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PubMed2002

Quality of removable partial dentures worn by the adult U.S. population.

STATEMENT OF PROBLEMS: Research-based assessments of the quality of removable partial dentures (RPDs), especially within a large patient population, are lacking. PURPOSE: This study evaluated the prevalence and quality of RPDs by use of the National Health and Nutrition Survey (NHANES III) data set. MATERIAL AND METHODS: Estimates of the health and nutritional status of the American population were obtained from the NHANES III data set (1988-1994). Calibrated dentists performed dental examinations on 17,884 adults. If the subject wore an RPD, its quality was assessed with 5 criteria: integrity, tooth wear, the presence of temporary reline material or adhesive, stability, and retention. In this study, the data on RPD defects were used to assess the prevalence of problems. The original population was divided into 4 subgroups: paired RPD data = subjects wearing both maxillary and mandibular RPDs (n = 600 prostheses, 300 maxillary and 300 mandibular); single RPD data = subjects with only one RPD (n = 1003 prostheses, 511 maxillary and 492 mandibular); maxillary versus mandibular RPD data = all subjects with all RPDs (n = 1603 prostheses, 811 maxillary and 792 mandibular); and pooled RPD data = all subjects with a single RPD plus subjects with 2 RPDs, counting only the RPD with the most defects (n = 1303 prostheses, 674 maxillary and 629 mandibular). The subjects were analyzed with descriptive statistics. The distribution of defects in the RPDs was examined for possible associations with chi(2) tests. The paired data for patients with both maxillary and mandibular RPDs were analyzed with Wilcoxon signed rank tests. The prevalence of RPDs as a function of patient age and the association between RPD defects and patient age were analyzed with chi(2) tests. The results were considered highly significant at P<.0001 and significant at P<.05. RESULTS: Of the 17,884 adults who underwent a dental examination, 1306 had RPDs. Three patients were excluded because their records were incomplete, leaving 1303 patients available for analysis. Most of the prostheses examined (65%) had at least 1 defect. Lack of stability was the most prevalent single defect. Distinctions in the type and prevalence of defects were observed between mandibular and maxillary RPDs. Mandibular RPDs had significantly more problems related to retention, whereas maxillary RPDs had significantly more problems related to the presence of reline material and to integrity defects. Tooth wear defects were significantly associated with patient age (P<.0001). Only one third of the RPDs were considered satisfactory according to NHANES III criteria. CONCLUSION: A review of the database used in this study indicated that, in spite of a decline in tooth loss, RPDs are still used in all age cohorts, including young adults. A large number of RPDs were found to have defects.

Adhesives↗
PubMed2001

Dental paleopathology in a Serbian Medieval population.

Analysis of the pattern of dental disease in two Late Medieval populations from cemeteries excavated at archaeological sites in western Serbia was based on the study of tooth wear, ante-mortem tooth loss, caries, dental enamel hypoplasia, alveolar resorption, abscesses and calculus. The findings reported here show a high prevalence of attrition, alveolar resorption and caries, which suggest an abrasive diet and poor oral hygiene.

Adult↗
PubMed1991

A study of human jaw movements deduced from scratches on occlusal wear facets.

In a previous investigation, scratches on tooth wear facets provided information about functional movements of the mandible in the occlusal range. Depending on the type of facet observed, two or three main directions were found. The aim now was to answer two questions: (1) how long does it take for a newly formed scratch to disappear? and (2) do the observed orientations of the scratches change over a long period of time? Eleven wear facets from lower first molars were analysed in four subjects with good natural dentition. Scratches recorded on cellulose replicas were observed under an interference microscope. The same wear facets were recorded one, two, three and six months later. From the photographs of the replicas, a sample of scratches was selected at random and their direction was measured. In the first part of the study, scratches absent at the time of the first observation appeared one month later; 87% of the new scratches had disappeared after one month. Ninety-six percent of the same group of scratches had disappeared after two months. In the second part of the study the angle made by each scratch with the sagittal plane was recorded. It was found that: (1) jaw movements in their occlusal phase can take any possible direction and (2) the distribution of the observed scratches was not random; preferential orientations exist and those present on the working facets are different from those on the non-working facets. Similar orientations were identified 6 months later.

Adult↗
PubMed2006

Indirect composite onlay restorations in primary molars: a clinical report.

The authors describe a clinical case of oral rehabilitation, in a 4-year-old patient, using indirect composite onlay restorations. Eight severely decayed primnary molars were restored. The clinical findings after 4 years demonstrated the efficiency of the technique as well as its indication in extensive restorations in Pediatric Dentistry, reestablishing function and aesthetics of these primary teeth. The indirect composite onlay restorations seem to wear at rate compatible with primary tooth wear and maintain a smooth, continuous anatomic form.

Acid Etching, Dental↗
PubMedDate not supplied

The diagnosis and control of extrinsic acid erosion of tooth substance.

As modern societies increase their acidic food and beverage consumption, erosive tooth wear is an increasing cause of tooth destruction among young people. The primary causes can be exacerbated by xerostomia, which can be induced by dehydration, several systemic diseases, or any of a number of drugs. Initial preventive treatments are directed at eliminating extrinsic acids, reducing xerostomia and other co-factors, and increasing teeth's resistance to acid. Initial restorative treatments should be conservative, using adhesive materials. Treatment of advanced tooth tissue loss is difficult; preventive management is emphasized.

Beverages↗
PubMed1995

A report of anterior In-Ceram restorations.

Thirty-one patients were restored with 35 anterior crowns and 7 anterior fixed partial dentures. The restorations were fabricated in In-Ceram, an all-porcelain ceramic material. The restorations were evaluated for fractures, tooth wear, recurrent caries, gingival inflammation and tooth sensitivity in a 21-month follow-up. Three of the 35 crowns fractured. The failure for the crowns was 8.5%. The remaining crowns provided excellent function and aesthetics. They had been in the mouth between 2.5 and 21 months. There were no fractures in the 7 fixed partial dentures. These had been in service between 4.5 and 21 months. More long-term clinical studies are recommended to determine the survival of In-Ceram fixed partial dentures.

Adolescent↗
PubMed2002

In vitro wear rates of materials under different loads and varying pH.

STATEMENT OF PROBLEM: Despite the need for information about the wear characteristics of restorative materials, there have been few systemic studies of the factors that influence the rate of material wear. PURPOSE: This study compared the wear rates of enamel and 3 tooth-colored restorative materials under different loads (0, 3.2, 6.7, and 9.95 kg) and pH levels (1.2, 3.3, and 7.0). MATERIAL AND METHODS: An electromechanical tooth wear machine was used so that standard restorations representing 3 materials could be worn by opposing enamel under controlled conditions. The wear rates of enamel, composite (Z100), a conventional glass ionomer cement (Fuji IX), and a resin-modified glass ionomer cement (Fuji II LC) were compared at a range of loads (0 to 9.95 kg) and pH levels (1.2 to 7.0) and also at different sites across each restoration. Ten specimens were randomly assigned to each experimental group. Wear assessment was performed with a modified light microscope to quantify the height changes at defined points across wear facets. Four-way analysis of variance was used to compare wear rates among materials, pH levels, loads, and sites. Post-hoc t tests identified significant differences between specific pairs of experimental conditions (P<.05). RESULTS: The wear rates of enamel and the other test materials varied significantly with pH (P<.0001), load (P<.0001), and type of material (P<.0001). Enamel wear was influenced most by varied pH, whereas the composite was least affected by acid. The conventional glass ionomer cement was more susceptible than the composite to the effects of varied pH; the acid susceptibility of the resin-modified glass ionomer cement was generally between that of the composite and conventional glass ionomer cement. Enamel and the conventional glass ionomer cement were affected similarly by load. The composite was more resistant than the conventional glass ionomer cement to wear at higher loads; the resin-modified glass ionomer cement exhibited intermediate load resistance. CONCLUSION: Within the limitations of this study, the 3 test materials were more resistant than enamel to acid, with the composite demonstrating the lowest susceptibility to acid. The acid- and load-resistance of the resin-modified glass ionomer cement was consistently less than that of the composite and greater than that of the conventional glass ionomer cement.

Acetates↗
PubMedDate not supplied

[Age assessment at the time of death based on panoramic radiography].

BACKGROUND: The determination of age at the time of death is an important method in forensic anthropology and paleodemography. The possible postmortem investigation of the teeth and jaws enables the determination of age at the time of death, as the bones and teeth are both resistant to degradation in soil and characterized by age-related morphological changes. The aim of this study was to determine whether the age-related changes visible on panoramic radiography correlated with age, and enabled the assessment of individual age. METHODS: Seven radiographic parameters were used in the study: tooth loss, occlusal tooth wear, pulp stones, carious teeth, periapical disease, tooth restoration, and alveolar bone loss associated with periodontal disease. RESULTS: The material comprised 314 dental panoramic tomograms of living patients of both sexes with documented age (18 to 77 years). Multiple regression equations were constructed for the age estimation, including four parameters (the number of missing teeth, the number of intact teeth, the distance of cement-enamel junction from the alveolar ridge, the number of abraded teeth). The nature of data treated by regression analysis required the careful choice of parameters, appropriate functional model for each parameter, and the experience of the investigator. With the four parameters included in equations, the error was +/- 2.55 years. CONCLUSION: This preliminary analysis showed that the conventional regression technique could be appropriate for the age estimation based on panoramic radiography, and that an additional study with a larger sample and on wider population was required.

Adolescent↗
PubMed1998

Wear of human enamel: a quantitative in vitro assessment.

Many factors influence the extent and rate at which enamel wears. Clinical studies in humans are limited by difficulties in the accurate quantification of intra-oral wear and by a lack of control over the oral environment. The purpose of this study was to determine the wear characteristics of human dental enamel under controlled experimental conditions. An electro-mechanical tooth wear machine, in which opposing enamel surfaces of sectioned, extracted teeth were worn under various conditions, was used to simulate tooth grinding or bruxism. Enamel surface wear was quantified by weight to an accuracy of 0.1 mg, with water uptake and loss controlled. The variables considered included the structure and hardness of enamel, facet area, duration of tooth contact, relative speed of opposing surfaces, temperature, load, pH, and the nature of the lubricant. Enamel wear under non-lubricated conditions increased with increasing load over the range of 1.7 to 16.2 kg. The addition of a liquid lubricant (pH = 7) reduced enamel wear up to 6.7 kg, but when the load increased above this threshold, the rate of wear increased dramatically. With the viscosity of the lubricant constant and pH = 3, the rate of wear was further reduced to less than 10% of the non-lubricated rate at 9.95 kg, after which the rate again increased substantially. Under more extreme conditions (pH = 1.2, simulating gastric acids), the wear was excessive under all experimental loads. When saliva was used as a lubricant, the amount of wear was relatively low at 9.95 kg, but rapid wear occurred at 14.2 kg and above. These results indicate that under non-lubricated conditions, enamel wear remains low at high loads due to the dry-lubricating capabilities of fine enamel powder. Under lubricated conditions, low loads with an acidic lubricant lead to little enamel wear, whereas very low pH results in a high rate of wear under all loads.

Analysis of Variance↗
PubMed2005

Tooth loss, the wearing of dentures and associated factors in Sri Lankan older individuals.

OBJECTIVE: To determine tooth loss, wearing of dentures and associated factors in older individuals from Sri Lanka. DESIGN: A cross-sectional survey where the data were collected by means of an oral examination and an interviewer administered questionnaire. SETTING: Negambo within the Gampaha district of Sri Lanka. SUBJECTS: A total of 630 subjects who were aged 60 years and above. RESULTS: Only 11 subjects had all 32 teeth and 17% were edentulous. Age, gender and level of income were significantly associated with the number of missing teeth. Of those with missing teeth, 22% wore dentures. Only 16% of the non-denture wearers perceived a need for dentures. Among the non-denture wearers who perceived a need for dentures, a majority had cited 'cost' as the main barrier for obtaining dentures. Logistic regression analysis revealed that age, gender, levels of income and education and missing teeth were significant predictors of wearing of dentures. CONCLUSIONS: Knowledge of factors that influence tooth loss and wearing of dentures may have implications for oral health care planners in the provision and delivery of oral health services to the older individuals.

Age Factors↗
PubMed1995

Twelve-month results of a clinical wear study of three artificial tooth materials.

This study compared in vivo wear of a new artificial tooth material with that of existing artificial tooth materials. Artificial tooth wear was determined by measuring height changes of selected points on contacting tooth surfaces in patients with complete dentures during a 12-month period. These results are part of an ongoing 3-year clinical study. A total of 67 patients were randomized to one of three treatment groups in this double-blind study. Group 1 received dentures with existing artificial tooth materials. Group 2 received dentures that contained teeth with the new experimental material. Group 3 received dentures with Bioform IPN resin teeth (Dentsply International Inc., York, Pa). A computerized coordinate measuring machine and computer-controlled X-Y positioning stages were used for this study. Tooth wear was determined by measuring vertical heights of contacting points from baseline points at each of two time intervals. The calculation of wear was made by comparing the differences in height at the beginning of the experiment with those measured at each time interval. A repeated measures analysis of variance (ANOVA) was used to test the difference in mean wear among the three groups from baseline to 6 months and from 6 to 12 months. Group differences in total wear at 12 months were also tested. The ANOVA results revealed no statistically significant differences in the wear among the three types of denture teeth at the 6- or 12-month time intervals or at 12 months (p > 0.05). The average total wear value at 12 months was 90 microns. Group 1 averaged 102 microns of wear, group 2 averaged 88 microns of wear, and group 3 averaged 76 microns of wear.

Acrylic Resins↗
PubMed1996

Incremental lines of von Ebner in dinosaurs and the assessment of tooth replacement rates using growth line counts.

Dinosaur dentine exhibits growth lines that are tens of micrometers in width. These laminations are homologous to incremental lines of von Ebner found in extant mammal and crocodilian teeth (i.e., those of amniotes). The lines likely reflect daily dentine formation, and they were used to infer tooth development and replacement rates. In general, dinosaur tooth formation rates negatively correlated with tooth size. Theropod tooth replacement rates negatively correlated with tooth size, which was due to limitations in the dentine formation rates of their odontoblasts. Derived ceratopsian and hadrosaurian dinosaurs retained relatively rapid tooth replacement rates through ontogeny. The evolution of dental batteries in hadrosaurs and ceratopsians can be explained by dentine formation constraints and rapid tooth wear. In combination with counts of shed dinosaur teeth, tooth replacement rate data can be used to assess population demographics of Mesozoic ecosystems. Finally, it is of historic importance to note that Richard Owen appears to have been the first to observe incremental lines of von Ebner in dinosaurs more than 150 years ago.

Animals↗
PubMed2003

Can tooth brushing damage your health? Effects on oral and dental tissues.

Circumstantial evidence based on anecdote, case reports, epidemiological data and studies in vitro and in situ implicate tooth brushing with toothpaste with tooth wear, gingival recession and dentine hypersensitivity. This review attempts to assess the clinical significance of the potential harm produced by this most common oral hygiene habit. The toothbrush alone appears to have no effect on enamel and very little on dentine. Most toothpaste also has very little effect on enamel and in normal use would not cause significant wear of dentine in a lifetime of use. Wear of enamel and dentine can be dramatically increased if tooth brushing follows an erosive challenge. Gingival recession has a multi-factorial aetiology and certain individuals and specific teeth may be predisposed to trauma from tooth brushing. Tooth brushing is known to cause gingival abrasions but how these relate to gingival recession is not known. The role of toothpaste in gingival abrasion and recession surprisingly has received little if any attention. Gingival recession most commonly exposes dentine and localises sites for dentine hypersensitivity. Some toothpaste products can expose dentinal tubules but erosion is probably the more dominant factor in dentine hypersensitivity. There is no evidence to indicate that electric and manual toothbrushes differ in effects on soft and hard tissues. It is only under, over or abusive use or when combined with erosion that significant harm may be thus caused. In normal use it must be concluded that the benefits of tooth brushing far out-way the potential harm.

Gingival Diseases↗
PubMed2004

[Rehabilitation of the occlusion of eroded teeth].

Intrinsic and extrinsic acids are the main etiologic reason for dental erosion. In combination of mechanical abrasion and tooth wear, the processes of erosion lead to substantial loss of tooth structure. In cases of severe eating disorders, like anorexia and bulimia, the whole supragingival tooth structure may be worn off over the years. These patients will need extensive reconstructive dental therapy to regain function and esthetics of their dentition. The described case report shows how a dentition, severely damaged by erosion, can be restored properly in private practice with regard to function and esthetics. The treatment plan and the therapy will be step by step systematically illustrated.

Adult↗
PubMed1993

Vertical height differences in subjects with severe dental wear.

The present study aims to determine differences in vertical facial dimensions as a result of severe dental wear. The sample consisted of 35 subjects (mean age 48.4 years) who had advanced dental wear recognized by loss of more than one-third of the estimated original incisor crown length. The control group comprised 40 subjects (mean age 26.1 years) with acceptable occlusions and no signs of severe generalized tooth wear. Lateral skull radiographs were taken for both the study sample and the control group with the mandible in the maximum retruded position, from which measurements were made using a digitizer. The results showed no significant differences for total face height (n-gn) between the groups (P > 0.05) although for the study sample, upper face height was greater (P < 0.05) and lower face height was smaller (P < 0.05). Smaller values for tooth length were found in the wear sample, with the mean differences in tooth length being 5.0 mm for upper incisors and 3.3 mm for lower incisors. The overbite was smaller in the wear sample and the lower incisor position differed from controls in this group. It is concluded that the differences in face height together with differences in lower incisor position through dento-alveolar development contribute to maintenance of total facial height, so compensating for loss of vertical height through severe dental wear.

Aging↗
PubMed1985

Dental occlusal wear and degenerative disease of the temporomandibular joint: a correlational study utilizing skeletal material from a contemporary population.

Forty crania and mandibles with intact dentition exceeding twenty-six teeth and bilaterally intact condyle-fossa apparatus were evaluated for attrition and degenerative joint disease. The skeletal specimens all represent a twentieth-century contemporary American population from the Atkinson Skull Collection at the University of the Pacific School of Dentistry. While 23.1% of this sample exhibited some degree of erosive osseous degenerative wear involving the condyle or articular fossa and 76.3% exhibited occlusal tooth wear, no significant correlation between the degree of attrition and the severity of degenerative joint disease could be documented.

Adult↗