Abstract
ObjectivesTo 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 methodsA 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).ResultsOnly 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.ConclusionsAll 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 relevanceSince 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.
Highlights
Tooth wear is defined as cumulative surface loss of mineralised tooth substance due to various physical or chemophysical impacts not caused by caries, trauma or resorption [1]
The few studies published to date have shown that an increase in the number and severity of lesions can be detected at a young age and within a few years [5,6,7,8,9], but we are still far from a deeper understanding of the dynamics of tooth wear in individual patients
The highest number of lesions was observed at the mesiobuccal cusp (96.4% of the teeth exhibited some kind of wear), and mesial ridges showed the fewest lesions (12.1% of the teeth exhibited some kind of wear)
Summary
Tooth wear is defined as cumulative surface loss of mineralised tooth substance due to various physical or chemophysical impacts not caused by caries, trauma or resorption [1] It is not reversible and, to some extent, is part of the physiological aging of the natural dentition. 19-year-olds is 30.4% [4] and in approximately 5% of 7- to 18-year-olds, even dentine is exposed [3] These findings indicate that tooth wear is a relevant oral health issue in young patients. The mandibular first molars are the most common teeth to exhibit these lesions and show the most pronounced progression rates [5, 7, 8, 10, 11] They have been proposed as marker teeth for erosive tooth wear in young subjects [5, 10]. The reasons for more severe involvement of mandibular first molars than their antagonists are unknown
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