Treatment planning for patients with tooth wear.

Providing restorative dental care for patients with tooth wear can, at times, seem complex and demanding. The key to this process lies in a systematic approach that breaks down the component parts. In this chapter, the importance of a comprehensive assessment at the outset will be highlighted. This should include identification of the patient's chief complaint, taking a thorough history, completing the clinical examination, undertaking any special tests and arriving at clinical diagnoses. Together, this information will influence the treatment planning process, identify appropriate treatment concepts and options available and the individual stages that may be involved. The process should be both holistic and thorough to enable the patient and clinician to build a clear pathway and vision. In parallel, and with patient input throughout, it is essential to manage patient expectations as best as possible whilst remaining pragmatic and honest about treatment outcomes, longevity of restorations and the risks of failure.

Intraoral scanner-based monitoring of tooth wear in young adults: 24-month results.

OBJECTIVES: Tooth wear causes irreversible cumulated surface loss and already occurs at a young age. Therefore, the objective of this clinical prospective observational study was to monitor the occlusal surface of a mandibular first molar in young adults for a period of 24 months. Furthermore, potential aetiological factors obtained by a questionnaire were considered. MATERIALS AND METHODS: The study teeth (FDI #36 or #46) of 81 participants (mean age 22.8 ± 2.2 years) were scanned with the intraoral scanner (IOS, Trios 3, 3Shape) at the second follow-up (T2) after an observation period of 24 months. Standard-tessellation-language datasets were superimposed with baseline (T0) and T2 scans in 3D analysis software (GOM Inspect). The maximum vertical substance loss was measured between T0 and T2 at 6/7 areas (4/5 cusps and 2 ridges) of each study tooth and data compared to the already published data of the first follow-up (T1) after 12-month observation period. The morphology of tooth wear was classified into three groups: cupping (C), facet (F) and combined cupping-facet (CF). The analysis of aetiological factors, such as acid impacts, was based on a questionnaire filled out by participants at time points T0, T1 and T2. Non-parametric tests were used for statistical analysis (p < 0.05). RESULTS: The buccal load-bearing cusps (mesiobuccal: median 15 µm, 95%CI 11/18 µm; mesiolingual 8 µm, 0/11 µm) were most affected by tooth wear. Loss values increased significantly at T2 compared to T1 for all areas, although significantly less than in the first 12 months (T0-T1). Areas that already exhibited F at T0 mostly displayed them also at T2 and only rarely developed further into C or CF. The only association between aetiological factors and loss values could be detected for sex as males had significantly higher loss values than females. CONCLUSIONS: Progression of tooth wear could be clearly shown with high interindividual variations in loss values among participants. This indicates the need for individual monitoring with IOS. CLINICAL RELEVANCE: IOSs show the potential for patient-specific monitoring to detect the progression of tooth wear. Thus, data of 24 months fills the gap of tooth wear data for young adults in literature. Further studies over a longer observation period are highly recommended to gain more information about the dynamic of tooth wear and aetiological factors.

Hipersensibilidade Dentinária Cervical: fatores de risco e protocolos de tratamento neural - estudo in vitro e clinico / Cervical Dentin Hypersensitivity: risk factors and neural treatment protocols - in vitro and clinical study

A lesão cervical não cariosa (LCNC) é uma doença caracterizada pela perda mineral do tecido dentário na região cervical. A sua progressão pode levar a hipersensibilidade dentinaria cervical (HDC). Apresenta etiologia multifatorial através de mecanismos de: fricção como a escovação (frequência, força, direção e creme dental abrasivo); tensão com sobrecarga oclusal (bruxismo e má-oclusão) e, principalmente, o mecanismo de corrosão através de doenças gástricas, transtornos alimentares e hábitos dietéticos (ingestão de ácido). Nos últimos anos é notório observamos a mudança de estilo de vida da população, e com isso um aumento da prevalência de HDC. É uma condição clínica comum caracterizada por uma dor aguda e transitória que surge devido a túbulos expostos em resposta a estímulos. Impacta negativamente a saúde bucal e a qualidade de vida dos pacientes. Para facilitar o entendimento, essa tese apresenta um compilado em três capítulos. Capitulo 1: O objetivo foi avaliar o pH de bebidas esportivas, energéticas, fitness/funcionais e suplementos, e a capacidade de neutralizar o ácido pela adição de saliva artificial, em um estudo experimental; capitulo 2: Avaliar o pH de bebidas, alimentos e medicamentos disponíveis no mercado brasileiro e a capacidade de neutralizar o ácido pela adição de saliva artificial; e capitulo 3: Através de um estudo clínico longitudinal randomizado, avaliar diferentes protocolos de tratamento da HDC com laser de baixa potência, agente dessensibilizante, e sua associação. Após as análises dos resultados ressalta-se que bebidas esportivas são comumente recomendadas por outros profissionais com o objetivo principal de atingir as metas de cada atleta, seja amador ou profissional. No entanto, como podem ter impacto na saúde bucal e um trabalho multidisciplinar é necessário, além de orientações para os pacientes esportivos. A maioria dos alimentos e bebidas consumidas por brasileiros são ácidas, e os resultados fornecem a dentistas e pacientes informações relevantes sobre as características do potencial corrosivo das bebidas comercialmente disponíveis no Brasil, sendo necessário orientações dietéticas específicas para prevenir ou minimizar o desgaste precoce dos dentes. E por último, encontrou-se que protocolo dessensibilizante de três sessões foi eficaz na redução da HDC após 3 meses, independentemente do mecanismo de dessensibilização utilizado.

In vitro evaluation of the effects of different particle types in toothpastes on the efficacy against enamel erosion and wear.

The effects of the particle fraction in toothpastes in the context of erosion and erosive tooth wear has not been fully elucidated. Thus, aim of this study was to investigate experimental toothpastes, each with one specific particle type. Toothpastes with seven different types of silica or alumina were prepared as slurry either with or without active ingredients (NaF or F/Sn). Human enamel samples were exposed to a cyclic erosion/abrasion model, and were either treated with the respective slurries only or additionally brushed in a brushing machine. Tissue loss was profilometrically monitored. After treatment with slurries without active ingredients or with NaF, tissue loss increased significantly within groups over time (p < 0.001 each). At the end of the trial, there were minor differences between groups (not exceeding 10-20%; p > 0.05 for most comparisons). After treatment with the F/Sn slurries, tissue loss stagnated completely over time, with the exception of one silica type and alumina, but both still reduced tissue loss by 40-50% (compared to control p < 0.001 each). Relative to the type of the active ingredient, the particle type seems to be a secondary factor for the efficacy of toothpastes on erosion and erosive tooth wear in enamel.

Intraoral scanner-based monitoring of tooth wear in young adults: 12-month results.

OBJECTIVES: To investigate tooth wear in young adults, intraoral scanning was used for digital monitoring of the mandibular first molar over 12 months. A possible influence of aetiological factors obtained by a questionnaire on tooth wear was investigated. MATERIALS AND METHODS: A total of 109 participants (mean age at the start of the study: 21.0 ± 2.2 years) were included in this clinical study. At baseline (T0), an intraoral scan (Trios 3, 3Shape) of the study tooth (FDI # 36 or #46) was conducted. After a mean observation period of 373 ± 19 days, a second intraoral scan (T1, n = 94) of the same tooth as at T0 was performed and standard tessellation language datasets were superimposed with 3D analysis software (GOM Inspect). The occlusal surface of the study tooth was divided into 7 areas (5 cusps, 2 ridges) and maximum vertical substance loss was measured between T0 and T1 (n = 91). Three types of tooth wear were defined: cupping (C), facet (F) and combined cupping-facet (CF). Furthermore, a questionnaire on aetiological factors, such as dietary behaviour, was filled out at T0. Data were analysed with non-parametric tests (p < 0.05). RESULTS: Only one study tooth exhibited no tooth wear at T0, whereas 3 teeth showed C, 47 teeth F and 40 teeth CF. A progression of vertical substance loss for all three types was shown. Most affected were the mesiobuccal cusps (43, 38/47 µm; median, 95%CI) followed by distobuccal (36, 33/39 µm), mesiolingual (35, 26/40 µm), distolingual (34, 27/36 µm) and distal (31, 25/34 µm). On mesial and distal ridges, only F was detected with the lowest vertical substance loss of all areas (mesial ridge: 0, 0/0 µm; distal ridge: 0, 0/0 µm). An association between aetiological factors and loss values could not be shown. CONCLUSIONS: All study teeth showed clear signs of wear, and after only 1 year, further substance loss was detectable. This result is of significance for young adults. CLINICAL RELEVANCE: Since data of young adults regarding tooth wear are scarce, the results give a first idea of the amount of vertical loss per year and its relation to aetiological factors such as dietary behaviour. Therefore, further studies over a longer observation period are highly recommended.

Efecto simbiótico de la L-arginina más Lactobacillus rhamnosus GG sobre el crecimiento Streptcoccus mutans cariogénico en personas con desgaste dental por el consumo de gaseosas / Symbiotic effect of L-arginine plus Lactobacillus rhamnosus GG on the growth of cariogenic Streptcoccus mutans in people with dental wear due to the consumption of soft drinks

La alta prevalencia de desgaste dental erosivo producido por la ingestión frecuente de bebidas gaseosas, se ha convertido en uno de los principales problemas de salud bucal en niños, adolescentes y adultos jóvenes, cuyo tratamiento deviene en desafío para los profesionales de la salud. La investigación se propuso evaluar el efecto erosivo exógeno de las bebidas gaseosas, sobre el tejido dentario mediante el proceso de termociclado in vitro, en el que se sometieron 50 premolares extraídos a la experiencia de exposición a una bebida gaseosa, bajo condiciones de experimentación, resultando una diferencia significativa entre el peso inicial pre termociclado en cada pieza y el peso final obtenido después del proceso, lo cual demuestra el efecto negativo del consumo de bebidas gaseosas. En ese mismo sentido, y como parte de esta investigación, se evaluó los efectos beneficiosos de los probióticos como la L-alanina como suplemento de las bacterias beneficiosas a la salud bucal como el Lactobalilos rhamnosus GG que logran detener el avance de bacterias patógenas y oportunistas como el Streptococcus mutans. Los resultados mostraron que a medida que aumenta la concentración del probiótico, mayor es la disminución del número de unidades formadoras de colonias y de las biopelículas de Streptococcus mutans. Además, la investigación aborda la percepción del riesgo en estudiantes, de ingestión de bebidas gaseosas en la erosión dentaria y los criterios que sobre el tema tienen sus profesores tutores(AU)

The high prevalence of erosive dental wear caused by the frequent ingestion of soft drinks has become one of the main oral health problems in children, adolescents and young adults, whose treatment becomes a challenge for health professionals. The research aimed to evaluate the exogenous erosive effect of soft drinks on dental tissue through the in vitro thermocycling process, in which 50 extracted premolars were subjected to the experience of exposure to a soft drink, under experimental conditions, resulting in a significant difference between the initial pre-thermocycling weight in each piece and the final weight obtained after the process, which demonstrates the negative effect of the consumption of soft drinks. In that same sense, and as part of this research, the beneficial effects of probiotics such as L-alanine were evaluated as a supplement for beneficial bacteria for oral health such as Lactobalilos rhamnosus GG, which manage to stop the advance of pathogenic and opportunistic bacteria such as Streptococcus mutans. The results showed that as the concentration of the probiotic increases, the decrease in the number of colony-forming units and biofilms of Streptococcus mutans is greater. In addition, the research addresses the perception of risk in students, of ingestion of soft drinks in dental erosion and the criteria that their tutor teachers have on the subject(AU)

Evidence of habitual behavior from non-alimentary dental wear on deciduous teeth from the Middle and Upper Paleolithic Cantabrian region, Northern Spain.

The use of 'teeth as tools' (non-masticatory or cultural-related dental wear) has largely been employed as a proxy for studying of past human behavior, mainly in permanent dentition from adult individuals. Here we present the analysis of the non-masticatory dental wear modifications on the deciduous dentition assigned to eight Neanderthal and anatomically modern human subadult individuals from Mousterian to Magdalenian technocultural contexts in the Cantabrian region (Northern Spain). Although preliminary, we tentatively suggest that these eight subadults present activity-related dental wear, including cultural striations, chipped enamel, toothpick grooves, and subvertical grooves. We also found evidence of habitual dental hygienic practices in the form of toothpicking on a deciduous premolar. Orientation of the cultural striations indicates similar handedness development as in modern children. Taken together, these dental wear patterns support the participation of young individuals in group activities, making them potential contributors to group welfare. This study potentially adds new evidence to the importance of the use of the mouth in paramasticatory activities or as a third hand throughout the Pleistocene, which can be confirmed with a more specific reference sample.

Dental microwear of a basal ankylosaurine dinosaur, Jinyunpelta and its implication on evolution of chewing mechanism in ankylosaurs.

Jinyunpelta sinensis is a basal ankylosaurine dinosaur excavated from the mid Cretaceous Liangtoutang Formation of Jinyun County, Zhejiang Province, China. In the present study, its dental microwear was observed using a confocal laser microscope. Jinyunpelta had steep wear facets that covered most of buccal surfaces of posterior dentary teeth. Observation of dental microwear on the wear facet revealed that scratch orientation varied according to its location within the wear facet: vertically (i.e. apicobasally) oriented scratches were dominant in the upper half of the wear facet, and horizontally (i.e. mesiolaterally) oriented ones were in the bottom of the facet. These findings indicated that Jinyunpelta adopted precise tooth occlusion and biphasal jaw movement (orthal closure and palinal lower jaw movement). The biphasal jaw movement was widely observed among nodosaurids, among ankylosaurids, it was previously only known from the Late Cretaceous North American taxa, and not known among Asian ankylosaurids. The finding of biphasal jaw movement in Jinyunpelta showed sophisticate feeding adaptations emerged among ankylosaurids much earlier (during Albian or Cenomanian) than previously thought (during Campanian). The Evolution of the biphasal jaw mechanism that contemporaneously occurred among two lineages of ankylosaurs, ankylosaurids and nodosaurids, showed high evolutionary plasticity of ankylosaur jaw mechanics.

Contemporary diagnosis and management of dental erosion.

OBJECTIVE: This article is aimed at providing an overview of the topic of erosive tooth wear (ETW), highlighting the clinical signs, diagnosis, and management of dental erosion. OVERVIEW: With the increased prevalence of ETW, it is important that oral health professionals are able to recognize the early signs. Early clinical signs of dental erosion are characterized by loss of enamel texture, a silky glossy appearance, and sometimes a dulling of the surface gloss, referred to as the "whipped clay effect, cupping, and restorations 'standing proud'." The progression of ETW should be monitored by means of diagnostic models or clinical photographs. ETW can be as a result of acid attack of extrinsic or intrinsic origin. CONCLUSION: There is an increase of ETW that is being recognized by the profession. The first step in diagnosing and management is to recognize as early as possible that the process is occurring. At that point a determination of whether the primary etiology is either intrinsic or extrinsic should be made. If these findings are confirmed, appropriate prevention, and management strategies can be adopted followed by appropriate restorative therapy. CLINICAL SIGNIFICANCE: The prevalence of ETW continues to increase. It is therefore important that oral health care providers have a better understanding of the etiology, pathophysiology, and management of this condition. This review aims to provide the guidelines for diagnosis and management of dental erosion.

Exploring late Paleolithic and Mesolithic diet in the Eastern Alpine region of Italy through multiple proxies.

OBJECTIVES: The analysis of prehistoric human dietary habits is key for understanding the effects of paleoenvironmental changes on the evolution of cultural and social human behaviors. In this study, we compare results from zooarchaeological, stable isotope and dental calculus analyses as well as lower second molar macrowear patterns to gain a broader understanding of the diet of three individuals who lived between the end of the Late Pleistocene and the Early Holocene (ca., 17-8 ky cal BP) in the Eastern Alpine region of Italy. MATERIALS AND METHODS: We analyze individuals buried at the sites of Riparo Tagliente (Verona), Riparo Villabruna, and Mondeval de Sora (Belluno). The three burials provide a unique dataset for diachronically exploring the influence of climatic changes on human subsistence strategies. RESULTS: Isotopic results indicate that all individuals likely relied on both terrestrial and freshwater animal proteins. Even though dental calculus analysis was, in part, hindered by the amount of mineral deposit available on the teeth, tooth macrowear study suggests that the dietary habits of the individuals included plant foods. Moreover, differences in macrowear patterns of lower second molars have been documented between Neanderthals and modern humans in the present sample, due to a prevalence of Buccal wear among the former as opposed to higher values of Lingual wear in modern human teeth. DISCUSSION: Isotopic analyses have emphasized the contribution of animal proteins in the diet of the three foragers from the Eastern Alpine region. The possible intake of carbohydrate-rich plant foods, suggested by the retrieval of plant remains in dental calculus, is supported by the signal of macrowear analysis. Moreover, the latter method indicates that the distribution of macrowear in lower second molars (M2 s) allows us to discriminate between Neanderthals and modern humans within the present reference sample. Overall, our results show these three prehistoric hunter-gatherers were well adapted to the environment in which they lived exploiting many natural resources.

Evidence That Daily Vinegar Ingestion May Contribute to Erosive Tooth Wear in Adults.

Vinegar ingestion at mealtime is gaining popularity for its antiglycemic effects; however, it is among the most acidic consumable substances. This study examined tooth wear in healthy adults participating in an 8-week randomized trial examining the effect of daily vinegar ingestion on insulin sensitivity and visceral fat reduction. Twice daily participants consumed a vinegar drink (two tablespoons vinegar in a cup of water; 3.6 g acetic acid) or a commercial vinegar pill (control, 0.045 g acetic acid) at mealtime. Participants were screened for dental erosion using the basic erosive wear examination (BEWE) by a blinded registered dental hygienist at trial baseline and week 8. Mean BEWE scores did not change in the control group but increased 18% in the vinegar group over the 8-week study (P = .038). Given the current popularity of vinegar as a medicinal agent, practitioners should caution patients who utilize this strategy on the possibility of erosive tooth wear. Trial registration: This trial was registered at ClinicalTrials.gov (NCT03577834) on July 5, 2018 and the institutional review board at Arizona State University provided ethical approval (STUDY00005418).

Tooth wear among five-year-old children in Jakarta, Indonesia.

BACKGROUND: This study aimed to evaluate the prevalence of tooth wear among preschool children in Jakarta, Indonesia, and examine the risk factors associated with its occurrence. METHODS: An epidemiological survey was conducted with a cross-sectional study design. The participants were recruited via cluster sampling. Tooth wear was clinically assessed by one examiner using the Basic Erosive Wear Examination (BEWE) criteria. The children's caries experience was also recorded. The parents of the participating children completed a self-administered questionnaire to answer demographic questions about the children and gather information about the children's diet and oral health behaviors as well as the parents' dental health-related knowledge. The data were analyzed using the Chi-square test and binary logistic regression. RESULTS: A total of 752 five-year-old children were invited to participate, with 691 (92%) enrolling in the study. Tooth wear occurred in 23% (161/691, BEWE > 0) of the participants, in which 78% (125/161) had at least one moderate tooth wear status (BEWE = 2). The consumption of citrus drinks, fruit juice, and vitamin C supplement drinks, together with the child's caries experience, the father's education level, and the family's socioeconomic status, were significantly associated with tooth wear. CONCLUSIONS: The five-year-old preschool children in Jakarta had a relatively low prevalence of tooth wear. Those consuming more acidic drinks, those with a higher socioeconomic status, and those with an absence of caries experience had a higher risk of tooth wear.

Cup-Shaped Tooth Wear Defects: More than Erosive Challenges?

BACKGROUND/AIM: The underlying mechanism of the development of cups and grooves on occlusal tooth surfaces is still unclear. The aim of this study was to evaluate factors contributing to in vitro cup formation, in order to elucidate the clinical process. METHODS: A total of 48 extracted human molar teeth were exposed to acidic aqueous solutions at pH of 4.8 and 5.5 in constant motion, in combination with different loading conditions: no load (0N group, control), 30 N (30N group) or 50 N (50N group) (n = 8 per group). Before and after 3 months of exposure (1,422,000 loading cycles), the samples were scanned using a non-contact profilometer. Pre- and post-exposure scans were subtracted and height loss and volume tissue loss were calculated. Representative samples with wear and cupping lesions were imaged using scanning electron microscopy, light microscopy and micro-computed tomography. RESULTS: Average height and volume tissue loss at pH 5.5 was 54 µm and 3.4 mm3 (0N), 52 µm and 3.4 mm3 (30N) and 58 µm and 3.7 mm3 (50N), respectively, with no statistically significant differences. Average height and volume loss at pH 4.8 were 135 µm and 8.7 mm3 (0N), 172 µm and 12.6 mm3 (30N) and 266 µm and 17.8 mm3 (50N), respectively, with a statistically significant difference between 0N and 50N (p < 0.002). Cup-shaped lesions had formed only at pH of 4.8, in the 30N and 50N groups. CONCLUSION: The study showed that a cup can arise fully in enamel and that mechanical loading in addition to erosive challenges are required.

Terapêutica convencional associada a medicamentos homeopáticos como alternativa no controle do bruxismo / Conventional therapy associated with homeopathic remedies as an alternative in the control of bruxism

O bruxismo é descrito como uma parafunção orofacial que afeta crianças e adultos caracterizado pelo hábito de ranger ou apertar os dentes, com etiologia complexa, multifatorial, assim como seu diagnóstico e controle. Pode ser considerado cêntrico, quando o hábito de apertar os dentes ocorre de ação semi-inconsciente, denominado diurno ou vigília (BV) e, excêntrico, quando ocorre ranger dos dentes de ação inconsciente, denominado noturno ou do sono (BS). A homeopatia (H) visa restabelecer o equilíbrio da energia vital do paciente permitindo o movimento de cura do organismo. O objetivo desta pesquisa foi avaliar a eficácia dos medicamentos homeopáticos (Matricaria chamomilla e Cimex lectularius), concomitante com a terapêutica convencional para que se tenha uma alternativa no controle do bruxismo. A amostra abordou 60 pacientes com diferentes antecedentes sociais, de ambos os gêneros, com idade de 18 a 60 anos, os quais responderam a questionários específicos e passaram por exames clínicos orais com resposta positiva para o bruxismo. Foram divididos aleatoriamente em Grupo Teste (GT) com 30 indivíduos tratados com placas interoclusais de acrílico associadas com medicamentos homeopáticos e Grupo Controle (GC) com 30 indivíduos utilizando placas interoclusais mais placebo (medicamentos homeopáticos sem o princípio ativo) por um período total de 6 meses, avaliados mensalmente para a verificação da diminuição dos sinais e sintomas do bruxismo. O resultado final concluiu a eficácia da terapêutica homeopática como coadjuvante ao tratamento convencional com as placas interoclusais, amenizando os transtornos de dor e desgastes dentários provocados pelo bruxismo (AU).

Bruxism is described as an orofacial parafunction that affects children and adults characterized by the habit of grinding or clench the teeth, with complex and multifactorial etiology, as well as its diagnosis and control. Can be considered centric when the habit of squeezing the teeth occurs semi-conscious and action is called day or vigil (BV) and, eccentric, when there is the gnashing of teeth and unconscious action is called nightcrawler night or sleep (BS). The homeopathy (H) aims to restore the balance of the vital energy of the patient allowing the motion of the body's healing. The objective of this research was to evaluate the efficacy of homeopathic medicines (Cimex lectularius and Matricaria chamomilla), concomitant with the conventional therapy for an alternative in the control of bruxism. The sample was constituted of 60 patients with different social backgrounds, both genders aged from 18 to 60 years old, who answered to questionnaires and passed through oral clinical examination with positive response to bruxism. They were divided into Test Group (GT) with 30 subjects treated with interoclusais acrylic plates associated with homeopathic medicines and the Control Group (GC) with 30 individuals using interoclusais plates more placebo (homeopathic medicines without the active) for a total period of 6 months, evaluated monthly for checking the reduction of signs and symptoms of bruxism. The final result was concluded the effectiveness of homeopathic therapy as an adjunct to conventional treatment with interoclusais board, easing pain disorders and dental damage caused by bruxism (AU).

Tooth grooves, occlusal striations, dental calculus, and evidence for fiber processing in an Italian eneolithic/bronze age cemetery.

OBJECTIVES: We conducted a systematic macroscopic and microscopic examination of occlusal and para-occlusal wear in a large dental sample (n = 3,014) from 217 individuals dated to the Early Bronze age site of Gricignano d'Aversa, Italy. We used macroscopic and microscopic techniques to document nondietary occlusal and para-occlusal wear and to analyze calculus inclusions in some of the teeth. In combining an analysis of the wear with the calculus inclusions we linked the specific wear to the likely fiber that was involved in producing it. MATERIALS AND METHODS: Teeth and their high resolution epoxy casts were analyzed through SEM and reflected light microscopes. Nineteen individuals (fifteen with activity induced dental modifications and four as a control sample) were examined for the presence of calculus inclusions. RESULTS: Activity induced dental modifications (AIDMs), notches, grooves and micro-striations, were found in the 62.2% of the adult females, in 21.2% of the adults of unknown sex and in a single male. We found the full spectrum of dental manipulations from very minor nonocclusal wear in some young individuals to severe attrition at the other extreme. The width of the striations and grooves, mostly on the upper incisors, suggests a craft activity involving fibers and thread production and manipulation. From the dental calculus of two females with grooves and striations, we extracted three fragments of fibers, identified as hemp (Cannabis, sp.). Previously from Gricignano woven hemp fibers were found on both surfaces of a metal blade associated with a male burial. DISCUSSION: This study found the co-occurrence of tooth AIDMs and the actual fibers preserved in the dental calculus. As more work is done analyzing dental calculus in a variety of humans, it is apparent that this biological material holds rich resources documenting non-dietary habits.

Association between traditional oral hygiene methods with tooth wear, gingival bleeding, and recession: A descriptive cross-sectional study.

BACKGROUND: Oral hygiene maintenance is crucial for prevention of various oral diseases. Oral hygiene practices across the country vary largely and people in peri-urban and rural areas use traditional methods of oral hygiene like powders, bark, oil and salt etc. Their effect on oral soft and hard tissues need to be studied to understand their beneficial and/ or harmful effects on maintenance of oral hygiene and prevention or causation of oral diseases. OBJECTIVES: This study aimed to assess the plaque-cleaning efficacy, gingival bleeding, recession and tooth wear with different traditional oral hygiene methods as compared to use of toothpaste-toothbrush, the most accepted method of oral hygiene practice. STUDY DESIGN: Hospital based cross sectional analytical study. Results: Total 1062 traditional oral hygiene method users were compared with same number of toothpaste-brush users. The maximum number in the former group used tooth powder (76%) as compared to other indigenous methods, such as use of bark of trees etc and out of tooth powder users; almost 75% reported using red toothpowder. The plaque scores and gingival bleeding & recession were found to be more in traditional oral hygiene method users. The toothwear was also more severe among the toothpowder users. CONCLUSIONS: Traditional methods were found to be inferior in plaque control as was documented by increased bleeding and gingival recession. Its effect on hard tissues of teeth was very damaging with higher tooth wear scores on all surfaces.

Photobiomodulation versus direct restoration in a patient presenting with dentinal hypersensitivity: a 6-month follow-up.

Despite nearly a century of research, the treatment of cervical dentinal hypersensitivity (DH) remains challenging. This case report discusses the indications for different approaches to the treatment of DH in a single patient; the chosen alternatives took into account the different degrees of tooth wear and levels of pain at different sites. A 31-year-old woman reported DH in the maxillary right canine and first premolar and the maxillary left lateral incisor and canine in response to thermal, tactile, and osmotic stimuli. Clinical examination revealed that the teeth on the right side presented noncarious cervical lesions deeper than 1 mm, while the teeth on the left side presented only minimal wear. Therefore, the right canine and premolar were restored with composite resin to create a mechanical barrier against stimuli and reestablish form, function, and esthetics. Prior to restoration, the teeth on the right side were irradiated with a low-power laser (808 nm, 100 mW, 1.1 J/point, 10 seconds), which was applied in a single session at 2 locations on each tooth. In contrast, the left lateral incisor and canine were irradiated in 3 sessions with the low-power laser, which reduces pain levels and depolarizes nerve fibers by means of cell biomodulation, and received no restorations. A visual analog scale (0.0-10.0) was used to record the patient's pain, and it was found that pain levels for the restored teeth decreased from 9.4 initially to 0.0 immediately after restoration, and pain levels for the irradiated teeth decreased from 5.4 initially to 2.0 after 3 sessions. After 6 months of clinical evaluation, both sets of teeth showed scores of 0.0 (no pain). Based on the results presented, it can be concluded that both treatments provided satisfactory outcomes when applied for the appropriate indication.

Exploring sex differences in diets and activity patterns through dental and skeletal studies in populations from ancient Corinth, Greece.

Sex and temporal differences are assessed in relation to dietary habits and activity patterns in three ancient populations from Corinth, Greece. The skeletal sample spans time from the Geometric to the Early Byzantine Period (9th c. BCE-5th c. CE). Dental caries and tooth wear have been proven to be reliable dietary indicators. Similarly, spinal osteoarthritis, spinal facet remodeling and Schmorl's nodes, have been used to infer activity patterns.

Transition to agriculture in South-Eastern Arabia: Insights from oral conditions.

OBJECTIVES: In Southeast (SE) Arabia, agriculture is supposed to expand around 3000 BC, but its tempo and its actual role in populations' subsistence is still debated by archaeologists. Here, we compare dental health conditions of 11 skeletal samples from coastal and inland sites, dated from the Late Neolithic (ca. 4500-3100 BC) to the Early Bronze Age (EBA), conventionally divided into Hafit (ca. 3100-2700 BC) and Umm an-Nar period (ca. 2700-2000 BC). The goal is to assess long-term trends in subsistence patterns and regional variability during the local transition to agriculture. METHODS: Seven indicators of oral health and childhood stress were analyzed, including dental wear, calculus, caries, alveolar resorption, periapical lesions, ante-mortem tooth loss (AMTL), and linear enamel hypoplasia (LEH). RESULTS: Neolithic coastal populations are globally characterized by high dental wear, high calculus frequency, high LEH frequency, and frequent periodontal disease, whereas they exhibit low abscesses and AMTL frequencies and a total absence of carious lesions. Samples from the Hafit period present high dental wear, low rates of calculus and LEH, frequent periodontal disease, combined with low abscess and AMTL frequencies and absence of caries. By contrast, samples from the Umm an-Nar period exhibit much lower dental wear, calculus and LEH rates, whereas caries, periapical lesions and AMTL frequencies increase significantly. Marked differences were observed between coastal and inland Umm an-Nar groups, the latter presenting significantly higher frequencies of caries, periapical lesions, alveolar resorption and AMTL. DISCUSSION/CONCLUSION: Oral conditions from the Neolithic coastal populations denote a diet mainly composed of unprocessed and abrasive food, with high protein and low carbohydrate intakes, and frequent stress episodes. Although Hafit populations display some changes in oral pathologies, which indicate modifications in their lifestyle and a diversification of the diet, no markers of high carbohydrate intakes were observed in our samples. The impact of agriculture on oral health appears clearly only from the Umm an-Nar period, and is more intense inland than on the coast, where marine resources are still a main component of the diet.

New methodology to reconstruct in 2-D the cuspal enamel of modern human lower molars.

OBJECTIVES: In the last years different methodologies have been developed to reconstruct worn teeth. In this article, we propose a new 2-D methodology to reconstruct the worn enamel of lower molars. Our main goals are to reconstruct molars with a high level of accuracy when measuring relevant histological variables and to validate the methodology calculating the errors associated with the measurements. METHODS: This methodology is based on polynomial regression equations, and has been validated using two different dental variables: cuspal enamel thickness and crown height of the protoconid. In order to perform the validation process, simulated worn modern human molars were employed. The associated errors of the measurements were also estimated applying methodologies previously proposed by other authors. RESULTS: The mean percentage error estimated in reconstructed molars for these two variables in comparison with their own real values is -2.17% for the cuspal enamel thickness of the protoconid and -3.18% for the crown height of the protoconid. This error significantly improves the results of other methodologies, both in the interobserver error and in the accuracy of the measurements. CONCLUSIONS: The new methodology based on polynomial regressions can be confidently applied to the reconstruction of cuspal enamel of lower molars, as it improves the accuracy of the measurements and reduces the interobserver error. The present study shows that it is important to validate all methodologies in order to know the associated errors. This new methodology can be easily exportable to other modern human populations, the human fossil record and forensic sciences.