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Dental erosion: a multi-factorial condition.
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Two year clinical evaluation of a paint-on restorative system for treatment of cervical erosion lesions.
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Erosion of the incisors of silage-fed cattle.
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Restoration of extensive erosion areas using an indirect composite technique.
Cervical erosion defects, particularly those of extensive size that are located in an area where control of the operative field is difficult, can present a significant restorative challenge. This article describes an indirect restorative technique to solve this problem. Following tooth preparation, an indirect restoration is luted to the tooth and the margins are finished and polished. Using an indirect technique minimizes operative field isolation time and the total chairside time required to restore the tooth. Clinical cases are presented to illustrate this technique.
Quantification of the configuration factor in Class I and II cavities and simulated cervical erosions.
The configuration factor of adhesive cavities is defined as the ratio of the restoration's bonded to unbonded (free) surfaces. Such a configuration factor was described, on ideal cavities, as having a potential value in predicting the behaviour of the restorations, because it is related to the restoration's capacity for relieving stress by flow. The aim of this study was to measure the configuration factor value for real Class I and II cavities and simulated cervical erosions prepared in molars. Ten Class I, five Class II cavities and seven cervical erosions were analysed using a computerised digitising system. The configuration factor values found were 4.03 +/- 0.33 for Class I cavities, 1.85 +/- 0.59 for Class II cavities and 1.10 +/- 0.09 for simulated cervical erosions (P < 0.01).
[Erosions and wedge-shaped defects in Swiss Army recruits].
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The Gluma bonding system: a clinical evaluation of its various components for the treatment of hypersensitive root dentin.
This study investigated the desensitizing effect of topically-applied Gluma on sensitive cervical erosion lesions. A total of 46 teeth exhibiting moderate to severe sensitivity to cold and instrumentation, in 15 patients, were included in the study. Mildly sensitive teeth and teeth with cervical caries lesions were excluded from the study. After each tooth was isolated with rubber dam, investigators applied cold air, as well as tactile stimuli using an explorer, and recorded the baseline responses. Nine of the 46 teeth then received Gluma primer only (group 1), 15 received cleanser followed by primer (group 2), 15 received cleanser followed by primer and sealer (group 3), and seven received a placebo (group 4). After two weeks, the teeth in group 4 were randomly placed in one of the other three groups. The responses of the teeth in each group to various stimuli were recorded immediately after the application of test materials, and subsequently at one week, two weeks, one month, three months, six months and one year. Statistical analysis indicates that the three treatment groups all showed significant differences compared to the untreated control group (p < .001). A reduction of sensitivity was noted immediately after primer, cleanser-primer, or cleanser-primer-sealer was applied. Treatment groups 2 and 3 demonstrated less sensitivity than group 1 (p = .02; p = .03, respectively). At the one-year recall, the observed order of treatment effectiveness by group was 2, 3, 1. In approximately 50 per cent of the teeth treated in the study, remission of sensitivity was seen after one year. All of the remaining teeth exhibited some relief of sensitivity. The treatments' success was found to be inversely proportional to the severity of the initial response.
Etiology of dental erosion--intrinsic factors.
Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must be taken into account as possible intrinsic etiological factors of dental erosion are thoroughly discussed with respect to the clinical picture, prevalence and risk of erosion.
Dental erosion, summary.
Although reports on dental erosion have always appeared in the dental literature, there is currently a growing interest among researchers and clinicians. Potential risk factors for dental erosion are changed lifestyle and eating patterns, with increased consumption of acidic foods and beverages. Various gastrointestinal and eating disorders expose the dentition to frequent contacts with very acidic gastric content, which may lead to erosion. Whether these factors indeed lead, on a population scale, to a higher prevalence and incidence of erosion is yet to be established. This article summarizes the different aspects of the prevalence, pathology, etiology, assessment, prevention and treatment of dental erosion, and concludes with recommendations for future research.
The erosive potential of the alcoholic lemonade Hooch.
The aim of this in vitro study was to assess the erosive potential of four flavours of the alcoholic lemonade Hooch. This study measured the pH on opening, the volume of 0.1M sodium hydroxide required to raise the pH of 20 mls of the lemonade to neutrality and the fluoride content. The amount of surface enamel lost following immersion for one hour was also assessed compared to water as a control. The pH on opening ranged from 2.57-2.86 and the volume of 0.1M sodium hydroxide required to neutralise 50 mls of the lemonade ranged from 15.4-23.1 mls. The fluoride content of the drinks ranged from 0.36-0.45 p.p.m. The amount of surface enamel lost over one hour ranged from 1.80-3.28 microns. This study suggests that the alcoholic lemonade Hooch has considerable erosive potential and seems likely to be as erosive as orange juice.
Erosion and fluoride content in molar surfaces of rats that drank a cola beverage with and without fluoride.
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Dental erosion: a review and new concerns for dental practitioners in Virginia.
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A safety study in vitro for the effects of an in-office bleaching system on the integrity of enamel and dentine.
OBJECTIVE: The aim of this study was to investigate safety concerns with bleaching procedures by studying the effects of a high concentration hydrogen peroxide (HP) in-surgery bleaching product on enamel and dentine. METHOD: Flat enamel and dentine samples embedded in epoxy resin were prepared from human third molar teeth. Erosion of enamel: groups of enamel samples were treated with 35% HP then citric acid (CA) or brushing with toothpaste or CA alone and water alone. Enamel Loss was measured using a profilometer. Abrasion/erosion of dentine: groups of dentine specimens were treated as follows: Group 1--brushed with water for 30 min. Group 2--brushed with 35% HP for 30 min. Group 3--power bleached for 30 min and then Group 4--brushed with toothpaste for 1 minute. Group 5--water soaked for 30 min followed by brushing with toothpaste for 1 min. Group 6--orange juice soaked for 30 min followed by brushing with toothpaste for 1 min. Treatment effects were measured using a profilometer. Hardness tests: enamel and dentine specimens were hardness tested using a Wallace indenter prior to and post bleaching. Scanning Electron Microscopy: enamel and dentine specimens were taped and the exposed tissue treated with 35% HP and then studied under scanning electronmicroscopy (SEM). RESULTS: Enamel erosion: bleaching enamel samples had no measurable effect on enamel. Pre-bleaching had no significant effect on subsequent CA erosion or brushing. Abrasion/erosion of dentine: no significant differences were found between treatments 1-5 with little change from baseline detected. Orange juice (Group 6) produced considerable and significantly more erosion than other treatments. Hardness tests: there were no significant changes in hardness values for enamel and dentine. SEM: there was no evidence of any topographical changes to either enamel or dentine. CONCLUSION: Using one of the highest concentrations of HP for tooth bleaching procedures and maximum likely peroxide exposure, there was no evidence of deleterious effects on enamel or dentine. It must be assumed that studies which reported adverse effects on enamel and or dentine of bleaches reflect not the bleach itself but the pH of the formulation used.
[Is Dutch swimming pool water erosive?].
Etiological factors in the development of dental erosion are usually listed as dietary acids, for instance in soft drinks and fruit juices, and intrinsic acid exposure due to gastro-intestinal disease or frequent vomiting. Quite often the list of causes in reviews and textbooks also includes frequent swimming. This paper evaluates the evidence behind this erosion etiology. The main disinfection techniques using gas chlorination and sodium hypochlorite are described, and their relative risk for development of low pH water is discussed. In the Netherlands only the relatively safe sodium hypochlorite method is used, and the quality of the water in public swimming pools is monitored monthly by independent test laboratories. Data for 2001 from such a test laboratory show that the percentage of low-pH results is very low (0.14%). It is concluded that the risk of dental erosion from frequent swimming in acidic pool water is probably negligible in the Netherlands.
Assessment of enamel erosion and protective effect of salivary pellicle by surface roughness analysis and scanning electron microscopy.
PURPOSE: To assess dental erosion caused by 0.1% and 1.0% citric acid in vitro and to estimate the protective influence of experimentally formed salivary pellicle. MATERIALS AND METHODS: Bovine enamel slabs (n = 80) were polished and embedded in epoxy resin. For the formation of pellicle layer 40 specimens were immersed for 24 h in pooled human saliva. Erosion was caused by immersion in citric acid solution for 1, 5, 10 and 30 min. Erosive alterations on the pellicle-covered and non-covered enamel specimens were scored as a change (delta) of surface roughness parameters Ra, Rt and RzDIN using contact profilometer and observed in scanning electron microscope. RESULTS: Profilometric analysis of eroded enamel specimens emphasized the aggressiveness of even low concentrated citric acid with a short period of challenge. The change of roughness parameters after 1-min immersion in 0.1% citric acid were 16.4, 182.6 and 132.2 nm for deltaRa, deltaRt and deltaRzDIN, respectively, and 54.8, 516.6 and 258.2 nm after 1-min immersion in 1.0% citric acid. Changes of the surface roughness were dependent on the exposure time and concentration of acidic solution. Pellicle layer significantly reduced the extent of erosive destruction, which was additionally documented on SEM-micrographs. Residual pellicle-like structures were detected after 5 min of immersion in 0.1% citric acid. However, there were no significant differences in pellicle-covered and non-covered enamel slabs measured profilometrically for 1.0% citric acid with 10 min and 30 min exposure time. CONCLUSION: The findings confirm the property of pellicle layer to resist against erosive influence of organic acids, which is, however, limited by duration of acidic treatment and concentration of erosive agent.
Influence of drinking patterns of carbonated beverages on dental erosion.
As a hard tissue dental disease, dental erosion has a multifactorial etiology. The majority of dental erosion that originates from extrinsic sources is the result of dietary intake, particularly acidic beverages. Several preventive means have been proposed to minimize the damage to the dentition, including a reduction in the consumption of causative beverages and the adoption of a specific method of drinking, utilizing a straw instead of a cup. This article presents two cases involving the clinical and radiographic features of erosion lesions associated with chronic and excessive intake of acidic carbonated beverages. These examples embody how drinking patterns influence the formation of erosion lesions in various anatomic locations within the dentition. The clinical and radiographic evidence presented in this report cautions against the use of nonspecific terms, such as "cup versus straw," and instead suggests implementing a more precise description of the suggested method. In view of the extensive damage inflicted by the chronic, excessive intake of carbonated beverages, preventive measures are considered to be the only effective course of management. This article offers illustrative examples of erosion lesions associated with long-term excessive intake of carbonated beverages. The influence of the drinking method--that is, a straw positioned into the labial vestibule versus a cup--on the anatomic location of the erosion lesions will be demonstrated through clinical and radiographic evidence.