Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion.

The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro.

An in vitro assessment of the effect of load and pH on wear between opposing enamel and dentine surfaces.

OBJECTIVE: Previous in vitro studies have described the wear characteristics of specimens in which enamel has been opposed to enamel and dentine opposed to dentine. The aim of this study was to assess the characteristics of wear between specimens in which enamel was opposed to dentine at loads simulating attrition and at pH values simulating different erosive environments. It was hypothesized that enamel would wear more slowly than dentine under all conditions. DESIGN: Opposing enamel and dentine specimens from 57 human third molar teeth were worn in electromechanical machines with various loads (32, 62 and 100 N) and lubricants (pH 1.2, 3.0 and 6.1). Tooth wear was quantified by measuring reduction in dentine volume over time using a 3D profilometer. Qualitative assessment was also carried out using scanning electron microscopy. RESULTS: Dentine wear increased with increasing load, and dentine wear was faster at pH 1.2 than at pH 3.0 or 6.1 for all loads tested. Interestingly, enamel wore more rapidly than dentine at pH 1.2 under all loads. At pH values of 3.0 and 6.1, enamel wear rates were not measurably different from zero and they were less than wear rates for opposing dentine specimens at all loads. Micrographic assessment showed extensive surface destruction of dentine wear facets due to erosion at pH 1.2. Dentine wear facets were smoother at pH 3.0 that at pH 6.1. CONCLUSIONS: When enamel wears against dentine in an acidic environment enamel will wear more rapidly at very low pH, while under less acid conditions dentine will wear faster than enamel.

An assessment of stress analyses in the theory of abfraction.

Wedged-shaped lesions at the cemento-enamel junction of teeth have been attributed primarily to biomechanical loading forces that cause flexure and failure of enamel and dentin. This theory, termed abfraction, remains controversial. This review examined studies on mechanical properties of enamel and dentin and studies on bite forces and mastication as background information. Abfraction is based principally on a few early finite element analysis and photoelastic models showing stress concentration at the dental cervical area without actually showing enamel and dentin fracture. However, a review of more recent dental stress analyses has been contradictory. Particularly, analyses of the periodontal ligament and alveolar bone, not modeled in previous studies, have shown that those structures may dissipate occlusal loading forces from the cervical areas. In addition, some models may not fully represent intricate dental anatomy and complex occlusal function. Therefore, the key basis of the abfraction theory may be flawed.