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Development of horizontal tooth wear in maxillary anterior teeth from five to 18 years of age.

Sizes of horizontal wear facets of maxillary anterior teeth were studied longitudinally from the primary dentition at age five to the young adult dentition at the age of 18 years. By a planimetric method, we calculated the wear areas on dental casts taken at the ages of five, ten, 14, and 18 years from the dentition of 39 healthy, orthodontically untreated subjects with good morphological occlusion. For young adults, we also studied the association between the amount of wear and reported parafunctions, maximal bite force, salivary buffer capacity, salivary flow rate, and some cephalometric variables. Size of wear facets on all anterior teeth increased with age. Significant correlations were found between the total wear areas of the six anterior primary teeth at five years of age and those of their permanent successors at age 14 (r = 0.44) and 18 (r = 0.39). For an individual, tooth wear at five years of age was, however, of low predictive value for tooth wear in young adulthood, whereas tooth wear at 14 years of age predicted it well (r = 0.89). Highest correlations between tooth wear and background factors at 18 years of age were found for maximal anterior bite force (r = 0.44) and for the size of the gonial angle (r = -0.31). Wear of anterior teeth was not associated with reported parafunctions in young adulthood.

Adolescent↗

A question of space: options for the restorative management of worn teeth.

The prevalence of tooth surface loss has increased in recent years. The essence of management is an effective preventive regime; however, in many instances restoration may also be necessary. A number of strategies is available for creating sufficient space to enable restoration and several techniques for restoration known. This article reviews the significance of the vertical dimension of occlusion and describes the restorative management of a patient affected by severe tooth wear.

Adult↗

Status report on acid etching procedures. Council on Dental Materials and Devices.

The introduction of acid etching techniques into many dental disciplines has resulted in safe, simple, conservative, and sometimes more economic methods of treatment. Further, in some instances, it has extended greater opportunities for treating such groups as those physically and emotionally handicapped in whom preventive and restorative procedures are often difficult. It is a significant departure from conventional, established techniques and may supersede some and may share with other established techniques an adjunctive relationship. By many, acid etching techniques are viewed with cautious optimism. It is deceptively simple. Strict adherence to the basic principles of application is important to its success.

Acid Etching, Dental↗

Silver-alloy powder and glass ionomer cement.

This article examines some physical property improvements made when a spherical silver alloy powder is added to a hydrous, restorative (type II) glass ionomer cement. When this first metal-reinforced glass ionomer cement is handmixed thickly and quickly, physical properties and clinical handling are improved. These various improvements make this metal-reinforced cement similar in clinical applications to a biocompatible dental epoxy. Three clinical cases are illustrated to show how simply this metal-reinforced glass ionomer cement can be used in dental practices.

Chemical Phenomena↗

How dentists classified and treated non-carious cervical lesions.

All North Carolina general dentists were shown color photographs of three non-carious cervical lesions. A fourth picture showed cervical caries. Respondents were asked how they defined each lesion, its cause, treatment and frequency of appearance in practice. Cervical caries was identified and treated by almost all responding dentists, but they applied more varied terms, causes and treatments to non-carious defects.

Clinical Competence↗

Occlusal characteristics and tooth mobility in periodontally healthy young males classified orthodontically.

Three groups of periodontally healthy young males classified as to orthodontic status by the Handicapping Labio-Lingual Deviations Index were evaluated for various occlusal characteristics. A much larger proportion (95%) of the orthodontically normal subjects (Group I) had an Angle Class I type of occlusion than the Group II subjects requiring orthodontic care (60.5%), or the Group III subjects who had received orthodontic care (63.4%). The percentages of subjects with a "cuspid-protected" type of occlusion were larger in the orthodontically normal and orthodontically treated groups than in the group requiring orthodontic care. Anterior displacement of the mandible in closing from centric relation to the intercuspal position was found in the majority of subjects in each group. Displacement of more than 2 mm was most common in the subjects requiring orthodontic care. Only 1 of the 41 orthodontically treated subjects reported that his occlusion had been adjusted by grinding after tooth movement. There were no statistically significant differences in mean tooth mobility values between the orthodontically normal and orthodontically treated subjects. The lateral incisor tooth had a significantly lower mean mobility value in subjects whose orthodontic care included removal of the first premolar than in subjects treated without removal of the first premolar. Wear facets were common in all three groups. Based on the findings, one can conclude that orthodontic therapy was only partially successful in obtaining the objectives described as part of an ideal result. It should be noted, however, that the status of the dentition and occlusion prior to orthodontic treatment could not be determined for more than a few subjects.

Adult↗

In vitro evaluation of four adhesive materials in the treatment of cervical lesions.

BACKGROUND: The aim of this study was the evaluation of four adhesive restorative materials regarding the possible microleakage along margins of cervical lesions (class V lesions). METHODS: The comparative in vitro experience was performed in 24 healthy inferior human molars previously extracted and stored in saline. We realized 24 class V lesions with standard dimensions, occlusal margins placed in enamel, cervical margins placed in dentin/cement. The teeth were randomly divided into four groups (six each) and were filled with two light-cured glass ionomer cements (Fuji II LC and Fuji II LC Improved-GC) and with two enamel-dentin adhesive systems/composite resins (Scotchbond MP-3M-/Enamel Plus-Mice-rium-; Prodigy/Optibond-Kerr). All materials were treated according to manufacturers' instructions. After thermocycling the restorations were placed in 2% methylene-blue aqueous solutions for 24 hours. Then we performed a SEM observation of the surface of margin restorations and a light-microscopy observation, after longitudinal section of specimens, to evaluate the marginal infiltration of the colouring solution. RESULTS: We submitted to statistical analysis the results of the light-microscopy observation. Differences in microleakage scores between materials were compared using Kruskall Wallis test. Although higher values of dye penetration were found at gingival margins all groups showed minimal microleakage. No statistical significative differences were seen between materials. Our results are in agreement with those of present in recent literature. CONCLUSIONS: On the basis of our results we can state that the treatment of cervical lesions is a safe and predictable clinical procedure either using light-cured glass ionomer cements or composite resins. Clinicians must take particular care of gingival margins of these lesions.

Composite Resins↗

[Morphogenesis and structure of teleost teeth (Salmo fario L.)].

Tooth formation has been studied in the fry and adult trout (Salmo fario L.) in order to describe their structure and investigate the links between histogenetic and architectural features. Odontoblasts show typical polarized kinetics during their activity; they shrink back from the tooth wall they have elaborated, without leaving any cytoplasmic process (Tomes' fibres); so the dentine in a characteristic way lacks any cellular or canalicular inclusion, at any stage of its development. The tooth as a whole grows from an apical to basal direction; its organic matrix is formed of coarse fibres from the pulp, and fine collagenous fibres formed by the odontoblastic layer. These various fibrillar systems assume definite orientations. Mineralization was studied by fluorescent markers and microradiography. The external apical part of the tooth is hypermineralized, but its structure and pattern of deposition would make it closer to a dentinal differentiation (enameloid) than to an ectodermal enamel. The ameloblasts of the inner epithelium are high, very polarized and active cells, but their participation in tooth tissue formation has not been definitely demonstrated.

Ameloblasts↗

Strengthening of tooth enamel by a remineralizing toothpaste after exposure to an acidic soft drink.

The effect of remineralizing and conventional toothpaste treatments on the hardness of intact and acid soft drink-etched enamel were assessed in a laboratory study. The remineralizing toothpaste (Enamelon Toothpaste) used in the study contains NaF, and simultaneously provides dissolved calcium, phosphate and fluoride ions. The conventional toothpaste contains NaF in a silica base. Sound extracted maxillary human incisors, mounted in epoxy resin with the facial incisal two-thirds exposed, were polished with 0.3 mu alumina. Groups of ten teeth were exposed to either twenty 5-minute treatments with an acid soft drink (pH 2.4), remineralizing or conventional fluoride toothpaste, or to twenty alternating cycles of a 5-minute protective treatment with either the remineralizing or conventional toothpastes, followed by 5-minute exposures to the acid soft drink, or to 20 five-minute exposures to the acid soft drink followed by 20 five-minute restorative treatments with the remineralizing or conventional toothpastes. Knoop Hardness measurements were made before and after treatment using a 500 g load and 15-second dwell time. Acid soft drink exposure produced a 15.4% drop in hardness compared with 4.9% and 1.6% hardness increases due to treatments of intact enamel with the remineralizing and conventional toothpastes, respectively. Protective treatments using the remineralizing and conventional toothpastes significantly reduced the drop in hardness due to acid soft drink exposure to 3.3% and 6.2%, respectively. Restorative treatments by the remineralizing and conventional toothpastes significantly increased the hardness of the acid soft drink-weakened enamel by 12.1% and 7.3%, respectively. Both toothpastes were effective in inhibiting damage due to acid soft drink exposure, but the remineralizing toothpaste was more effective in hardening intact and decalcified enamel than the conventional toothpaste (p < 0.05).

Analysis of Variance↗

A case report: recognizing factitious injuries secondary to multiple eating disorders.

This report describes the uncommon problem of a female patient diagnosed with an eating disorder, bulimia nervosa, who reported self-mutilating dental factitious behavior. The case presents a serious diagnostic and management problem. Notwithstanding the clinical appearance of the dentition, a thorough medical-dental history was essential for this uncommon diagnosis.

Adolescent↗

Dealing with sensitive teeth.

Dental pain is extremely common in the UK and can severely reduce the quality of life when it is associated with eating, drinking or speech. Patients often present complaining of a short, sharp, stabbing pain from hot or cold air, foods or drinks: while this may be caused by tooth decay, failing fillings or cracks in teeth, a major cause is sensitivity from exposed dentine. Treatment varies from dietary control, desensitising toothpastes to protection with dentine-bonding agents and glass ionomers. In extreme cases elective devitalisation is necessary.

Dentin Permeability↗