however, are difficult to interpret and compare due to differences in terminology and the large number of indices that have been developed for diagnosing, grading and monitoring dental hard tissue loss. These indices have been designed to identify increasing severity and are usually numerical. Some record lesions on an aetiological basis (e.g. erosion indices), others record lesions irrespective of aetiology (tooth wear indices); none have universal acceptance, complicating the evaluation of the true increase in prevalence reported. This article considers the ideal requirements for an erosion index. It reviews the literature to consider how current indices have evolved and discusses if these indices meet the clinical and research needs of the dental profession.
Topics: Dental Research; Health Status Indicators; History, 20th Century; Humans; Odontometry; Tooth Abrasion; Tooth Erosion
PubMed: 18228055
DOI: 10.1007/s00784-007-0184-2 -
Journal of Dentistry Nov 2023To explore the variability of tooth wear progression at the surface-, tooth- and patient-level over a period of three years three years using in vivo 3D-measurements of...
Inter- and intra-variability in tooth wear progression at surface-, tooth- and patient-level over a period of three years: A cohort study: Inter- and intra-variation in tooth wear progression.
OBJECTIVE
To explore the variability of tooth wear progression at the surface-, tooth- and patient-level over a period of three years three years using in vivo 3D-measurements of full dentitions amongst patients with moderate to severe tooth wear and without demand for restorative rehabilitation.
METHODS
Fifty-five eligible patients with moderate to severe tooth wear had intra-oral scans taken using either the 3 M True Definition Intraoral Scanner or the 3 M Lava Chairside Oral Scanner. The maximum height loss (µm) per cusp/incisal/palatal surface at unrestored surfaces was measured using the 3D Wear Analysis (3DWA)-protocol with Geomagic Qualify, resulting in sixty-four measurements per dentition. Data was visualized using box plots. Correlation was calculated between tooth wear progression rates of different tooth types and surfaces.
RESULTS
Thirty patients with scans at intake and after three years were included (38 ± 8 years, 77% M, 23% F). Mean observation time was 3.1 ± 0.2 years. Surface measurements (N = 1,615) showed a high deviation and a high number of outliers at all surfaces, indicating large variability amongst the surfaces, tooth types and patients with tooth wear progression rates. Correlations between regions were very low: anterior-molar region -0.219, anterior-premolar region 0.116 and premolar-molar region 0.113. Correlations between the surfaces of molars were also low (between 0.190 and 0.565).
CONCLUSIONS
In a group of patients with moderate to severe tooth wear, large differences in wear progression were found within and amongst patients. Tooth wear progression is therefore highly individualized and can be very localized.
CLINICAL SIGNIFICANCE
This study confirms the necessity of individual management of patients with moderate to severe tooth wear. Effective monitoring of tooth wear is important when deciding the timing and need for restorative intervention.
CLINICAL TRIAL REGISTRATION NUMBER
NCT04790110.
Topics: Humans; Cohort Studies; Tooth Wear; Tooth Attrition; Molar; Bicuspid
PubMed: 37683799
DOI: 10.1016/j.jdent.2023.104693 -
Journal of Personalized Medicine May 2020Bruxism is a masticatory muscle activity characterized by grinding of the teeth and clenching of the jaw that causes tooth wear and breakage, temporomandibular joint...
Bruxism is a masticatory muscle activity characterized by grinding of the teeth and clenching of the jaw that causes tooth wear and breakage, temporomandibular joint disorders, muscle pain, and headache. Bruxism occurs in both adults and children. Clinical characteristics and habits were evaluated in an adult sample. Moreover, we used DNA samples from 349 adults and 151 children to determine the presence of association with specific genes. Genomic DNA was obtained from saliva. The markers and (metalloproteinase 2 ()), and (metalloproteinase 9 ()), and (cathecol-o-methyltransferase ()) were genotyped. Data were submitted to statistical analysis with a significance level of 0.05. In adults, in univariate logistic regression, presence of caries, attrition, and use of alcohol were increased in bruxism individuals ( < 0.05). In addition, in adults, there was an association between bruxism and (, = 0.0001) and bruxism and (, = 0.003). In children, a borderline association was observed for (, = 0.08). When we performed multivariate logistic regression analyses in adults, the same clinical characteristics remained associated with bruxism, and orthodontic treatment was also associated, besides , in the AG genotype ( = 0.015, OR: 3.40 (1.27-9.07)). For the first time, we provide statistical evidence that these genes are associate with bruxism.
PubMed: 32471213
DOI: 10.3390/jpm10020044 -
Caries Research 2020Our understanding of erosive tooth wear and its contributing factors has evolved considerably over the last decades. New terms have been continuously introduced, which... (Review)
Review
Our understanding of erosive tooth wear and its contributing factors has evolved considerably over the last decades. New terms have been continuously introduced, which frequently describe the same aspects of this condition, whereas other terms are being used inappropriately. This has led to unnecessary confusion and miscommunication between patients, professionals, and researchers. A group of 15 experts, selected by the European Organization for Caries Research (ORCA) and the Cariology Research Group of the International Association for Dental Research (IADR), participated in a 2-day workshop to define the most commonly used terms in erosive tooth wear. A modified Delphi method was utilized to reach consensus. At least 80% agreement was achieved for all terms discussed and their definitions related to clinical conditions and processes, basic concepts, diagnosis, risk, and prevention and management of erosive tooth wear. Use of the terms agreed on will provide a better understanding of erosive tooth wear and intends to enable improved communication on this topic.
Topics: Consensus; Dental Caries; Humans; Tooth Attrition; Tooth Erosion; Tooth Wear
PubMed: 31610535
DOI: 10.1159/000503308