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.

Risk factors of tooth wear in permanent dentition: A scoping review.

BACKGROUND: Tooth wear (TW) prevalence is high and increasing and has important consequences on the patient's quality of life. Knowledge of risk factors is crucial to promote diagnosis, prevention strategies and timely interceptive treatment. Many studies have identified TW risk factors. OBJECTIVE: This scoping review aims to map and describe suspected available factors associated with TW in permanent dentition based on quantitative measurement. METHODS: The scoping review was conducted using the PRISMA extension of the Scoping Reviews checklist. The search was conducted in October 2022 from the Medline® (PubMed® interface) and Scopus® databases. Two independent reviewers selected and characterised the studies. RESULTS: 2702 articles were identified for assessment of titles and abstracts, and 273 articles were included in the review. The results show a need to standardise TW measurement indices and the study design. The included studies highlighted various factors, classified into nine domains: sociodemographic factors, medical history, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders, behavioural factors, and stress. Results related to chemical TW (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, particularly drinking and eating behaviours, which supports developing public health information campaigns and interventions. Besides chemical, this review identifies evidence of several mechanical TW risk factors, such as toothbrushing and bruxism; the influence of this last factor needs to be further explored. CONCLUSIONS: TW management and prevention require a multidisciplinary approach. Dentists are in the first line to detect associated diseases such as reflux or eating disorders. Consequently, practitioners' information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.

The association of severely worn dentition resulting from betel nut chewing with temporomandibular disorders: a cross-sectional study.

BACKGROUND: Most studies support parafunctions play an important role in temporomandibular disorders (TMD), whereas the association between tooth wear and TMD remains controversial. Betel nut chewing as a parafunction is popular in South and Southeast Asia. We therefore investigated the association of severely worn dentition resulting from betel nut chewing with TMD. METHODS: A cross-sectional analysis of 408 control participants (male: 380, female: 28, 43.62 ± 9.54 years) and 408 participants with betel nut chewing related severely worn dentition (male: 380, female: 28, 43.73 ± 8.93 years) who received dental and TMD checkup according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Health Management Center, Xiangya Hospital was performed. Betel nut chewing related severely worn dentition meant all the natural teeth had moderate to severe tooth wear [Tooth Wear Index (TWI) ≥ 2)] including ≥ 2 severe wear teeth (TWI ≥ 3) due to betel nut chewing. Multivariable logistic regression analysis was used. RESULTS: After adjusting for age, gender, betel nut chewing related severely worn dentition, oral submucosal fibrosis, number of missing teeth, number of dental quadrants with missing teeth, visible third molar and orthodontic history, variables of age, gender and betel nut chewing related severely worn dentition were significant for overall TMD. Multivariable analysis showed betel nut chewing related severely worn dentition was significantly associated with intra-articular TMD [odds ratio and 95% confidence intervals: 1.689 (1.271-2.244), P = 0.001] in a betel nut chewing dose-dependent manner. CONCLUSION: Betel nut chewing related severely worn dentition was associated with intra-articular TMD.

Mandibular Distalisation for Tooth Wear in Patients Requiring Mandibular Protrusion for Sleep Apnoea.

BACKGROUND: Pathological tooth wear is an increasing concern and may require intervention and occlusal rehabilitation. Often the treatment includes distalisaton of the mandible to restore the dentition in centric relation. Obstructive sleep apnoea (OSA) is another condition treated my mandibular repositioning but in this case by an advancement appliance. The authors have a concern that there could be a group of patients with both conditions where distalisation for their tooth wear management would be contrary to their OSA treatment. This paper aims to look at this potential risk. METHODS: A literature search was carried out using the following keywords (OSA or sleep apnoea or apnea or snoring or AHI or Epworth score) and for tooth surface loss (TSL or distalisation or centric relation or tooth wear or full mouth rehabilitation). RESULTS: No studies were identified which considered the effect of mandibular distalisation on OSA. CONCLUSION: There is a theoretical risk that dental treatment involving distalisation may adversely affect patients at risk of OSA or worsening their condition due to the modification of airway patency. Further study is recommended.

Prevalence of Erosive Tooth Wear and Associated Dietary Factors among a Group of Finnish Adolescents.

The aim of this study was to investigate the prevalence and severity of erosive tooth wear (ETW) among Finnish adolescents and to evaluate how frequency as well as amount of the use of erosive products is associated with ETW. The study population consisted of 328 voluntary, >15-year-old secondary school students (males 49.1%, females 50.9%) in three municipalities in Finland. Clinical examination to measure ETW (BEWE index) was carried out by trained and calibrated dentists. Piloted questionnaires included questions on consumption of drinks, fruits and berries, as well as tooth brushing frequency. Means and medians of frequencies and amounts of consumed erosive products were calculated and associations with ETW severity were analysed by logistic regression models. One-third (36.9%) of the participants were in need of at least preventive measures for ETW (BEWE sum score ≥3), but severe ETW (BEWE sum score >9) was rare (2.1%). Boys had severe ETW significantly more frequently than girls (p < 0.001). Habitual consumption of erosive drinks was common especially among boys compared to girls (p = 0.001). ETW was significantly associated with the amount of consumed erosive drinks, fruits, or berries. The prevalence of ETW among adolescences in Finland seems to be at the same level as in other Nordic and European countries. Consumption of erosive products is common and thus, the risk for tooth erosion is high, especially in boys. In addition to erosive drinks, also berries and fruits are associated with ETW and should be included in individual dietary counselling when early signs of ETW are clinically detected.

Non-Biological and Biological Risk Indicators for Tooth Wear Outcomes in Adults.

This study was undertaken to estimate the prevalence and severity of tooth wear (TW), as well as to assess non-biological and biological risk indicators for TW outcomes in adults. A cross-sectional study, adhering to the reporting STROBE guidelines, was conducted and had a convenience sample of adults ≥18 years of age who had at least one bilateral posterior molar contact. A total of 570 participants, seeking consultation at the University Hospital in Brussels, Belgium, were allocated to three age groups: 18-34 years (n = 232), 35-54 years (n = 256), and ≥55 years old (n = 79). Participants answered a self-applied questionnaire regarding sociodemographics, oral hygiene, and lifestyle behavior. The questionnaire was tested-retested (intraclass correlation coefficient = 0.71). Inter-examiner reliability for clinical examinations was k = 0.76-0.80. The prevalence of TW was 75% (95% CI: 71.7-78.9). Out of these patients, 42% (95% CI: 38.0-46.3) had as the primary etiological factor the process of dental erosion, while 22% (95% CI: 18.9-25.9) and 11% (95% CI: 8.6-13.9) had the processes of dental attrition and dental abrasion, respectively. The severity of TW according to BEWE highest score was mild in 31%, moderate in 28%, and severe in 17% of participants. The hierarchical logistic regression model for the association between risk indicators and TW irrespective of the etiology was significant for age (>35-54 years: OR = 2.35 and ≥55 years: OR = 3.89; p < 0.001), gender (>male: OR = 2.03; p < 0.001), toothpaste (>sensitive teeth: OR = 2.34; p = 0.005), occlusal splint (>yes: OR = 1.62; p = 0.03), and acidic beverages (≥once per day: OR = 1.62; p = 0.044). Consumption of acidic beverages was not associated with TW having as the primary etiological factor the process of dental attrition or dental abrasion, while it was significantly associated with the process of dental erosion (>once per week: OR = 1.69; p = 0.043 and ≥once per day: OR = 1.73; p = 0.016). Medical conditions were equally associated with the latter (OR = 3.11; p < 0.001). These findings could contribute to improving the effectiveness and sustainability of awareness in contemporary adult populations. In conclusion, the prevalence and severity of TW in adults were substantial. Medical conditions and consumption of acidic beverages were risk indicators for TW having as the primary etiological factor the process of dental erosion, although associations were moderate and weak, respectively.

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.

Validation of an erosive tooth wear risk factors questionnaire for adolescents.

OBJECTIVE: To validate a questionnaire for the identification of factors associated with erosive tooth wear (ETW) in adolescents. MATERIALS AND METHODS: Based on previous questionnaires, a 73-question instrument was designed (four domains: socio-demographics, general/oral health history, diet and oral care habits). Content validity was assessed by five external experts, and the questions' understandability was evaluated in a pilot study (10 adolescents). Three internal experts agreed on modifications. Construct validity was assessed after the resulting questionnaire was applied to 454 12- to 15-year olds from Bogotá (Colombia). Statistical analyses included exploratory factor analysis (EFA), internal consistency, and confirmatory factor analysis (CFA). RESULTS: After the content validation, 52% of the questions were excluded and remaining 38 questions were adjusted. Construct validation: The EFA resulted in the regrouping of questions into the three remaining domains (KMO = 0.68; Bartlett's test: p < 0.001). Internal consistency was good (general questionnaire Cronbach's α = 0.67; individual factors' Cronbach's α = 0.30-0.69; ICC = 0.39-0.62; p < 0.001), and the model showed satisfactory fit. CFA showed good convergent and discriminatory validity suggesting the elimination of 14 additional questions (χ2 = 238.518; p > 0.086; CFI = 0.96; TLI = 0.95; RMSEA = 0.017; PRATIO = 0.76). The final validated questionnaire comprised 24 questions (general/oral health history: n = 5; dietary habits: n = 15; oral care habits: n = 4). CONCLUSION: The validation of the ETW questionnaire for adolescents was satisfactory and resulted in a short applicable questionnaire version. CLINICAL RELEVANCE: This study achieved a satisfactorily validated, short, and applicable questionnaire for assessing erosive tooth wear risk factors in adolescents, recommended for the clinical practice, research, and epidemiology.

Relationship between erosive tooth wear and possible etiological factors among dental students.

OBJECTIVES: The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students. MATERIALS AND METHODS: A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables. RESULTS: Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001). CONCLUSIONS: Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times. CLINICAL RELEVANCE: The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.

Prevalence and risk factors of erosive tooth wear among young adults in the Singapore military.

OBJECTIVES: Erosive tooth wear (ETW) is defined as the irreversible chemo-mechanical loss of dental hard tissues without plaque or bacteria and has been a growing phenomenon in the general population worldwide. The aim of this study was to determine the prevalence of ETW and the associated risk factors among young military personnel in Singapore. MATERIALS AND METHODS: This cross-sectional study consisted of a questionnaire and clinical examination of military personnel between 18 and 25 years. The questionnaire collected information on demographics, medical and dental history, lifestyle and dietary habits. Tooth wear was clinically evaluated using the Basic Erosive Wear Examination (BEWE) index. The participants were profiled into four risk categories (none, low, moderate, severe) based on the sum score. Multivariable logistic regression analysis was performed to determine the risk factors associated with the presence of ETW. RESULTS: Out of 1296 participants evaluated, 21.8% of them had ETW. The anterior sextants were more affected by erosion than posterior sextants for both arches. The risk factors significantly associated with ETW were GERD (OR = 2.83, p = 0.041), presence of self-reported TMD symptoms (OR = 2.51, p < 0.001), acidic food (OR = 2.03, p < 0.001) and drinks (OR = 3.07, p < 0.001), high caries risk (OR = 4.59, p < 0.001) and toothbrush stiffness (OR = 4.67, p < 0.001). CONCLUSION: ETW is prevalent among the young military population, with over half of the population at a risk of ETW. Gastric reflux disease, TMD, acidic diet, dental caries susceptibility and the use of stiff toothbrushes were identified as significant risk factors. CLINICAL RELEVANCE: A large proportion of young military personnel exhibited mild to moderate risk of ETW. Dental professionals can identify risk-susceptible individuals at a young age and educated them with preventive measures and dietary interventions to prevent the progression of the condition.

Enamel wear against monolithic zirconia restorations: A meta-analysis and systematic review of in vitro studies.

OBJECTIVE: An assessment was performed to identify and evaluate dental enamel wear caused by monolithic zirconia restoration. Literature searches were conducted in PubMed, Science Direct, Cochrane Evidence, and the Cochrane Library up to May 2020. MATERIAL AND METHODS: Studies were selected for systematic review according to the inclusion (articles conducted on the wear of enamel samples opposing monolithic zirconia) and exclusion (case reports, non-English articles, and monolithic zirconia samples facing other materials rather than human enamel) criteria. Of those, articles on polished and glazed monolithic zirconia subjected to a 50 N vertical load with a range of 240,000-250,000 cycles, equivalent to 1 year of in vivo mastication, were included in the meta-analysis. RESULTS: In total, 3968 articles were pooled. Twenty-five articles met the inclusion criteria for the systematic review. Three studies were included in the meta-analysis. The results showed that the enamel wear against monolithic zirconia was within the statistically accepted level. Moreover, the polished monolithic zirconia surface caused less enamel wear than the glazed surface. CONCLUSION: This review indicates that monolithic zirconia restorations cause acceptable antagonist enamel wear. Moreover, the meta-analysis results agreed that the final restoration's surface texture plays an essential role in the wear process. CLINICAL SIGNIFICANCE: Monolithic zirconia restorations have been widely used in dental practice because they eliminate the chipping problems resulting from using veneered restorations. With recent technology development, monolithic zirconia has obtained more esthetic features and a more natural look. However, due to the high strength and surface roughness of monolithic zirconia, wear on the antagonist's teeth was detected. The results showed that this wear amount was statistically acceptable and lower than other ceramics such as feldspathic porcelain and enamel. Furthermore, surface treatment methods must be applied to minimize tooth wear, as polished or glazed surfaces interfere with enamel loss.

Tooth wear, growth and height in rabbits (Oryctolagus cuniculus) fed pelleted or extruded diets with or without added abrasives.

Among the different factors thought to affect dental wear, dietary consistency is possibly the least investigated. To understand tooth wear of herbivorous animals consuming different dietary consistencies with different abrasive potential, we fed 14 rabbits (Oryctolagus cuniculus) exclusively with a timothy grassmeal-based diet in either pelleted or extruded form, or the same diets with an addition of 5% fine sand abrasives (mean size 130 µm). First, we offered the rabbits the pelleted and extruded diets as well as the pelleted control and pelleted abrasive diet in a two-stage preference experiment. Then, the rabbits received each diet for 2 weeks in a randomised serial feeding experiment, where each animal served as its own control. Tooth measurements for wear, growth and height were achieved using a manual calliper, endoscopic examination and CT scans. The analysis of the diets as fed showed almost identical mean particle size, but the extruded diet had a lower density (volume/mass) and softer consistency compared to the pelleted one and was favoured by most rabbits. The rabbits selected against the diet with sand during the preference experiment, possibly because it caused more tooth wear, especially on the teeth most exposed to wear along the upper tooth row (upper P4 and M1). The maxillary teeth also showed evidence of an increased chewing laterality by the end of the experiment. The extruded diet led to a significantly lower cheek teeth height than the pelleted diet, potentially due to the higher chewing effort needed for a similar dry matter intake. The results suggest that dietary hardness alone is a poor predictor of dental wear. The regrowth of the teeth matched wear consistently.

Correlations between dental wear and oral cavity characteristics: Mandibular torus, palatine torus, and oral exostoses.

OBJECTIVE: This study evaluates the correlations amongst mandibular torus, palatine torus, oral exostoses to dental wear/loss and temporomandibular damage. METHODS: The sample consists of 504 skulls from the Hamann-Todd Osteological Collection; 223 African American and 281 European Americans aged between 30 and 80 years. The sample was analyzed using Pearson's Chi-square for significance of sex, age, ancestry, and wear as well as the interactions between the demographic variables and the presence of mandibular torus, palatine torus and oral exostoses. RESULTS: Wear was statistically significant by age and sex but not ancestry. The maxillary exostoses varied significantly by age, ancestry and wear but not sex. Mandibular torus frequencies varied significantly by wear, sex and ancestry. The palatine torus varied significantly across wear groups, sex and ancestry. DISCUSSION: The etiology of nonmetric oral cavity characteristics, mandibular torus, palatine torus and oral exostosis, is complex. The degree to which traits' presence and expression is the result of genetic and environmental interactions is not fully understood. More than age, sex or ancestry, the degree of dental wear and tooth loss influences the presence and expression of the oral cavity traits. The sample can be characterized as the presence of exostoses in higher frequencies in young African American males with little tooth loss. Males of both ancestral groups with heavy wear have higher frequencies of mandibular tori than females. The palatine torus is more common in edentulous European American females.

Epidemiology of Erosive Tooth Wear, Dental Fluorosis and Molar Incisor Hypomineralization in the American Continent.

Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.

Erosive Tooth Wear among Adults in Lithuania: A Cross-Sectional National Oral Health Study.

INTRODUCTION: Erosive tooth wear has a multifactorial origin, where multiple risks contribute to its initiation and subsequent progression. The prevalence of tooth wear varies among countries; therefore, national studies are needed to examine the prevalence of this condition and its associated determinants. MATERIALS AND METHODS: A sample of this national study included a total of 1,397 adults (response rate of 52%). Severity and number of teeth with erosive tooth wear, caries experience (D3MFS), and fluorosis were assessed clinically. A self-reported questionnaire inquired about sociodemographics, oral health behavior, diet, and general health. Fluoride levels in drinking water at the recruitment areas were also recorded. Data were analyzed by bivariate and multivariate methods. RESULTS: The prevalence of erosive tooth wear in enamel and dentin combined was 59% among 35- to 44-year-old, 75% among 45- to 54-year-old, 70% among 55- to 64-year-old, and 66% among 65- to 74-year-old males. The prevalence among females in the respective age groups was 44, 60, 63, and 59%. Erosive tooth wear in enamel was associated with a lower fluoride level (≤1 ppm) in the drinking water (OR 2.1, 95% CI 1.1-4.2). Erosive tooth wear in dentin was positively associated with male gender (OR 1.7, 95% CI 1.1-2.5), periurban/rural residency (OR 1.6, 95% CI 1.1-2.4), older age (OR 1.6, 95% CI 1.3-1.9), presence of reflux (OR 3.3, 95% CI 1.0-10.9), and negatively with higher D3MFS scores (OR 0.7, 95% CI 0.5-0.9). CONCLUSIONS: The prevalence of erosive tooth wear in enamel and dentin was relatively high in Lithuania; the erosive tooth wear in enamel and dentin combined was 52% among 35- to 44-year-olds, 68% among 45- to 54-year-olds, 67% among 55- to 64-year-olds, and 63% among 65- to 74-year-olds. Lower fluoride level in drinking water was associated with erosive tooth wear in enamel. Male gender, residency in periurban/rural areas, older age, and presence of acid reflux were associated with higher odds, while higher D3MFS scores were associated with lower odds for erosive tooth wear in dentin. These results can be used to plan dental public health prevention.

Susceptibility of Dental Enamel of Different Ages to Caries-Like Lesion Development.

This study investigated the impact of estimated age, anatomical location, and the presence of wear facets on the susceptibility of enamel to develop caries-like lesions. Extracted human premolars (n = 261) had their age estimated between 10 and 93 years old, using established forensic methods. Specimens of enamel (4 × 4 mm) were prepared from the middle of the buccal surfaces, preserving the outer surface layer. The central area of the block (4 × 1 mm) was protected with nail polish and used as an internal control. The specimens were demineralized for 8 days (with 0.1 M acetic acid, 1.28 mM Ca, 0.74 mM Pi, and 0.03 µg F/mL, pH 5.0), to simulate caries-like lesion development. They were then scanned individually using microtomography, and digital 2D images were used to calculate the outcomes of integrated mineral concentration loss (ΔZ in µm/g/cm3) and lesion depth (LD in µm) at 3 locations, i.e., the cervical, middle, and occlusal thirds. The presence of natural surface wear facets was considered in the analysis. Data were evaluated using a linear mixed-effects models (α = 0.05). ΔZ increased significantly as a function of estimated tooth age at all 3 locations, and this increase was greater after the age of 30 years (p < 0.001), when a higher ΔZ was found in the occlusal third than in the middle and cervical thirds (p < 0.001). LD increased only in the occlusal third before the age of 30 years (p = 0.039) and this increase was significantly greater after 30 years at all 3 locations (p < 0.01), with no differences among them (p > 0.15). The presence of wear facets significantly increased ΔZ and LD (p < 0.001 for both). Overall, we concluded that the susceptibility of enamel to developing caries-like lesions increased with estimated dental age. This effect was more pronounced after the estimated age of 30 years and in the presence of natural tooth wear facets.

Erosive Tooth Wear, Presence of Parafunctional Habits and Tooth Injuries-Occurrence in a Group of Children and Adolescents Exposed to Domestic Violence.

OBJECTIVES: To compare the prevalence of parafunctional habits, erosive tooth wear and occurrence of tooth injuries among children being under the care of Social Welfare Centre and children treated in the Department of Children's Dentistry of the Medical University of Warsaw. STUDY DESIGN: The study contains environmental and medical interviews, record-based analysis and clinical examination. Parafunctional habits were rated on the base of dental interviews and clinical examinations. The occlusal surfaces were evaluated by visual examination using modified tooth wear index (TWI). Tooth injuries were reported from a medical interview labeled using Andreasen classification. The consent of the bioethics committee and guardians of children participated in the study was obtained. RESULTS: The study involved 782 patients, including 404 children from dysfunctional families (average age 11,4 ± 3,7) and 378 from ordinary families-control group (8,53 ± 3,92). In the study group we observed higher prevalence of erosive tooth wear (44,66% vs 18,02% p=0,000), dental trauma (9,4% vs 3,44% p=0,001) and a presence of parafunctional habits (67,8% vs 20,4 % p=0,000). CONCLUSION: The occurrence of parafunctional habits, erosive tooth wear and tooth injuries may be an indicator of domestic violence and a component of maltreated child syndrome.

Age-related tooth wear in African rainforest hunter-gatherers.

OBJECTIVES: Central African small-scale foragers subsist primarily on hunting game activities and wild plant-food gathering. Starch-rich tubers are underground storage organs (USOs) and staple food resources in savanna and tropical rainforests. However, little is known about the effect of USO consumption on tooth wear development in living hunter-gatherers. We report age- and sex-dependent tooth wear rates in forest-dwelling Baka Pygmies with well-documented wild-yam-tuber-based diet to explore the long-term impact of USO mechanical hardness and abrasiveness on the wearing down of the teeth. MATERIALS AND METHODS: Percentages of dentine exposure (PDEs) of permanent left mandibular first molars (M1 ) were recorded using in vivo high-resolution replicas of Baka individuals (aged 8-33 years), inhabiting Le Bosquet district in Cameroon (Western Africa). Regression and covariance analyses were used to test the effect of individual aging by sex on PDE rates. RESULTS: We found a strong increase of PDE by age among Baka individuals. No evidence of sexual dimorphism in wear patterns suggests similar sex-related dietary and masticatory demands during growth. Overall, greatest dentine exposure values ≈4% denote unexpected slow wear down rates for foraging diets relying on USO consumption. DISCUSSION: The low molar wear rates with age found in Baka Pygmies contrast with extensive wear rates in savanna-dwelling foragers, reflecting differences in thermal processing techniques affecting fracture toughness and grittiness of mechanically challenging foods. Our findings reveal that culture-specific dietary proclivities influence tooth wear among foraging behaviors with important implications in hominin dietary versatility and abrasive stress on chewing surfaces.

Non-carious cervical lesions and risk factors: A case-control study.

OBJECTIVES: To evaluate whether the presence of non-carious cervical lesions (NCCLs) was related to the considered risk factors and to show the corresponding odds ratio in a predictive model. METHODS: The sample was 280 dentistry students. In an initial clinical examination, 140 cases were selected that presented one or more teeth with non-carious cervical wear. For each case, a similar sex and age control without any tooth with non-carious cervical lesions was selected. An occlusal examination and periodontal probing were performed in all cases and controls by skilled dentists. All the subjects answered a questionnaire referring to factors of brushing, bruxism, preferred chewing side, consumption of extrinsic acids and the presence of intrinsic acids. Data were analysed by means of univariate and multivariate logistic regression. RESULTS: Of all the study variables, only the protrusion interferences, interferences on the non-working side, the brushing force, CPITN value and the consumption of salads increase the risk of NCCLs in the univariate regression. The best predictive model was formed by the combination of CPITN variables >1, the consumption of acidic salads, self-reported bruxism, brushing force and attrition. However, it only correctly classifies 68.75% of subjects. CONCLUSIONS: This study supports the multifactorial aetiology of NCCLs, the combination of several factors being necessary to explain their presence. The risk factors that make up the predictive model are not sufficient to explain the appearance of NCCLs. Dentists should take into account all these risk factors in prevention, diagnosis and treatment.

Assessment of Antagonist Enamel Wear and Clinical Performance of Full-Contour Monolithic Zirconia Crowns: One-Year Results of a Prospective Study.

PURPOSE: To assess the clinical performance and survival of full-contour monolithic zirconia (MZ) crowns and enamel wear produced over a 1-year period. MATERIALS AND METHODS: 60 patients requiring full-coverage restorations for endodontically treated posterior teeth opposed by healthy unrestored antagonistic teeth were selected. MZ crowns were fabricated. Vinyl polysiloxane impressions of the antagonist teeth were made, and the stone casts were digitized using a 3D laser scanner. Wear of the opposing natural teeth was evaluated at baseline (1 week), 6 months, and 1 year after crown cementation. Superimposition of the follow-up scans on the baseline scans were performed to evaluate wear. Survival and function of the restorations were evaluated by the modified USPHS rating criteria at the same timeframes. RESULTS: Comparison of the baseline and the follow-up wear values was statistically tested using the paired t-test. Statistical significance was noted between the wear values at 6 months (15.5 µm) and at 12 months (16.3 µm) (p < 0.05). The Wilcoxon signed rank sum test was performed to evaluate each parameter of the modified USPHS criteria and to analyze the change in the follow-up scores of the restorations. The survival rate for the crowns was 100%. Results were classified as "excellent" over a 1-year follow up. CONCLUSIONS: MZ crowns showed promising results related to antagonist enamel wear and survival/clinical performance.