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PubMed2004

Why is there and should there be more attention paid to dental erosion?

Fluoride delivered by fluoridation, toothpaste, and mouth rinses, combined with regular preventive professional and personal care, has given us a much better opportunity to keep our teeth for a lifetime. But in contrast to better preventive care, lifestyle changes leading to stress or dietary changes in what and how we drink and eat may adversely affect the esthetics and/or healthy look of our teeth. Surface-enamel wear can be described as the result as well as a chronicle of an individual's life. Components of wear--including abfraction, attrition, abrasion, and erosion--combine to characterize the lifetime of wear. The chemical-erosive-wear component appears to be changing because of modern cultural life choices. A number of literature reports conclude that excessive exposure to various acid sources can contribute to the chemical erosion of tooth surfaces. For example, the hydrochloric acid regurgitated from the stomach, the acid added to swimming pools to combat microbes, the citric and chelating carboxylic acids of fruit and fruit-based beverages, the phosphoric acid of cola beverages, and the acetic acid of vinegars used for salads all can contribute to the chemical erosion of tooth surfaces. While these acid sources have the potential to erode, our saliva and the manner in which we consume these substances can largely modify the erosive action of the acids they contain. With a better understanding of our personal lifestyle choices coupled with the educated guidance of our profession, we can help to reduce the opportunities for erosive wear to occur.

Acetic Acid↗
PubMed1995

Color characterization of denture base material.

The time taken to create a more natural prosthesis by twisting a tooth, carving wax and applying a few basic colors can make a world of difference for patients wearing dental prosthesis. The technician can achieve a natural resemblance of tissue coloration in the oral cavity when these procedures are applied.

Dental Prosthesis Design↗
PubMed2002

In vitro wear assessment of titanium alloy teeth.

PURPOSE: Wear of commercially pure (CP) titanium prosthetic teeth has frequently been observed. The greatest wear has been found when the same grades of CP titanium are used for both maxillary and mandibular teeth. This study examined the wear behavior of teeth made with cast titanium alloy and compared these results with those for CP titanium and gold alloy teeth. MATERIALS AND METHODS: All tooth specimens were cast with grade 3 alpha titanium, 3 metastable beta alloys [Ti-15Mo-2.8Nb-0.2Si (Timetal 21 SRx), Ti-13Nb-13Zr, and Ti-15V-3Cr-3Sn-3Al], and 2 alpha+beta alloys (Ti-6Al-7Nb and Ti-6Al-4V). As a control, Type IV gold alloy was also cast conventionally. All teeth (both maxillary and mandibular) were secured in an in vitro 2-body wear testing apparatus that simulated chewing function (60 strokes/min; grinding distance, 2 mm under flowing water). Wear resistance was assessed as volume loss (mm(3)) at 5 kgf (grinding force) after 50,000 strokes. The results (n = 5) were analyzed using analysis of variance or Fisher's exact test (alpha = 0.05). RESULTS: Of the titanium teeth, the wear of 2 of the metastable beta alloys (Timetal 21 SRx and Ti-15V-3Cr-3Sn-3Al) was found to be significantly (p <0.05) higher than that of CP titanium and the 2 alpha+beta alloys. The Type IV gold alloy exhibited better wear resistance than all of the titanium teeth tested. No correlation was found between wear loss and hardness among all the metals tested. CONCLUSIONS: Among the titanium teeth examined, the alpha+beta alloys exhibited significantly less wear than the other types of titanium. The dental casting gold alloy tested exhibited the best wear resistance among all of the metals tested.

Alloys↗
PubMedDate not supplied

Glass ionomer cement, an intelligent material.

The main task of a dental filling material is to permanently seal the dentinal wound and to restore the anatomy. In particular with respect to the former requirement, glass-ionomer cements exhibit, thanks to it's ingenious composition, unique properties, which allows it to react on external information in such a way that the cement automatically and adequately fulfills it's function as a proper restorative material. Because of it's setting mechanism, glass-ionomer cement restorations have a better perspective to seal the tissue than amalgam or resin composites do. As resistance to wear of glass ionomers is inferior to resin composites it proves to be a better dentin replacement, than a substitute for tooth enamel. Restorations made in a combination of glass-ionomer cement and resin composite, the so called sandwich restorations, have shown to function excellently, both at the tooth interface as well as the outer surface. As any leakage still cannot be excluded, the fluoride release at the margins of the restoration forms a wellcome contribution to the prevention of secondary caries. Once more, glass-ionomer cement shows to be intelligent by automatically activating an advantageous process when the environment requires it.

Dental Bonding↗
PubMed2000

Minimal intervention: advanced lesions.

Minimal intervention techniques are generally considered in relation to initial carious lesions. However, it appears logical to apply the same principles to extensive cavities as well as to the replacement of failed existing restorations. As the cavity becomes larger, there is an increasing need to consider protection of remaining cusps because they become seriously weakened by loss of the central core of the crown and therefore become subject to the development of splits at the base. However, it is possible to develop a protective cavity design without undue sacrifice of remaining tooth structure, at the same time that maintenance of occlusal anatomy and correct contact with the opposing arch are ensured. For larger cavities, special consideration needs to be given to the strength of the restorative material. Glass ionomer is relatively brittle and should not be exposed to undue occlusal load. Resin composites cannot be regarded as universal in their physical properties, and placement is time-consuming. A lamination technique is often useful, combining the advantages of both glass ionomer and resin composite. Amalgam should not be entirely discarded as an option because it has greater strength than both glass ionomer and resin composite and is still useful for the restoration of extensive cavities and for protection and retention of weakened cusps. Minimal intervention principles, designed to limit the loss of natural tooth structure, should be applied to all restorative dentistry. None of the available restorative materials is entirely satisfactory in the long term.

Bite Force↗
PubMed2006

Prismatic dentine in the Australian lungfish, Neoceratodus forsteri (Osteichthyes: Dipnoi).

The Australian lungfish, Neoceratodus forsteri, has a dentition consisting of enamel, mantle dentine and bone, enclosing circumdenteonal, core and interdenteonal dentines. Branching processes from cells that produce interdenteonal dentine leave the cell surface at different angles, with collagen fibrils aligned parallel to the long axis of each process. In the interdenteonal dentine, crystals of calcium hydroxyapatite form within fibrils of collagen, and grow within a matrix of non-collagenous protein. Crystals are aligned parallel to the cell process, as are the original collagen fibrils. Because the processes are angled to the cell surface, the crystals within the core or interdenteonal dentine are arranged in bundles set at angles to each other. Apatite crystals in circumdenteonal dentine are finer and denser than those of the interdenteonal dentine, and form outside the fibrils of collagen. In mature circumdenteonal dentine the crystals of circumdenteonal dentine form a dense tangled mass, linked to interdenteonal dentine by isolated crystals. The functional lungfish tooth plate contains prisms of large apatite crystals in the interdenteonal dentine and masses of fine tangled crystals around each denteon. This confers mechanical strength on a structure with little enamel that is subjected to heavy wear.

Animals↗
PubMed2000

[Bruxism: well known, but difficult to fathom].

Tooth clenching or grinding may cause serious problems for patients and dentists. Symptoms occur at the level of the teeth (wear), the periodontium and the musculoskeletal system. In the past, the definition of bruxism often was vague and controversial, and also a clinical diagnosis appeared to be difficult. More recently research in the sleep laboratory, using a combination of electromyography video- and sound recording, made it possible to distinguish between bruxism and other oral behaviour. The association between pain and dysfunction of the masticatory system with bruxism is still unclear.

Adult↗
PubMed1982

Clinical management of non-carious enamel defects.

Enamel defects not caused by decay may occur singly or may be generalized over the entire tooth surface. In the past, treatment of these aesthetic problems required large cavity preparations or full crown coverage of the affected teeth. Now, with the advent of various resin restorative materials capable of bonding to enamel, new techniques are being developed which are less radical. By etching the surface of the enamel with varying concentrations of dilute phosphoric acid, sufficient porosity is produced to allow the resin to adhere to it. Thus, by removing a minimal amount of tooth structure, the affected area can be masked with a thin layer of resin material after the surface has been properly prepared. If the fault in the enamel is generalized, the whole surface of the tooth may be restored using this technique, effectively covering the tooth with an aesthetic veneer. The new resin filling materials offer good colour stability as well as resistance to abrasive wear. Tests have revealed that this mode of treatment has a successful retention rate of over 92 per cent after 5 years. Lightly discoloured or stained defects of the enamel may be treated by bleaching the affected area with no adverse effect on the pulp tissue. Those teeth not improved by bleaching can be conservatively managed by veneering their surfaces with smooth finishing plastic materials.

Acid Etching, Dental↗
PubMed2003

Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach.

OBJECTIVES: This paper reports on a longitudinal evaluation of three materials (glass ionomer, zinc oxide-eugenol cement, and composite) employed in a minimal restorative intervention approach of 81 high caries-active pregnant women selected for a preventive oral health program in Brazil. The aim of the study was to evaluate the clinical behavior of the glass ionomer cement, currently indicated in programs for control of carious lesions. METHODS: The patients were randomly divided into two groups. Both groups were engaged in an oral health promotion approach. In Group 1, 417 glass ionomer restorations were placed in 43 individuals, involving all types and sizes of cavities. In the second group, 213 posterior zinc oxide-eugenol (ZOE) restorations and 127 anterior composite restorations were placed in 38 patients. Minimal cavity preparations were made, in which only soft or infected dentin was removed, on the basis of clinical judgment. RESULTS: After two years, the restorations were clinically evaluated by two examiners for marginal integrity, amount of wear, presence of fracture, carious lesions, and lost restorations. Statistical analysis (chi-square test) identified statistically significant difference between glass ionomer and ZOE (90.6% vs 9.2%). Comparing glass ionomer and composite, similar survival rates were observed. The success rate observed for the glass ionomer cement ranged from 77.1 percent to 92.5 percent, depending on the type and size of cavity in which it was applied. Four teeth restored with glass ionomer cement and one tooth restored with composite showed caries signs. Regarding the ZOE restorations, caries was always associated with other causes of failure such as excessive wear, restoration loss, or marginal defects, with no possibility of separate evaluation. Despite the preventive and therapeutic measurements employed, a mean increase of 2.15 new surfaces with cavities was observed in Group 1, as well as 2.83 surfaces presenting the same status in Group 2. CONCLUSIONS: This study demonstrated that highly viscous glass ionomer cement applied in a minimal intervention approach provided high-quality preventive and restorative care after two years to a population at high risk for caries. The composite was employed in cavities exposed to lower stress, such as in the anterior teeth, and its behavior was comparable to that of the glass ionomer cement. The reinforced ZOE presented a high failure rate, thus contraindicating its use for such purpose.

Adult↗
PubMed1971

Interstitial wear.

Explore the source record for details and available documents.

Adaptation, Biological↗
PubMed1985

Periostitis and osteitis associated with hyaline bodies.

Twenty four cases of periostitis and osteitis associated with hyaline bodies are reviewed. The condition primarily affects the premolar and molar region of the mandible in patients who wear dentures. It is suggested that exogenous foreign material, especially from leguminous food impacted into the tissues following tooth extraction, is involved in the pathogenesis of the lesions. In dentate patients there are several other routes by which such material could gain access to the deeper tissues.

Adolescent↗
PubMed1992

Wear in dentistry--current terminology.

There is some confusion in the dental literature concerning the phenomenon of wear which is usually considered in terms of its clinical manifestations rather than its underlying processes. The parent discipline for the study of these processes is tribology. The terms attrition, abrasion and erosion are common to both dentistry and tribology; however their meanings are different. Even within the various disciplines of dentistry there are differences in the understanding of the same terms. This article relates the dental appreciation of wear to the underlying processes.

Humans↗
PubMed1997

In vitro wear of composite with varied cure, filler level, and filler treatment.

For the clinical wear of composite filing materials to be reduced, compositional factors such as degree of cure, filler level, and silanation level should be optimized. An oral-wear-stimulating machine was used to explore the effects of these factors on abrasion and attrition wear as well as on opposing enamel wear. The composites were made from Sr glass (1-2 micron avg) and a 50/50 Bis-GMA/TEGDMA resin. Series I (A-D, E) were light-cured (Triad II) for 9, 12, 25, and 40 sec/side to produce degree of cure (DC) as measured by FTIR of 56, 60, 61, and 63%, respectively. E received an additional heat cure (120 degrees C for 10 min) to reach a DC of 66%. Series II (D, F-I) were filled to 62, 53, 48, 37, and 28 vol%, respectively. In series III (D, J-M), the portion of fillers treated with a silane coupler (MPS) was 100, 80, 60, 40, and 20%, respectively. Samples were cycled 50,000 times against an enamel antagonist in a poppy seed/PMMA slurry in the oral wear simulator to produce abrasion (load = 20 N) and attrition (load = 70 N) simultaneously. Wear depth (micron: n = 5) was measured by profilometry. Results for each series were analysed by ANOVA/Turkey's (p < or = 0.05). The wear depths did reflect cure values, though only the abrasion difference for E < A was significant. Greater wear was correlated with lower filler levels (r2 = 0.88; p < 0.05), significantly increasing below 48 vol% (G). Wear increased linearly as the percent of silane-treated fillers was reduced (r2 = 0.99; p < 0.05). Abrasion and attrition did not differ significantly for any composite. Wear of the opposing enamel was largely unchanged by these factors. Compositional factors including degree of cure, filler level, and silanation directly affected the wear resistance of dental composites evaluated in an oral wear simulator.

Analysis of Variance↗