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At least 163 records · Page 9Linked to original sources

Wine tasting and dental erosion. Case report.

A case of widespread dental erosion is reported in an individual who had worked in the wine industry for ten years. This occupation involved daily tasting of at least 20 wines, but often more. The erosion manifested as dental sensitivity with there being cervical erosion, occlusal pitting, and loss of enamel around restorations. The effect of immersing unerupted human teeth in white wine (pH 3.3) was examined with the scanning electron microscope, where marked surface changes had occurred after 24 hours of exposure.

Adult↗

Dental cervical lesions associated with occlusal erosion and attrition.

Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedge-shaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedge-shaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusal and cervical pathology. Shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge-shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the site-specificity of dental erosion than to attrition from occlusal forces. Non-carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.

Adolescent↗

Localised enamel hypoplasia of human deciduous canines: genotype or environment?

A discrete area of defective enamel formation that appears on the labial surface of the crowns of deciduous canine teeth has been described in both recent and prehistoric human populations, with reported frequencies varying from 1 to 45 per cent. Suggestions about the aetiology of this localized hypoplasia range from genotypic factors to environmental conditions and systemic effects. The major aims of this study were to describe the frequency of occurrence and pattern of expression of the lesion in Australian Aboriginal and Caucasian ethnic groups, and to clarify the role of genetic factors by examining a sample of twins. The study sample consisted of dental casts of 181 pairs of Australian Caucasian twins, 215 Aborigines and 122 Caucasian singletons, together with 253 extracted deciduous canines. Examination of dental casts and extracted teeth was undertaken under 2x magnification with emphasis being placed upon location and expression of the lesion. The defect was observed in 49 per cent of twins and 44 per cent of Aborigines, but only 36 per cent of singletons. The percentages of affected teeth in each group were: 18 per cent in twins, 17 per cent in Aborigines and 13 per cent in Caucasians. A significant proportion of the defects occurred on the mesial aspect of the labial surface, in the middle area incisocervically, with the majority in the lower jaw. A number of significant differences in frequency were observed between groups, sexes, arches and sides. The results confirm some of the findings of previous studies, but also suggest that none of environmental, genetic or systemic factors can be ruled out as being involved in aetiology of the defect. The higher incidence of the lesion occurring on the mesial aspect of the labial surface is suggestive of physical trauma. Also, the vulnerability of the prominent developing mandibular canine, with its thin or missing labial covering of bone, would be expected to lead to higher prevalence of the lesion in the lower jaw. Although not definitive, the results of concordance analyses in twins were suggestive of a possible genetic predisposition in the formation of the lesion. Further research with a greater clinical orientation and emphasis on determining specific aetiological factors within any given environment in different ethnic groups may provide better insight into the ambiguous aetiology of the hypoplastic enamel defect.

Australia↗

Studies of dental root surface caries. 2: The role of cementum in root surface caries.

Artificial caries lesions were produced in roots of teeth using an acetate buffer system, when the layer of cementum was either normal in thickness, excessively thickened by hypercementosis, or had been removed completely. The rates of lesion progression were measured in each case using polarized light microscopy to measure lesion depth. Analysis of calcium (Ca) and phosphorus (P) loss during the demineralizing process was carried out. The removal of cementum was found to significantly increase the initial rate of penetration of the lesion into the root, although this rate progressively reduced to a level consistent with that found in normal roots after seven days of demineralization. The overall depth remained consistently greater than that observed in normal roots, or when lesions were produced entirely within hyperplastic cementum. Chemical analysis also showed removal of cementum resulted in an initial doubling of the Ca and P lost from the root surface. Prior direct exposure of segments of normal roots to the oral environment was found not to significantly alter the rate of artificial lesion progression, in comparison with that in the originally protected segment of the root surface. It was concluded that an intact cementum layer has the intrinsic ability to protect the underlying dentine of exposed tooth roots against acidic demineralization and that prior exposure to the oral environment does not significantly alter this ability.

Calcium↗

Dental erosion patterns from intrinsic acid regurgitation and vomiting.

BACKGROUND: The distribution of lesions from dental erosion due to intrinsic acid regurgitation and vomiting may be different from patterns of dental erosion due to extrinsic acids. To date studies have failed to validate this assumption. This study described the sites and nature of lesions from dental erosion in cases of intrinsic acid regurgitation, and compared them with the distribution of lesions occurring in age and sex matched controls, whose lesions are due to extrinsic acids. METHODS: The University of Queensland tooth wear clinic patients were screened to select 30 cases, 21 self-identified bulimics and nine medically diagnosed chronic gastric acid regurgitators, and 30 controls. Epoxy resin models of the subjects' dentition were examined under stereoscopic light microscope at magnification 16 to 40. The patterns and sites of tooth wear were recorded for teeth representative of 20 tooth sites in every subject. RESULTS: While the incisal edges of maxillary and mandibular anterior teeth of acid regurgitators were more frequently affected by erosion, incisal attrition was more common on controls' teeth. Cervical lesions were more commonly found in association with incisal attrition in the controls, and in association with incisal erosion in the cases. In 10 per cent of sites in case subjects, cervical lesions associated with incisal erosion were found on the lingual aspects of their mandibular incisors, canines and premolars. These lesions were almost exclusive to the case subjects. CONCLUSIONS: These results validate that lingual cervical lesions associated with incisal erosion on the mandibular anterior teeth are strong discriminators between tooth wear in patients with bulimia nervosa or chronic gastro-oesophageal reflux and those whose dental erosion is due to extrinsic acids.

Adult↗

Strains in the marginal ridge during occlusal loading.

BACKGROUND: The marginal ridge is considered fundamental to the ability of the tooth to resist functional and parafunctional occlusal loads without damage. Despite this role, very little is known of patterns of stress and strain in marginal ridges under load. This study investigated strains in proximal enamel of mandibular premolars using finite element analysis (FEA) and strain gauge measurements. METHODS: A three-dimensional FEA model of a human mandibular premolar was developed using commercial FEA software, and strains were computed in response to loads simulating clenching and chewing functions. Strains were measured in extracted premolars using strain gauges mounted on the proximal surfaces, under similar occlusal loading conditions. RESULTS: Strains in the vicinity of contact areas and marginal ridges were lower than near the cemento-enamel junction and on buccal and lingual surfaces. The magnitude of proximal strains increased with oblique loading on cuspal inclines. Finite element analysis results correlated well with strain gauge measurements and can be used to predict strain directions and magnitudes. CONCLUSIONS: At least for mandibular premolars, the marginal ridges are not highly stressed areas during simulated occlusal loading.

Analysis of Variance↗

Clinical evaluation of an 'all-in-one' bonding system to non-carious cervical lesions--results at one year.

BACKGROUND: The recent trend in using dentine adhesives is to simplify the number of steps required for bonding. The simplest are now the so-called 'all-in-one' products which combine the etching, priming and bonding steps into a single application. However, few clinical trials have been reported using this type of material. The current study reports the one-year results of a clinical trial with One-Up Bond F and Palfique Estilite resin composite. METHODS: Fifty-one non-undercut non-carious cervical lesions were restored with One-Up Bond F and Palfique Estilite in 15 patients (mean age 57.5 years). Restorations were evaluated at six months and one year for presence or absence and for marginal staining using standardized colour photographs for comparison. RESULTS: At one year, 42 restorations could be evaluated and all were intact. Slight marginal staining was observed around three restorations but was considered to be of no clinical significance. CONCLUSIONS: One-Up Bond F with Palfique Estelite shows good promise for the restoration of non-carious cervical lesions.

Adolescent↗

Longevity of a resin-modified glass ionomer cement and a polyacid-modified resin composite restoring non-carious cervical lesions in a general dental practice.

BACKGROUND: Long-term prospective survival studies of resin-modified glass ionomer cements (RMGICs) and polyacid-modified resin composites (compomers) placed in non-carious cervical lesions (NCCLs) are lacking from general dental practice. Short-term studies have shown an unsatisfactory clinical performance for several materials. METHODS: One practitioner placed 87 compomer (Compoglass, Vivadent-Ivoclar) and 73 encapsulated RMGIC (Fuji II LC, GC Int.) restorations in NCCLs for 61 adults. Compoglass was placed using SCA primer, and Fuji II LC using GC Dentin Conditioner. No cavity preparation was undertaken. The Kaplan-Meier method was used for estimating the cumulative survivals for those restorations that were replaced, with the probability level set at alpha = 0.05 for statistical significance. RESULTS: Restorations were judged unsatisfactory (by the practitioner and the subjects) because of surface and marginal loss of material (68.8 per cent), dislodgement (18.8 per cent) and discoloration (12.4 per cent), these modes being similar for both materials (P = 0.35). Unsatisfactory restorations were replaced in 121 (75.6 per cent) instances. After periods of up to five years, cumulative survival estimates were 14.9 (5.8 Standard Error) per cent for Compoglass and zero per cent for Fuji II LC (P = 0.74). Median survivals were 30 months for Compoglass and 42 months for Fuji II LC. CONCLUSION: Both materials had high long-term unsatisfactory performances when placed in non-prepared NCCLs in a general dental practice.

Acrylic Resins↗

The prevalence, aetiology and clinical appearance of tooth wear: the Nigerian experience.

OBJECTIVE: To establish the prevalence and severity of tooth wear among Nigerians and to compare the pattern and aetiology with findings of earlier studies in Western populations. DESIGN: Clinical examinations for tooth wear using the tooth wear index (TWI). SETTING: The Federal Republic of Nigeria. PARTICIPANTS: Patients attending the Dental Hospital, Obafemi Awolowo University Teaching Hospital's Complex Ile-Ife. OUTCOME MEASURES: Attrition, abrasion and erosion. RESULTS: Of the 126 patients with tooth wear 81 had attrition, 20 had abrasion, 9 had erosion and 16 had attrition and abrasion combined. A total of 15,480 tooth surfaces were examined. 2,229 (14.4%) surfaces had tooth wear out of which 1,007 (6.5%) were pathologically worn down. The frequency of tooth wear increased with the age of patients. Most of the pathologically worn surfaces were just one point above maximum acceptable value. CONCLUSIONS: The aetiological factors associated with tooth wear are not different from those encountered in Western cultures but the pattern of wear differs. Pathological tooth wear presents as an age related phenomenon and is probably more severe in Nigerians.

Adult↗

A proposal for a new classification of lesions of exposed tooth surfaces.

In the presence of improved methods of identification and treatment of lesions on the exposed surfaces of teeth, it should now be acknowledged that the GV Black "classification of carious cavities" is out of date. This paper describes a new system, proposed in 1997, discussed broadly throughout the profession, and eventually modified. The system has been adopted in several regions around the world as being a useful corollary to the current developing concept of minimal intervention dentistry. It is now desirable to adopt a new approach to the identification and recording of the lesions caused by both caries and non-carious tooth loss. A major advantage arising from its adoption would be that it would encourage the profession to minimise the amount of normal healthy tooth structure that is often sacrificed in pursuit of the cavity designs as suggested by Black. The authors are members of a Project Group of the FDI Science Committee, and this paper explains the concept and offers justification for the adoption of the system.

Dental Caries↗

Fluoride distribution in sound and carious root tissues of human teeth.

Proton probe analysis has been used to provide for the first time quantitative F concentration data in carious root tissues from subjects consuming water containing 1 ppm F. In small lesions at the neck of the tooth with minimal tissue loss the F concentration was significantly higher at the outer lesion edge than at the outer edge of adjacent sound root tissue. In one sample with high F values the lesion edge had 19,000 ppm F and the adjacent sound root surface 5,400 ppm F microg F/g apatite). In large lesions with extensive cavitation F was again concentrated in the outer edge of the lesion and was significantly higher (1,800-4,100 ppm) than in adjacent sound inner dentine (190-290 ppm). Fluoride concentrations varied markedly along the outer edge of both normal and carious root tissues. Fluoride increase at the lesion edge is not an effect of tissue shrinkage but probably a result of remineralisation events during caries. This additional F may be expected to increase tissue resistance to further acid attacks.

Acids↗

A Raman spectroscopic investigation of dentin and enamel structures modified by lactic acid.

Confocal Raman microspectrometry allows a thorough molecular analysis of mineralised dental tissues. The output information is provided in the form of curves representing the intensity of the signal according to the frequency, and its mathematical exploitation permits all sorts of comparative and quantitative analyses. By this process, we investigated the in vitro action of lactic acid on enamel and dentin from human permanent teeth. Modifications due to the acidic attack essentially concern phosphate grouping PO(4)(3-), which represents the mineral phase in enamel and dentin (hydroxyapatite): on Raman spectra, changes in intensity of the PO(4)(3-) band are linked to the type of dentin, to its anatomical location, and to the age of the subject. The variability of the dentinal chemical structure was confirmed by a quantitative statistical analysis, revealing a significant spectral difference between coronal and root dentin.

Adult↗

The effect of adjacent dentine blocks on the demineralisation and remineralisation of enamel in vitro.

The aim was to investigate interactions between enamel and dentine at low pH under conditions simulating those at the enamel-dentine junction. Sound enamel blocks were demineralised in acid-gel systems, at pH 4.6, either in isolation, next to one, or in the middle of two, abutting dentine blocks. The gels were initially infinitely undersaturated with respect to enamel. In a second study, enamel blocks containing pre-formed lesions were placed in acid-gel systems, at pH 5.0, either in isolation or next to dentine blocks. The systems were initially either partially or infinitely undersaturated. In the partially saturated systems, calcium and phosphate concentrations were representative of plaque fluid. In the first study, demineralisation of enamel next to one dentine block was reduced in inverse proportion to the distance from the dentine. Demineralisation of enamel between two dentine blocks was retarded markedly across the whole block. In the second study, in the partially saturated systems, enamel lesions next to dentine blocks remineralised, whereas those in isolation demineralised further. We suggest that diffusion of dissolved dentine mineral over the enamel in the infinitely undersaturated system was sufficient to reduce undersaturation, thus retarding demineralisation, and that in the partially saturated systems, dentine dissolution together with the added calcium phosphate caused remineralisation of enamel lesions. Fluoride released from dissolving dentine may have augmented these effects. Different rates of demineralisation in enamel and dentine, or enamel remineralisation with concurrent dentine demineralisation, enabled by differences in their solubilities, could help explain the progression of so-called 'hidden caries'.

Analysis of Variance↗

Diagnosis of erosive tooth wear.

The clinical diagnosis 'erosion' is made from characteristic deviations from the original anatomical tooth morphology, thus, distinguishing acid induced tissue loss from other forms of wear. Primary pathognomonic features are shallow concavities on smooth surfaces occurring coronal from the enamel-cementum junction. Problems from diagnosing occlusal surfaces and exposed dentine are discussed. Indices for recording erosive wear include morphological as well as quantitative criteria. Currently, various indices are used making the comparison of prevalence studies difficult. The most important and frequently used indices are described. In addition to recording erosive lesions, the assessment of progression is important as the indication of treatment measures depends on erosion activity. A number of evaluated and sensitive methods for in vitro and in situ approaches are available, but the fundamental problem for their clinical use is the lack of re-identifiable reference areas. Tools for clinical monitoring are described.

Acids↗

Expression of adhesion molecules during tooth resorption in feline teeth: a model system for aggressive osteoclastic activity.

Tooth resorption, a common feline dental problem, is often initiated at the cemento-enamel junction and hence is called cat 'neck' lesion. Studies have demonstrated that osteoclasts/odontoclasts are increased and activated at resorption sites, and that areas of resorption are partly repaired by formation of tissues resembling bone, cementum, and possibly dentin. However, the cellular/molecular mechanisms/factors involved in resorption and repair are unknown. In this study of tissues from cats with 'neck' lesions, we used specific antibodies and immunohistochemical analyses to examine adhesion molecules associated with mineralized tissues, bone sialoprotein (BSP) and osteopontin (OPN), and a cell-surface receptor linked with these molecules, alpha v beta 3, for their localization in these lesions. In addition, to determine general cellular activity during repair, we performed in situ hybridization using a type I collagen riboprobe. Results showed OPN localized to resorption fronts and reversal lines, while BSP was localized to reversal lines. However, some osteoclasts and odontoblasts "sat" on mineralized surfaces not associated with OPN. The cell-surface receptor, alpha v beta 3, was localized to surfaces of osteoclasts/odontoclasts. Type I collagen mRNA was expressed where osteoblasts attempted to repair mineralized tissue. In contrast, odontoblasts did not express mRNA for type I collagen. This study suggests that osteoclastic resorption is the predominant activity in 'neck' lesions and that this activity was accompanied, at least in part, by increased concentrations of OPN and an associated integrin, alpha v beta 3, at resorption sites. Lack of collagen expression by odontoblasts indicates that odontoblasts do not play an active role in attempts at repair.

Animals↗

Indentation damage and mechanical properties of human enamel and dentin.

Understanding the mechanical properties of human teeth is important to clinical tooth preparation and to the development of "tooth-like" restorative materials. Previous studies have focused on the macroscopic fracture behavior of enamel and dentin. In the present study, we performed indentation studies to understand the microfracture and deformation and the microcrack-microstructure interactions of teeth. It was hypothesized that crack propagation would be influenced by enamel rods and the dentino-enamel junction (DEJ), and the mechanical properties would be influenced by enamel rod orientation and tooth-to-tooth variation. Twenty-eight human third molars were used for the measurement of hardness, fracture toughness, elastic modulus, and energy absorbed during indentation. We examined the effect of enamel rod orientation by propagating cracks in the occlusal surface, and in the axial section in directions parallel and perpendicular to the occlusal surface. The results showed that the cracks in the enamel axial section were significantly longer in the direction perpendicular to the occlusal surface than parallel. The cracks propagating toward the DEJ were always arrested and unable to penetrate dentin. The fracture toughness of enamel was not single-valued but varied by a factor of three as a function of enamel rod orientation. The elastic modulus of enamel showed a significant difference between the occlusal surface and the axial section. It is concluded that the cracks strongly interact with the DEJ and the enamel rods, and that the mechanical properties of teeth are functions of microstructural orientations; hence, single values of properties (e.g., a single toughness value or a single modulus value) should not be used without information on microstructural orientation.

Analysis of Variance↗

Spectroscopic imaging of mineral maturation in bovine dentin.

Dentin is a useful model for the study of mineral maturation. Using Fourier Transform Infrared Imaging (FTIRI), we characterized distinct regions in developing dentin at 7- micro m spatial resolution. Mineral-to-matrix ratio and crystallinity in bovine dentin from cervical and incisal parts of 3rd-trimester fetal compared with one-year-old incisor crowns showed that virtually all maturation stages in dentin could be spectroscopically isolated and analyzed. In the fetal incisors, mantle and circumpulpal dentin presented distinct patterns of mineral maturation. Gradients in both mineral properties examined were observed at the mineralization front and at the dentino-enamel junction.

Animals↗

Characterization of dental epithelial progenitor cells derived from cervical-loop epithelium in a rat lower incisor.

Dental epithelial progenitor cells differentiate into various cell types during development of tooth germs. To study this mechanism, we produced immortalized dental epithelial progenitor cells derived from the cervical-loop epithelium of a rat lower incisor. The expression patterns of cytokeratin 14, nerve growth factor receptor p75, amelogenin, Notch2, and alkaline phosphatase were examined by immunohistochemistry in both lower and higher cell densities. The patterns of each were compared in the dental epithelium of rat lower incisors. The results demonstrated that these cells could produce ameloblast lineage cells, stratum intermedium cells, stellate reticulum, and outer enamel epithelium. Furthermore, fibroblast growth factor 10 stimulated proliferation of dental progenitor cells and subsequently increased the number of cells expressing alkaline phosphatase. These results suggest that fibroblast growth factor 10 plays a role in coupling mitogenesis of the cervical-loop cells and the production of stratum intermedium cells in rat incisors.

Alkaline Phosphatase↗