Abstract
The purpose of this systematic review was to identify the different methods used to measure artificial teeth wear and to determine which denture teeth (or which combination of tooth types) have better wear resistance. The focused patient, intervention, comparison, and outcome (PICO) question for this review was “which available denture teeth or combination of teeth have higher wear resistance?” The method of testing and measuring the artificial teeth wear was also evaluated as a secondary outcome. We searched OVID Medline, PubMed and SCOPUS using the following terms (MeSH words) with any synonyms and closed terms: “wear”, “denture teeth”, “denture tooth”, or “artificial tooth”, “tooth wear”, or combination of “denture tooth wear”. Database searches were limited to the English language and studies published between years 1997 and 2021. Further hand searches were carried out of studies identified from the bibliographies of relevant articles. The electronic data base search identified 293 articles of which 213 were eliminated after removing duplicates and screening the titles of the articles. A further 31 articles were eliminated upon application of the exclusion criterion and full text reading because they were either not in the English language or were review articles. Only 41 articles met the inclusion criterion; along with addition of one hand search article, a total of 42 articles were included in the review. The studies showed that rate of denture teeth wear is influenced by factors such as the material and composition of the artificial teeth, the denture tooth antagonist, the tooth being replaced, patient’s age and sex, the type of removable prosthesis and the amount of the superficial layer removed during occlusal adjustments. The testing parameters were inconsistent across all studies. In conclusion, artificial teeth of same material should be used as antagonists where possible, and the superficial outer layer of the teeth must be preserved as much as possible during occlusal adjustments to enhance wear resistance. Denture teeth should be selected taking into consideration the tooth being replaced, the age and sex of the patient, and the type of prosthesis. Incorporation of nano fillers into acrylic resin teeth does not increase wear resistance; therefore, there is no evidence to favour the use of nano-filled composite teeth over micro-filled or conventional acrylic resin teeth.
Highlights
Wear resistance is an important physical property of artificial teeth used in removable prosthodontics
A total of 23 studies carried out further microscopic analysis of post-wear testing: Scanning Electron Microscopy (SEM)
The rate of denture teeth wear is influenced by various factors such as the material and composition of the artificial teeth, the denture tooth antagonist, the tooth being replaced, patient’s age and sex, the type of removable prosthesis, and the amount of superficial layer removed during occlusal adjustments
Summary
Wear resistance is an important physical property of artificial teeth used in removable prosthodontics. It is an important determinant of the longivity of dentures because it determines the ability of the prosthesis to maintain the established occlusal relationship [1]. In addition to aesthetics and speech, patient expectations of their new dentures are high in respect of masticatory efficiency, which can be compromised if denture teeth wear occurs [2]. Teeth wear is of great concern to both patients and clinicians because the altered teeth morphology can result in loss of occlusal vertical dimension, compromised masticatory efficiency, fatigue of the muscles of mastication and patient discomfort, as well as affecting aesthetics [7]. Excessive wear of denture teeth has even been reported to affect the quality of life of dentures wearers [3]
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