EFFECT OF LASER IRRADIATION ASSOCIATED WITH FLUORIDE IN DECREASING EROSIVE TOOTH WEAR: A SYSTEMATIC REVIEW WITH A NETWORK META-ANALYSIS  .

OBJECTIVE: The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW). METHODS: The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in µm). RESULTS: A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss. CONCLUSIONS: Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful.

Resistance of CAD/CAM composite resin and ceramic occlusal veneers to fatigue and fracture in worn posterior teeth: A systematic review.

Severe tooth wear is related to substantial loss of tooth structure, with dentin exposure and significant loss (≥1/3) of the clinical crown. The objective of this systematic review was to summarize and analyze the scientific evidence regarding the mechanical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin and CAD/CAM lithium disilicate ceramic occlusal veneers, in terms of fatigue and fracture resistance, on severely worn posterior teeth. Currently, occlusal veneers are an alternative for treating worn posterior teeth. Although scientific evidence demonstrates the good performance of lithium disilicate occlusal veneers, there are less brittle materials with a modulus of elasticity more similar to dentin than ceramics, such as resin CAD/CAM blocks. Therefore, it is important to identify which type of material is best for restoring teeth with occlusal wear defects and which material can provide better clinical performance. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the PubMed, Embase, Web of Science, Scopus, Cochrane, OpenGrey, Redalyc, DSpace, and Grey Literature Report databases was conducted and supplemented by a manual search, with no time or language limitations, until January 2022. We aimed to identify studies evaluating the fatigue and fracture resistance of CAD/CAM composite resin and ceramic occlusal veneers. The quality of the full-text articles was evaluated according to the modified Consolidated Standards of Reporting Trials (CONSORT) criteria for in vitro studies, and 400 articles were initially identified. After removing duplicates and applying the selection criteria, 6 studies were included in the review. The results demonstrated that the mechanical performance of CAD/CAM composite resin occlusal veneers is comparable to that of CAD/CAM lithium disilicate occlusal veneers in terms of fatigue and fracture resistance.

Cervical wear pathobiology by robot-simulated 3-year toothbrushing - New methodological approach.

OBJECTIVES: An ex-vivo study was aimed at (i) programming clinically validated robot three-year random toothbrushing, (ii) evaluating cervical macro- and microwear patterns on all tooth groups of different functional age, (iii) documenting and codificating wear related morphological features at the cemento-enamel junction in young teeth and on roots in older teeth. DESIGN: Following ethical approval random toothbrushing (44 strokes per tooth horizontally, rotating, vertically; 2x/d) with manual toothbrushes and low-abrasive dentifrice was performed in an artificial oral cavity with brushing-force 3.5 N on 14 extracted human teeth. Morphological features were examined by SEM at baseline and after simulated 3 years using the replication technique. 3D-SEM analyses were carried out with a four-quadrant back scattered electron detector. Wilcoxon-Mann-Whitney-test was used for statistical analyses. RESULTS: 3-year random toothbrushing with horizontal, rotating and vertical brushing movements revealed morphological features classified as four enamel patterns, one dentin pattern and three cervical patterns. Negative impacts were enamel, cementum and dentin loss. Positive impact on oral health was removing dental calculus and straightening cervical traumatic and iatrogenic damages. The volume loss varied from x̅=34.25nl to x̅=87.75nl. Wear extended apically from 100 to 1500 micrometres. CONCLUSION: Robot simulated toothbrushing in an artificial oral cavity, with subsequent SEM and 3D-SEM assessment, elucidated both negative and oral health-contributing micromorphology patterns of cervical wear after simulated 3-year random toothbrushing. Cervical macro- and microwear of cementum revealed, for the first time, what we describe as overhanging enamel peninsulas and enamel islands on roots in young teeth, but no enamel islands on roots from older teeth after root cementum loss. In contrast, many older teeth exhibited enamel peninsulas.

Should We Wait to Brush Our Teeth? A Scoping Review Regarding Dental Caries and Erosive Tooth Wear.

BACKGROUND: Tooth brushing is a universal recommendation. However, the recommendations related to the time of its execution are conflicting, especially when dealing with patients at risk of erosive tooth wear (ETW) or dental caries. SUMMARY: Our objective was to summarize the evidence on the timing of brushing with fluoridated toothpaste in relation to ETW and cariogenic dietary challenges. We conducted a scoping review following the PRISMA-ScR checklist, using three databases searching for in vivo, in situ, or in vitro studies involving human teeth exposed to either a cariogenic or an erosive challenge. Only models including human saliva and fluoride were assessed. Data selection, extraction, and risk of bias analysis were done in duplicate and independently. From 1,545 identified studies, 17 (16 related to ETW and 1 to dental caries) were included. Most evidence (n = 10) supported that brushing with a fluoride-containing product does not increase ETW, independent of the moment of brushing. Delaying tooth brushing up to 1 h (n = 4) or individualized recommendations based on the patient's problem (n = 2) were less frequent. Only one study reported that brushing pre- or post-meal does not affect Streptococcus mutans counts. Most data were in situ (n = 13), and the overall study quality was judged as sufficient/low risk of bias. KEY MESSAGES: Although the available evidence lacked robust clinical studies, tooth brushing using fluoridated products immediately after an erosive challenge does not increase the risk of ETW and can be recommended, which is in line with recommendations for dental caries prevention. Furthermore, we suggest updating the international guidelines to promote individualized recommendations based on risk factors to prevent either ETW or dental caries.

Tooth surface loss: causes, management, and prevention.

OBJECTIVES: Tooth wear, also referred to as tooth surface loss, occurs due to causes other than caries. This involves the loss of hard tissues, namely enamel, dentin, and/or cementum. Types of tooth wear/tooth surface loss are abrasion, abfraction, attrition, and erosion. These multifactorial conditions can be caused by factors such as lifestyle, diet, or even habits, and may not be symptomatic. The focus of this article is to provide clinicians with detailed examples and explanations of the causes of tooth loss to aid in early diagnosis. Through early identification, the preventive measures outlined can be implemented to avoid excessive tooth wear. The provision of a treatment flowchart and general treatment recommendations aims to help clinicians determine when to restore these lesions and the most appropriate treatment measures for the four types of wear. METHOD AND MATERIALS: The PubMed (MEDLINE) search engine was used to gather information on teeth restricted to a 5-year period (26 August 2018 to 25 July 2022). Only English-language studies and reviews with the best balance of sensitivity and specificity were considered. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: ("tooth wear" OR tooth attrition OR tooth erosion OR tooth abrasion OR tooth abfraction). Additional articles were selected through Google Scholar. RESULTS: By this process, many articles and studies were obtained, and the 48 most relevant published studies were chosen and used in the current review. CONCLUSION: Tooth wear affects an increasing number of individuals and can have detrimental effects physically, mentally, and emotionally. It is important to stress early diagnosis and management of tooth wear through monitoring, prevention, and treatment where indicated.

Anamnestic risk factors for erosive tooth wear: Systematic review, mapping, and meta-analysis.

OBJECTIVES: Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in permanent dentition. STUDY SELECTION: Observational studies reporting anamnestic risk factors for erosive tooth wear. Methodological quality and risk of bias were assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Risk factors were visually presented in a heatmap, and where possible, random-effects meta-analyses were performed for the odds ratios (ORs) of risk factors. SOURCES: Electronic databases (MEDLINE, Embase, Scopus, and Web of Science) and manual searches in February 2023. The protocol was registered in PROSPERO (CRD4202339776). DATA: A total of 87 publications reporting on 71 studies were included in the systematic review. The studies examined a variety of anamnestic risk factors (n = 80) that were categorized into ten domains (socio-demographics, socio-economics, general health, oral diseases, medication, oral hygiene, food, beverages, dietary habits, and leisure-related risk factors). Meta-analyses revealed significant associations between erosive tooth wear and male gender (padj.<0.001; OR=1.30, 95 % CI: 1.16-1.44), regurgitation (padj.=0.033; OR=2.27, 95 % CI: 1.41-3.65), digestive disorders (padj.<0.001; OR=1.81, 95 % CI: 1.48-2.21), consumption of acidic foods (padj.=0.033; OR=2.40, 95 % CI: 1.44-4.00), seasoning sauces (padj.=0.003; OR=1.28, 95 % CI: 1.13-1.44), nutritional supplements (padj.=0.019; OR=1.73, 95 % CI: 1.28-2.35), and carbonated drinks (padj.=0.019; OR=1.43, 95 % CI: 1.17-1.75). Most included studies exhibited low bias risk. CONCLUSIONS: Observational studies investigated a variety of anamnestic risk factors for erosive tooth wear. Future studies should employ validated questionnaires, particularly considering the most important risk factors. CLINICAL SIGNIFICANCE: Erosive tooth wear is a prevalent condition. Clinicians should concentrate primarily on symptoms of gastroesophageal reflux disease and dietary factors when screening patients at risk for erosive tooth wear.

Antagonist enamel tooth wear produced by different dental ceramic systems: A systematic review and network meta-analysis of controlled clinical trials.

OBJECTIVES: The aim of this study was to evaluate the amount of enamel tooth wear induced by different antagonistic ceramic crown materials in the posterior area within a follow-up period up to 24 months in function. A network meta-analysis was performed to assess the effect of the materials on the mean vertical loss (MVL) of the antagonist enamel tooth surface. DATA: Main search terms used in combination: ceramic, dental materials, metal ceramic, tooth wear and dental enamel. SOURCES: An electronic search was conducted in PubMed/Medline, Embase, and Cochrane CENTRAL plus hand-searching. STUDY SELECTION: Eligibility criteria included clinical studies reporting on MVL on antagonist's tooth up to 24 months following the permanent crown placement. From a total of 5697 articles, 7 studies reporting on 261 crowns for 177 subjects with 3 ceramic materials (Lithium disilicate, metal-ceramic, monolithic zirconia) were included. Among all, metal-ceramic and zirconia caused significantly higher enamel tooth wear on antagonist teeth, representing 82.5 µm [54.4; 110.6]) and 40.1 µm [22.2; 58.0]) more MVL than natural teeth group. In contrast, lithium disilicate showed only 5.0 µm [-48.2; 58.1]) more MVL than occurs on opposing natural teeth. CONCLUSIONS: This systematic review demonstrated that prosthodontic ceramic materials produced significantly more antagonist enamel tooth wear than opposing natural enamel tooth wear, and ceramic material type was correlated to the degree of enamel tooth wear. Additional well-conducted, randomized controlled trials with homogeneous specimens are required due to inadequate sample size and number of the clinical studies included in the analyses. CLINICAL SIGNIFICANCE: The amount of wear caused by different restorative materials has a high influence on the antagonistic natural teeth and should therefore be evaluated intensively by the dentist.

Prevalence and Associated Factors to Non-Carious Cervical Lesions in Brazilian University Students: A Cross-Sectional Survey

Abstract Objective: To identify the prevalence, severity, hypersensitivity, and distribution of Non-carious cervical lesions (NCCL) among university students in Brazil. Material and Methods: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Results: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Conclusion: The prevalence of NCCL was 15.1% and abfraction was the most frequent lesion. Premolars were the teeth most affected by non-carious cervical lesions.

Tempo de confecção clínica e laboratorial de placas oclusais convencionais x fresadas em pacientes com bruxismo do sono: ensaio clínico / Clinical and laboratory production time of conventional x milled occlusal splints in patients with sleep bruxism: clinical trial

O objetivo desse estudo foi comparar o tempo de confecção clínica, laboratorial e ajustes clínicos para a instalação de placas oclusais termopolimerizáveis convencionais (PC) e confeccionadas por CAD/CAM fresadas (PF) em pacientes com bruxismo do sono. Para tanto, foi realizado um ensaio clínico controlado e não randomizado onde foram incluídos pacientes com diagnóstico de provável bruxismo do sono. Foram confeccionadas PC (n = 24) e PF (n = 24) sendo mensurados o tempo de confecção clínica (TCC), tempo de confecção laboratorial (TCL) e tempo de instalação (TI) para cada uma das placas. Foi utilizado o teste Mann-whitney com nível de confiança de 95% no programa SPSS IBM Statistics para analisar se existe diferença entre os tempos analisados e o tipo de placa confeccionada. Como resultado, verificou-se que a PC possuiu maior TCC total (média de 94,39 min) em relação à PF (17,85 min) (p<0,001). Entretanto, o TCL total da PC foi menor (164,80 min), que a PF (182,64min) (p=0,015). Para o TI, foi encontrado que PF obteve uma média 21, 26 min, enquanto PC obteve 37,19 min (p<0,001). Como conclusão, dentro as limitações do estudo, observou-se que as placas fresadas apresentaram menor tempo clínico tanto na etapa de confecção quanto de instalação. Entretanto, o tempo de confecção laboratorial das placas convencionais foi inferior (AU).

The aim of the study was to compare the clinical and laboratory preparation time and clinical adjustments for the installation of conventional thermopolymerizable resin splint (CS) and milled CAD/CAM (MS) occlusal splints in patients with sleep bruxism. For this purpose, a controlled and non-randomized clinical trial was carried out in which patients diagnosed with probable sleep bruxism were included. CS (n = 24) and MS (n = 24) were prepared and the clinical preparation time (CPT), laboratory preparation time (LPT) and installation time (IT) were measured for each of the splints. The Mannwhitney test with a confidence level of 95% was used in the SPSS IBM Statistics program to analyze whether there is a difference between the analyzed times and the type splint performed. As a result, it was found that CS had higher total CPT (mean of 94,39 min) in relation to MS (17,85 min) (p0<001). However, the total LPT of the CS was lower (164,80 min) than the MS (182,64min) (p=0.015). For the IT, it was found that the MS had an average of 21,26 min, while the CS had 37,19min (p0<001). In conclusion, within the limitations of the study, it was observed that the milled splint had a shorter clinical time both in the manufacturing and installation stages. However, the laboratory preparation time of the conventional splint was shorter (AU).

Erosive tooth wear knowledgein a Brazilian dental school: what haschanged after a decade? / Conhecimento sobre desgaste dentário erosivo em uma faculdade de Odontologia brasileira: o que mudou depois de uma década?

This study aimedto assess knowledge related to erosive tooth wear (ETW) among patients, students and facultymembersin a Brazilian dental school and compare it with data from a previous studyconducted ten years earlier in the same academic environment. Acontrolled cross-sectional study involving 289 participants was conducted at a dental school in Belo Horizonte, Southeastern Brazil. Knowledge ofETWwasevaluated through a self-administered questionnaire. Statistical analysis usedchi-square test;z-test adjusted by Bonferroni correction(p≤0.05). Ethical approval and informed consent were obtained.Among the 289 participants, 71.0% had heard about ETWwith a lower percentage among patients (p<0.001). Students and faculty members frequently mentioned eating disorders and acidic diet as the main etiological factors for ETW (p<0.001). However, patientsacknowledged bacteria (p=0.026) and poor oral hygiene (p=0.002) as etiological factors.Comparison between present findings and data from the previous studyshowed no significant increase in participants who had heard about the condition (p>0.499). There was also no improvement in knowledge of ETW among patients(p>0.227), andno significant difference when patients were asked whether they had received preventive recommendations by students (p=0.303).However, there was a significant improvement in all variables regarding students' diagnostic skills (p<0.005) and in the knowledgeof ETW signs and symptoms among faculty members (p=0.030).In conclusion, knowledge of ETW is still not fully incorporated by the sample. However, there was an improvement in students and faculty's diagnostic skillssince the last study conducted in 2010 (AU).

Este estudo teve como objetivo avaliar o conhecimento relacionado ao desgaste dentário erosivo entre pacientes, alunos e docentes deuma faculdade de odontologia brasileira,e compará-lo com um estudo anterior, realizado dez anos antes, no mesmo ambiente acadêmico. Trata-se de um estudo transversal controlado,envolvendo 289 participantes,que foi realizado em uma faculdade de odontologia em Belo Horizonte, sudeste do Brasil. O conhecimento do desgaste erosivo foi avaliado por um questionário autoaplicável. A análise estatística utilizou o teste qui-quadrado e teste Z ajustado pela correção de Bonferroni (p<0,05). Aprovação ética e consentimento informado foram obtidos. Dentre os 289 participantes, 71,0% já ouviram falar sobre o desgaste dentário erosivo,com menor percentual entre os pacientes (p<0,001). Alunos e docentes frequentemente mencionaram transtornos alimentares e dieta ácida como os principais fatores etiológicos para o desgaste erosivo (p<0,001).No entanto, os pacientes relataram bactérias (p=0,026) e má higiene bucal (p=0,002) como fatores etiológicos. A comparação entre os resultados atuais e oestudo anterior não mostrou aumento significativo quantoaos participantes que tinham ouvido falar sobre a essa implicação dentária (p>0,499). Tambémnão houve melhora no conhecimento do desgaste erosivo entre os pacientes (p>0,227), e nenhuma diferença significativa quando elesforam questionados se haviam recebido recomendações preventivas dos alunos (p=0,303). No entanto, houve uma melhora significativa em todas as variáveis em relação às habilidades diagnósticas dos alunos (p<0,005) e no conhecimento dos sinais e sintomas do desgaste erosivo entre os docentes (p=0,030). Em conclusão, o conhecimento do desgaste dentário erosivo ainda não está totalmente incorporado pela amostra. No entanto, houve uma melhoria nas habilidades de diagnóstico dos alunos e docentesdesde o último estudo,realizado em 2010 (AU).

Association between bariatric surgery and oral health: a literature review

Objective: to review the literature on the relationship between oral health and bariatric surgery in obese individuals. Methods: articles published until March 2021 were searched in the Medline/PubMed, LILACS, BBO, and Web of Science databases. The search used a combination of descriptors related to the words: obesity, bariatric surgery, and oral health. Results: one hundred thirty-five studies were identified in the database search. Of these, 47 were included in this review. The oral changes investigated in the literature for individuals who underwent bariatric surgery were dental caries, tooth wear/erosion, hypersensitivity, periodontal disease, hyposalivation, halitosis, and changes in mastication and oral soft tissue. The evaluated articles showed methodological controversy regarding the study design, follow-up period, sample size, and assessed clinical parameters, which complicated the comparison of studies. Final considerations: there is no consensus in the literature regarding the relationship between oral health and bariatric surgery in obese individuals. Further prospective cohort studies should be conducted to investigate this association better.(AU)

Objetivo: revisar a literatura sobre a relação entre saúde bucal e cirurgia bariátrica em indivíduos obesos. Métodos: foi realizada uma busca de estudos publicados até março de 2021 nas bases de dados Medline/PubMed, LILACS, BBO e Web of Science. Foi utilizada uma combinação de descritores relacionada às palavras: obesidade, cirurgia bariátrica e saúde bucal. Resultados: foram identificados 135 estudos nas bases de dados pesquisadas. Desses, 47 estudos foram incluídos nesta revisão. As alterações bucais investigadas em indivíduos que realizaram cirurgia bariátrica apresentadas na literatura foram: cárie dentária, desgaste dentário/erosão dentária, hipersensibilidade, doença periodontal, hipossalivação, halitose, alterações da função mastigatória e alterações no tecido mole bucal. Os estudos avaliados mostraram controvérsia metodológica em relação a: tipo de desenho de estudo, tempo de seguimento, tamanho da amostra e parâmetros clínicos avaliados, fato que dificultou comparar os estudos. Considerações finais: não há consenso na literatura sobre a relação entre saúde bucal e cirurgia bariátrica em indivíduos obesos. Mais estudos de coorte prospectivos devem ser realizados para estudar melhor essa associação.(AU)

Comparative Effect of Calcium Mesoporous Silica Versus Calcium and/or Fluoride Products on the Reduction of Erosive Tooth Wear and Abrasive Enamel Lesion

Abstract Objective: To evaluate the effect of a calcium nanocompound on the reduction of erosive tooth wear and abrasion. Material and Methods: Bovine enamel specimens (BE), were randomly assigned to the following groups (n = 10): G1 = Calcium mesoporous silica nanoparticles (Ca2+MSNs); G2 = casein phosphopeptide-amorphous calcium phosphate (CPP-ACP, 2% CPP-ACP, GC®); G3 = casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP, 2% CPP-ACP + 900 ppm F-, GC®); G4 = sodium fluoride NaF (900 ppm F-, positive control); and G5 = distilled and deionized water (negative control). Each product was applied to the exposed area for one minute, three times per day for three consecutive days, and followed by the immersion of the specimens in Sprite Zero™ - a low-pH solution (2.58) for five minutes (Coca-Cola™). After the first and last erosive challenges of the day, the specimens were submitted to abrasion in a toothbrush machine for 15 seconds (200 g/BE). The specimens were analysed using 3D non-contact optical profilometry, with tooth structure loss (TSL) measurements and scanning electron microscopy (SEM). TSL values were analysed by Kruskal-Wallis and Mann-Whitney tests (p<0.05). Results: There were no significant differences between G1 (10.95 µm) and G3 (10.80 µm) treatments for TSL values; however both resulted in significantly reduced TSL values compared with the G5 (16.00 µm) (p<0.05). The G4 (12.26 µm) showed no statistically significant difference when compared to the G5 (16.00 µm). The groups G1 and G3 presented higher surface preservation than the G5. Conclusion: Ca2+MSNs was effective for reducing tooth surface loss caused by erosive tooth wear and abrasion.

Bruxismo y manifestaciones clínicas en el sistema estomatognático / Bruxism and clinical manifestations in the stomatognathic system

Fundamento: en tiempos actuales el bruxismo es un problema médico a escala mundial que involucra el apretamiento y rechinado de los dientes, diurno o nocturno, con distintos grados de intensidad y persistencia en el tiempo, de manera inconsciente.Objetivo: caracterizar el bruxismo y manifestaciones clínicas en el sistema estomatognático. Métodos: se realizó un estudio descriptivo trasversal en el consultorio No 14 de la clínica estomatológica Reynaldo Aday López del municipio Nuevitas de la provincia Camagüey, desde enero hasta julio de 2017, de un universo de 139 pacientes diagnosticados con bruxismo, se seleccionó una muestra no probabilística constituida por 67 pacientes. Resultados: predominó el sexo femenino y el grupo de edad entre 31 a 45 años. Se destacó el bruxismo tipo excéntrico respecto al céntrico. La principal manifestación clínica fueron las facetas de desgastes no funcionales en el 100 porciento de los pacientes examinados. Conclusiones: la caracterización de la población con bruxismo aportó datos de interés con mayor afectación en el sexo femenino, durante la tercera y cuarta década de vida, en los bruxópatas excéntricos, donde la totalidad de los pacientes presentaron facetas de desgaste no funcionales como principal manifestación clínica(AU)

Background: in current times bruxism is a medical problem on a world scale that involves clenching and grinding of the teeth, diurnal or nocturnal, with different degrees of intensity and persistence over time, unconsciously. Objective: to characterize bruxism and clinical manifestations in the stomatognathic system. Methods: a cross-sectional descriptive study was carried out in the clinic No 14 of Reynaldo Aday López stomatology clinic in the municipality of Nuevitas of Camagüey province, from January to July 2017, from a universe of 139 patients diagnosed with bruxism, a sample was selected not probabilistic constituted by 67 patients. Results: the female sex predominated and the age group between 31 to 45 years. The eccentric type bruxism was highlighted with respect to the centric one. The main clinical manifestation was the facets of non-functional wear in 100 percent of the patients examined. Conclusions: the characterization of the population with bruxism contributed data of interest with greater affectation in the female sex, during the third and fourth decade of life, in the eccentric bruxópatas, where all the patients presented nonfunctional wear facets as the main manifestation clinic(AU)

Bruxismo na infância ­ aspectos contemporâneos no século 21 ­ revisão sistemática / Bruxism in children ­ contemporary aspects in 21st century ­ systematic review

O bruxismo é definido como uma atividade rítmica, repetitiva e involuntária dos músculos da mastigação caracterizado pelo ranger e/ou apertar dos dentes. Com alta prevalência em crianças, o bruxismo infantil é relatado na literatura recente, apresentando risco de danos aos tecidos dentários, demonstrando a relevância de se conhecer a etiologia, diagnóstico, epidemiologia, consequências e propostas terapêuticas para essa condição. Objetivou-se realizar revisão sistemática de literatura científica coletando dados relevantes e atuais para discutir as informações existentes. Foram realizadas buscas por livros-textos e artigos de texto completo nas bases de dados, selecionados ao todo 84 artigos e dois manuais. O bruxismo é uma manifestação de origem central, portanto, definir sua causa é um desafio, considerando seu aspecto multifatorial, comumente associado a fatores psicológicos/emocionais como estresse e ansiedade, fatores sistêmicos como distúrbios do sono e fatores locais como hiperplasias das amigdalas e adenoides, presença de vermes, dentre outros. A identificação e eliminação, quando possível, dos fatores causais podem eliminar a ocorrência do evento. Desgastes dentários podem ser sinais clínicos da ocorrência de bruxismo, todavia, podem ser sinais de eventos passados e não mais presentes desta condição, portanto, o diagnóstico deve considerar uma anamnese específica. O controle, seja por supervisão, seja por proteção, dos desgastes dentais, associado à investigação médica de fatores causais e adoção de práticas de "higiene do sono", parecem compor estratégia mais adequada para o tratamento desta condição (AU).

Bruxism is a widely studied alteration in Dentistry and other medical classes because of its multifactorial etiology. It is defined as a rhythmic, repetitive and involuntary activity of the chewing muscles characterized by teeth grinding and/or clenching. Having high prevalence in children, infant bruxism is reported in recent literature, presenting a risk of dental tissues damage, demonstrating the relevance of knowing the etiology, diagnosis, epidemiology, consequences, and therapeutic proposals for this condition. The aim of the present work is to perform a systematic review of the scientific literature collecting relevant and current data, in order to discuss existing information and disseminate it in the community of students and teachers. Thus, there were search for textbooks and full text articles in the databases, selecting altogether 84 articles and two manuals considered relevant to the study. There is no consensus in the literature on the etiology of bruxism, but psychological/emotional factors such as stress and anxiety, systemic factors such as sleep disturbances, and local factors such as tonsils and adenoids hyperplasia are the most described and at higher risk of development of bruxism. The involvement of a multidisciplinary team is fundamental for correct diagnosis and efficient treatment, reaching all causal aspect (AU).

Bariatric surgery impact on gastroesophageal reflux and dental wear: a systematic review / Impacto da cirurgia bariátrica no refluxo gastroesofágico e no desgaste dental: uma revisão sistemática

ABSTRACT Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: "bariatric surgery" AND "dental erosion" OR "bariatric surgery" AND "dental erosion" AND "gastroesophageal reflux disease". After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.

RESUMO Introdução: Diversos problemas bucais podem ser percebidos nos indivíduos que foram submetidos à cirurgia bariátrica, frente às mudanças metabólicas e comportamentais referentes à alimentação e higienização. O desgaste dentário parece sofrer impacto após a cirurgia bariátrica, uma vez que pode ocorrer o aumento do refluxo gastresofágico após a operação. Objetivo: Analisar o impacto da cirurgia bariátrica no refluxo gastresofágico e no desgaste dentário por meio de uma revisão sistemática da literatura. Método: As seguintes bases de dados foram acessadas por dois examinadores independentes e calibrados: PubMed, Medline, Lilacs, Scielo e Cochrane usando os descritores: "bariatric surgery" AND "dental erosion" OR "bariatric surgery" AND "dental erosion" AND "gastroesophageal reflux disease". Após a exclusão dos estudos duplicados, 12 estudos foram avaliados inicialmente pelo título e resumo. Foram excluídos os sem relevância para a presente pesquisa, os de revisão da literatura e os relatos de caso. Sendo assim, foram incluídos neste estudo quatro artigos. Todos os artigos avaliados indicaram uma alta associação entre refluxo gastresofágico e desgaste dentário em pacientes submetidos à cirurgia bariátrica. A associação destes desfechos foi mais evidente após seis meses do procedimento cirúrgico. Conclusão: Pacientes submetidos à cirurgia bariátrica mostram maior prevalência de refluxo gastresofágico e desgaste dentário.

Analysis of enamel and material wear by digital microscope: an in-vitro study

Abstract: The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.

Relación entre desgaste dental severo y síndrome de apnea-hipoapnea del sueño (SAHS) / Relationship between dental wear and severe sleep apnea-hypopnea syndrome (SAHS)

Introducción: El síndrome de apneashipopneas del sueño (SAHS) es un problema mayor de salud pública que, en sus formas más graves, afecta al 3-6% de los hombres, al 2-5% de las mujeres y al 1-3% de los niños. Estudios epidemiológicos han encontrado una elevada prevalencia de bruxismo en pacientes con SAHS. Este artículo investiga la presencia de desgaste dentario en pacientes con apnea del sueño y la asociación potencial entre ambos factores. La hipótesis nula es la no asociación entre el desgaste dentario y el SAHS. Material y métodos: Se reclutaron pacientes de forma retrospectiva desde la unidad del sueño del centro que cumpliesen con los siguientes criterios de inclusión: mayores de 18 años y estudio realizado en la unidad del sueño confirmando la presencia de SAHS. Una vez reclutados, los pacientes se sometieron a una exploración dental con el fin de detectar posibles alteraciones dentales. Los parámetros dentales evaluados fueron: desgate dental (leve, moderado y severo) y causa del desgaste (atrición, erosión y abfracción). Resultados: Fueron reclutados 99 pacientes de forma consecutiva que cumplieron los criterios de inclusión anteriormente descritos. EL 46,5% de los pacientes fueron hombres con una edad media de 54±11 años. Al relacionar el grado de desgaste dentario en los diferentes grupos de pacientes con SAHS observamos que los pacientes con mayor grado de desgaste dental (severo) presentaron un IAH correspondiente a un SAHS leve en 2 casos (2,02%), un IAH correspondiente a un SAHS moderado en 6 casos (6,06%) y un IAH correspondiente a un SAHS severo en 8 casos (8,08%), siendo las diferencias entre los grupos estadísticamente significativas (Chi-cuadrado, p=0,000). Conclusiones: El desgaste dentario puede ser un indicativo de que el paciente presente enfermedades asociadas como el SAHS por lo que debe ser tomado como un síntoma y realizar las pruebas necesarias para su confirmación o exclusión

Introduction: The obstructive sleep apnea (OSA) is a major public health problem that, in its most severe forms, affects 3-6% of men, and 2-5% of women and 1-3% of children. Epidemiological studies have found a high prevalence of bruxism in patients with Osa. This article investigates the presence of dental wear in patients with sleep apnea and the association potencies between both factors. The null hypothesis is the non-association between dental wear and OSA. Material and methods: Patients were recruited retrospectively from the sleep unit that fulfilled the following inclusion criteria: Over 18 years and study performed in the sleep unit confirming the presence of OSA. Once recruited, the patients underwent a dental examination in order to detect possible dental alterations. The dental parameters assessed were: Dental wear (mild, moderate and severe) and cause of wear (attrition, erosion and abfraction). Results: 99 patients were recruited consecutively who met the inclusion criteria mentioned above. 46.4% of the patients were males with an average age between 54 +-11 years. In relation to the degree of dental wear of the different groups of patients with OSA observed that patients with higher degree of dental wear (severe) presented an AHI corresponding to a mild osas in 2 cases (2.02%), an AHI corresponding to a moderate OSA in 6 cases (6.06%) and an AHI corresponding to a severe osas in 8 cases (8,08%) the differences between the statistically significant groups (Chi-squared, p = 0,000). Conclusions: The tooth wear can be an indication that the patient presents diseases associated with the Osas so it should be taken as a symptom and perform the necessary tests for their confirmation or exclusion

Erosive tooth wear-why clinicians should be aware of this condition

Introduction: Erosive tooth wear (ETW) is defined as a chemical-mechanical process leading to the cumulative loss of hard dental tissue without the involvement of bacteria. Objective: to give to clinicians an overview about most important ETW topics. Data source: main scientific data base (PubMed, Lilacs) in the last 10 years, with the keywords: dental erosion, diagnosis and prevention. Classical articles were selected for the realization of an integrative literature review. Data synthesis : the prevalence of ETW has been reported to range from 10% to 80% in children and 4% to 82% in adults. The management of ETW should include early diagnosis, the evaluation of different etiological factors, risk identification and the proposal of preventive measures to avoid the progression of the condition. These measures include fluoride exposure, use of low abrasive toothpastes, clinical monitoring, and in more severe cases sealant application and restorations. Patients suffering from eating disorders with purging behaviour and gastroesophageal reflux disease are considered the most important risk groups. Conclusion : Clinicians should be aware of this condition with growing prevalence, once substance loss is an irreversible condition, providing prompt preventive measures during the early stages that are essential to reduce ETW.

Introdução: O Desgaste Dentário Erosivo é definido como um processo químico- mecânico que leva a uma perda cumulativa de tecido dentário duro, sem que ocorra o envolvimento de bactérias. Objetivo : atualizar os cirurgiões-dentistas sobre os principais tópicos a respeito do Desgaste Dentário Erosivo. Fonte de dados: principais bases científicas (PubMed, Lilacs) nos últimos 10 anos, com as palavras-chave: erosão dentária, diagnóstico e prevenção. Foram selecionados os artigos clássicos sobre o tema para a realização da revisão integrativa de literatura. Síntese de dados : A prevalência de Desgaste Dentário Erosivo tem sido reportada na literatura em porcentagens que variam de 10% a 80% em crianças e de 4% a 82% em adultos. A abordagem clínica do Desgaste Dentário Erosivo deve incluir um diagnóstico precoce, a avaliação dos diferentes fatores etiológicos, a identificação do risco e a proposta de medidas preventivas para retardar a progressão dessa condição. Essas medidas incluem a aplicação de fluoretos, o uso de dentifrícios com baixa abrasividade, monitoramento clínico e, em casos mais graves, a aplicação de selantes e procedimentos restauradores. Pacientes diagnosticados com transtornos alimentares ou com refluxo gastroesofágico são considerados um dos grupos de risco mais importantes para o desenvolvimento dessa condição. Conclusão: Os clínicos devem estar atentos a essa condição de prevalência crescente, uma vez que a perda de estrutura dentária é irreversível, promovendo medidas preventivas eficazes, desde os estágios iniciais, contribuindo assim para o controle e redução do Desgaste Dentário Erosivo entre seus pacientes.