Loss Of Contour Research Articles

MP19-16 RENAL PAPILLARY PLUGGING IN CALCIUM STONE FORMERS MAY ARISE VIA RANDOM AND INDEPENDENT CRYSTALLIZATION EVENTS

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology II1 Apr 2017MP19-16 RENAL PAPILLARY PLUGGING IN CALCIUM STONE FORMERS MAY ARISE VIA RANDOM AND INDEPENDENT CRYSTALLIZATION EVENTS Melanie Adamsky, Andrew Cohen, Glenn Gerber, Elaine Worcester, and Frederic Coe Melanie AdamskyMelanie Adamsky More articles by this author , Andrew CohenAndrew Cohen More articles by this author , Glenn GerberGlenn Gerber More articles by this author , Elaine WorcesterElaine Worcester More articles by this author , and Frederic CoeFrederic Coe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3258AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The causes of renal papillary abnormalities observed endoscopically within a single kidney are incompletely known. One testable theory is that plugging, and perhaps Randall's plaque (RP), are random and independent events of crystallization whose risk is increased by local supersaturations. If so, their occurrence in the papillae of a kidney must follow the Gaussian distribution. Using scores from a previously introduced and validated papillary grading system, we sought to test if this is true. METHODS We reduced papillary grading scores from patients who had undergone unilateral ureteroscopic stone treatment to ″present″ or ″absent″ for each variable in the grading system - pitting, plugging, loss of contour, and RP. From this we calculated the proportion of graded papillae in a given kidney involved. Probability density functions were generated and Shapiro-Wilks (SW) and Anderson-Darling AD) tests of normality were applied. RESULTS Our cohort included 42 patients (42 kidneys), all of whom had calcium stones - 28 calcium oxalate and 14 calcium phosphate - on subsequent analysis. The mean number of papilla graded per kidney was 5.97 (95% CI 5.40-6.55). The mean proportion of papillae with plugging was 51.7% (±4.3), pitting was 20.1% (±3.0), loss of contour was 22.7% (±3.6), and RP was 33.7% (±4.0). Probability density functions are shown in Figure 1. Unlike pitting, loss of contour, and RP, plugging is uniquely normally distributed (SW and AD tests p>0.01). CONCLUSIONS Unlike pitting, loss of contour, and RP, plugging is uniquely normally distributed (SW and AD tests p>0.01), supporting that plugging is a random and independent process in individual papillae and plaque, pitting, and contour changes cannot be. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e236 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Melanie Adamsky More articles by this author Andrew Cohen More articles by this author Glenn Gerber More articles by this author Elaine Worcester More articles by this author Frederic Coe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Labiogingival groove: A rare developmental tooth anomaly

Labiogingival groove is a congenital morphologic dental anomaly, in which an infolding of the inner enamel epithelium and Hertwig's epithelial root sheath create a groove extending varying depth into root. Epithelial attachment can be breached by gingival irritation secondary to plaque accumulation creating a periodontal defect that spreads to the pulp causing primary periodontal/secondary endodontic. A 12-year-old boy reported with the complaint of painful tooth with pus discharge from labial gingival surface in the maxillary right lateral incisor for 4 months. Intraoral examination revealed bluish red gingiva with loss of contour in relation to maxillary right lateral incisor and purulent discharge in relation to it. A provisional diagnosis of localized gingival abscess in relation to maxillary right incisor (primary periodontic and secondary endodontic involvement) was given, and required treatment was carried out. On exposure of the involved tooth, a labiogingival groove was noticed which could have been a contributing factor for the progression of the condition.

Endoscopic Evidence That Randall's Plaque is Associated with Surface Erosion of the Renal Papilla.

This study was conducted to assess the reliability and precision of an endoscopic grading scale to identify renal papillary abnormalities across a spectrum of equipment, locations, graders, and patients. Intra- and interobserver reliability of the papillary grading system was assessed using weighted kappa scoring among 4 graders reviewing a single renal papilla from 50 separate patients on 2 occasions. Grading was then applied to a cohort of patients undergoing endoscopic stone removal procedures at two centers. Patient factors were compared with papillary scores on the level of the papilla, kidney, and patient. Graders achieved substantial (kappa >0.6) intra- and inter-rater reliability in scored domains of ductal plugging, surface pitting, and loss of contour. Agreement for Randall's Plaque (RP) was moderate. Papillary scoring was then performed for 76 patients (89 kidneys, 533 papillae). A significant association was discovered between pitting and RP that held both within and across institutions. A general linear model was then created to further assess this association and it was found that RP score was a highly significant independent correlate of pitting score (F = 7.1; p < 0.001). Mean pitting scores increased smoothly and progressively with increasing RP scores. Sums of the scored domains were then calculated as a reflection of gross papillary abnormality. When analyzed in this way, a history of stone recurrence and shockwave lithotripsy were strongly predictive of higher sums. Renal papillary pathology can be reliably assessed between different providers using a newly described endoscopic grading scale. Application of this scale to stone-forming patients suggests that the degree of RP appreciated in the papilla is strongly associated with the presence of pitting. It also suggests that patients with a history of recurrent stones and lithotripsy have greater burdens of gross papillary disease.

An open randomized controlled clinical trial to evaluate ridge preservation and repair using SocketKAP(™) and SocketKAGE(™) : part 1-three-dimensional volumetric soft tissue analysis of study casts.

The aims of this study were to evaluate (i) the efficacy of ridge preservation and repair involving SocketKAP(™) and SocketKAGE(™) devices following tooth removal; and (ii) ridge contour changes at 6months post-extraction in intact sockets and sockets with dehiscence defects. Thirty-six patients required a total of 61 teeth to be extracted. Five cohorts were established with groups A-C involving intact sockets and groups D and E involving facial dehiscence: (A) Negative Control; (B) SocketKAP(™) alone; (C) Anorganic Bovine Bone Mineral (ABBM)+SocketKAP(™) ; (D) Negative Control; and (E) ABBM+SocketKAP(™) +SocketKAGE(™) . Preoperative CBCT and laser-scanned casts were obtained. Teeth segmented from preoperative CBCT were merged with study cast images to allow for digital removal of teeth from the casts. Volumetric measurements of ridge contour were performed. Images of preoperative and 6months post-operative casts were superimposed to measure ridge contour changes. Post-extraction contour loss occurred in all sockets primarily in the crestal 3mm but was also detected up to 6mm from alveolar crest. For intact sockets, SocketKAP(™) or SocketKAP(™) +ABBM interventions led to greater percentages of remaining ridge contour when compared to controls. A significant difference favoring SocketKAP(™) +SocketKAGE(™) +ABBM treatment was observed for sockets with facial dehiscence when compared to controls. SocketKAP(™) , with or without ABBM, significantly limited post-extraction ridge contour loss in intact sockets. In the absence of a group treated with only the SocketKAGE(™) , it is not possible to determine its efficacy, although the combination of SocketKAGE(™) +SocketKAP(™) +ABBM was effective in limiting post-extraction ridge contour loss in sockets with dehiscence defects.

A Proposed Grading System to Standardize the Description of Renal Papillary Appearance at the Time of Endoscopy in Patients with Nephrolithiasis

The appearance of the renal papillae in patients with nephrolithiasis can be quite variable and can range from entirely healthy to markedly diseased. The implications of such findings remain unknown. One potential reason is the lack of a standardized system to describe such features. We propose a novel grading scale to describe papillary appearance at the time of renal endoscopy. Comprehensive endoscopic renal assessment and mapping were performed on more than 300 patients with nephrolithiasis. Recurring abnormal papillary characteristics were identified and quantified based on degree of severity. Four unique papillary features were chosen for inclusion in the PPLA scoring system- ductal Plugging, Pitting, Loss of contour, and Amount of Randall's plaque. Unique scores are calculated for individual papillae based on reference examples. The description and study of renal papillary appearance in stone formers have considerable potential as both a clinical and research tool; however, a standardized grading system is necessary before using it for these purposes.

An unusual cause of limp

A 38-year-old male re-presented to the ED five days after being discharged with a diagnosis of soft tissue injury to the left knee. Re-attendance was prompted by increased inability to weightbear and loss of joint function. The patient limped into the department and was asked to lie supine for examination. Even a cursory visual examination revealed marked infra-patellar swelling with a loss of contour and definition to this aspect of the joint. Pain was not a significant part of the presentation being scored at 2/10 at worst. The patient was an otherwise active adult who had become frustrated by his inability to indulge in any sort of sporting activity since discharge. After visiting the gym that morning he had been advised by one of the staff to re-attend as there was a possibility that he may have a more significant injury than previously diagnosed.

Evaluation of the efficacy and tolerance of an antiaging facial cream on multiethnic women with mild to moderate photo damage and loss of facial firmness and contours

Evaluation of the efficacy and tolerance of an antiaging facial cream on multiethnic women with mild to moderate photo damage and loss of facial firmness and contours

Evidence for bactericidal activities of lipidic nanoemulsions against Pseudomonas aeruginosa.

Pseudomonas aeruginosa has been implicated in a broad range of infections and shown to acquire rapid resistance to anti-microbial agents. In the present, study we have used particular amalgamation of specific lipids that hold innate antibacterial activities, which can be transformed into cationized and non-cationized nanoemulsions. The anti-Pseudomonas activities were then elucidated by transmission/scanning electron microscopy, and atomic force microscopy. The microscopic studies revealed the cell lysis due to the formation of blebs, exudation of essential cellular contents and loss of characteristics contour of the cells. The microscopic studies were then corroborated by zone of inhibition, cytoplasmic release studies, time dependent killing and MIC determination. Conclusively, it can be inferred that the delivery issues of antibiotics could be reassessed by using certain excipients that possess inherent antibacterial properties. This will not only avoid unnecessary introduction of inactive excipients in the body, but will also reduce the dose of antibiotics because of synergistic effects of excipients and drug acting together.

Prevalence and risk factors for non-carious cervical lesions in children attending special needs schools in India.

We assessed the prevalence and risk factors for development of non-carious cervical lesions (NCCLs) in children attending special needs schools in India. The participants were 395 children aged 12-15 years with disabilities in learning, communication, physical function, and/or development. A questionnaire was designed in order to collect information on sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for NCCLs. The chi-square test, bivariate analysis, and logistic regression analysis were used to analyze the data. Presence of NCCLs was associated with use of toothpowder or other materials for teeth cleaning, use of harder toothbrushes, use of a horizontal scrub technique for toothbrushing, consumption of a vegetarian diet, and greater consumption of lemon. The overall prevalence of NCCLs was 22.7%. Most lesions involved minimal loss of contour or defects <1 mm in depth. The prevalence of non-carious cervical lesions was slightly higher than the global average. Effective policies should be developed for oral health care among children attending special needs schools.

Onlay bone graft maintenance using guided bone regeneration, platelet rich plasma, and their combination.

Onlay bone grafts have a bad reputation of resorption with loss of contour and volume. Rigid fixation reduces the incidence of resorption but does not prevent it. Literature shows reduction of resorption by applying guided bone regeneration (GBR) barriers and platelet-rich plasma (PRP). Investigating the effect of combining them together to reduce resorption was the aim of this study. This study included 4 groups: control group, GBR group, PRP group, and GBR + PRP group. Twenty rabbits were used (40 mandibular halves). Onlay bone grafts were fixed by titanium miniscrews in all groups. Computed tomography scans of harvested mandibles after euthanasia allowed calculations of bone graft volume and density. Onlay bone graft volumes in all experimental groups were significantly higher than in the control group. Volume maintenance in the GBR group was significantly higher than in the PRP group. There was no significant difference in the volume of onlay bone grafts between the group of combined GBR + PRP and GBR alone. It was concluded that, to maintain the volume of onlay bone grafts, either GBR or PRP can be added. Combining them did not add any advantage over the GBR alone.

Radiographic sclerotic contour loss in the identification of glenoid bone loss.

Quantification of glenoid bone loss guides surgical management in the setting of anterior shoulder instability. Glenoid defects resulting in ≥20% articular area loss require bony reconstruction. The objective of this study was to evaluate the utility of sclerotic glenoid contour loss on true anteroposterior radiography in the detection of varying quantities of simulated glenoid bone loss using a cadaveric model. Eight cadaveric scapulae with full radiographic sclerotic contour were osteotomized to produce glenoid surface area reductions of 10-50%. Radiography was performed initially and following each osteotomy, and assessed by an orthopedic surgeon and radiologist twice. Quantity of glenoid loss was compared using Fisher's exact test. Sensitivity, specificity, and reliability analyses were performed. On the first radiographic review, sclerotic contour loss was detected in 6 out of 8 scapulae with 50% area loss, but only 1 out of 8 scapulae with 20% area loss. There was a significantly higher proportion of radiographs containing sclerotic contour loss for defects with 50% area loss compared to those with 0-25% loss (p≤0.02). In the detection of ≥20% area loss, sclerotic contour loss had a sensitivity of 33-43% and specificity of 88-100%. Moderate inter-observer reliability (Cohen's kappa value of 0.42-0.53) and intra-observer reliability (kappa value of 0.46-0.58) were found. Radiographic sclerotic contour loss is commonly observed in radiographs of scapulae with 40-50% glenoid area loss and less often with smaller lesions. However, this finding lacks utility in discerning specific quantifications of glenoid bone loss. In a clinical setting, sclerotic contour loss suggests the presence of a large glenoid defect that may require bony reconstruction. However, an intact sclerotic contour does not rule out significant bone loss.

Effectiveness of Alveolar Preservation Techniques over Post-Extraction Socket Compared with and without Socket Preservation. Systematic Review of Literature

Background: Loss and bone deformities of the alveolar ridge after a tooth extraction are some of the main challenges when fabricating a dental prosthesis. Purpose: To determine the effectiveness of preservation techniques on alveolar height and width loss of alveolar contours compared with socket without preservation by a systematic review of the literature. Methods: The search included databases Medline, Cochrane, Embase, Ovid, SciELO, LILACS, ScienceDirect, Hinary, Wiley Online (up to July 2012), about papers on changes in alveolar height and thickness after a dental extraction with or without preservation treatment as bone grafts, collagen membranes, or growth factors. Results: 272 references were found of which 19 articles met the inclusion criteria. There was heterogeneity among studies (p= 0.00001) with statistically significant differences (p ≤ 0.0001) favoring the experimental group (alveolar preservation) regarding alveolar ridge width and height after extraction. However, when comparing subgroups, the difference between intervention groups (intervention in both groups) did not turn out to be significant for width (p = 0.21) or for height (p = 0.96). Conclusions: Articles showed significant differences when comparing experimental groups with intervention and control groups without it, which indicates that performing a method of alveolar preservation after tooth extraction seems to positively influence the maintenance of the alveolar ridge.KEYWORDSalveolar bone loss; tooth extraction; alveolar ridge augmentation; biological dressings; boneresorption; dental implants

Clinical longevity of extensive direct composite restorations in amalgam replacement: Up to 3.5 years follow-up

ObjectivesThis prospective clinical trial evaluated the longevity of direct resin composite (DRC) restorations made on stained dentin that is exposed upon removal of existing amalgam restorations in extensive cavities with severely reduced macro-mechanical retention for amalgam replacement. MethodsBetween January 2007 and September 2013, a total of 88 patients (57 women, 31 men; mean age: 51.6 years old) received extensive cusp replacing DRCs (n=118) in the posterior teeth. DRCs were indicated for replacement of existing amalgam restorations where dentin substrates were stained by amalgam. After employing a three-step total-etch adhesive technique (Quadrant Unibond Primer, Quadrant Unibond Sealer, Cavex), cavities were restored using a hybrid composite (Clearfil Photo Posterior, Kuraray). At baseline and thereafter every 6 months, restorations were checked upon macroscopically visible loss of anatomical contour, marginal discolouration, secondary caries, fractures, debonding and endodontic problems. Restorations were scored as failed if any operative intervention was indicated for repair, partial or total replacement. ResultsRestorations were observed for a minimum of seven, and maximum 96 months (mean: 40.3 months). In total, four failures were observed due to fracture (n=1), endodontic complications (n=2) and inadequate proximal contact (n=1). Failures were related neither to inadequate adhesion nor to secondary caries. Cumulative survival rate was 96.6% (95% CI: 89–95) up to a mean observation time of 40.3 months (Kaplan–Meier) with an annual failure rate of 0.9%. ConclusionIn case of amalgam replacement, dentin that is exposed upon removal of existing amalgam restorations does not impair clinical longevity of extended cusp replacing direct resin composite restorations. Clinical significanceExtensive amalgam restorations can be replaced with a variety of treatment options. This clinical study indicates that in such cases directly applied resin based composites offer a reliable and low-cost treatment option, even if dentin is stained by amalgam corrosion products.

Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography.

To evaluate imaging findings of patients with focal choroidal excavation (FCE) in the macula using swept-source optical coherence tomography (SS-OCT) and correlate it clinically. Prospective observational case series. Eleven consecutive patients (12 eyes) with FCE were described. Data on demographics and clinical presentation were collected and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and SS-OCT) were analyzed. The primary diagnosis was epiretinal membrane (two eyes), choroidal neovascularization (one eye), polypoidal choroidal vasculopathy (three eyes), central serous chorioretinopathy (one eye), and dry age-related macular degeneration (two eyes). Eleven out of 12 of the lesions were conforming. One presented with a non-conforming lesion that progressed to a conforming lesion. One eye had multiFCE and two had two overlapping choroidal excavations. Using the SS-OCT, we found the choroid to be thinned out at the area of FCE but sclera remained normal. The choroidal tissue beneath the FCE was abnormal, with high internal reflectivity and poor visualization of choroidal vessels. There was loss of contour of the outer choroidal boundary that appeared to be pulled inward by this abnormal choroidal tissue. A suprachoroidal space was noted beneath this choroidal tissue and the choroidal-scleral interface was smooth. Repeat SS-OCT 6 months after presentation showed the area of excavation to be stable in size. FCE can be associated with epiretinal membrane, central serous chorioretinopathy, and age-related macular degeneration. The choroid was thinned out in the area of FCE.

English

MATERIALS & METHODS: A 35years old male presented in the emergency department with complaints of severe pain and inability to move both the shoulders following assault by many persons and fall on ground. He attempted saving himself by lifting both his upper limbs in abduction and external rotation at shoulder. Examination revealed both his arms lying in abduction and external rotation and loss of rounded contour of shoulders. Humeral heads were palpable anteriorly in the subcoracoid location. Movements were painfully restricted and there was no neurovascular deficit in the limbs. Radiographs of the shoulders showed BADS without any evidence of fracture in tuberosities or neck humerus. Dislocations were reduced by closed manipulation under general anesthesia using Kocher’s maneuver and both his arms were immobilized in adduction and internal rotation for 04 weeks. The patient underwent gradual mobilizing exercises and was able to resume his routine activities after 03 months.

Rehabilitación con coronas completas de metal-cerámica y prótesis parciales removibles convencionales

El tratamiento se realizó en un paciente de sexo femenino de 67 años, con buen estado de salud general, portadora de prótesis removible superior incómoda para sus funciones fisiológica y estética. Al examen presenta PPR (prótesis parcial removible) superior de marcado desgaste incisal y oclusal, soporte y retención deficiente, disminución de la DVO (dimensión vertical oclusal), pérdida de contorno facial, edentulismo superior clase II modificación 2 de Kennedy, rebordes conservados, presencia de piezas 1.7, 1.3 y 2.3; edentulismo parcial inferior clase III modificación 1, sin aditamento protésico, rebordes muy reabsorbidos, presencia de piezas 3.8, 3.4, 3.3, 3.2, 3.1, 4.1, 4.2, 4.3, 4.4, 4.5 y 4.8. Se restauró la DVO confeccionando coronas metal cerámica con islas de metal para los apoyos oclusales y brazos recíprocos en los pilares de las piezas 1.7, 3.8 y 4.5. ; y de placas linguales sobre los cíngulos de la piezas 1.3 y 2.3., de la PPR superior e inferior respectivamente. Se construye la morfología oclusal dándole over jet y over bite, desoclusión canina y protección mutua, con cúspides de 30º. Estéticamente se procedió a restablecer el contorno vestibular superior perdido, con la línea de la sonrisa específica.

Undesirable effect of cosmetic lip augmentation with autologous fat tissue

BackgroundFacial cosmetic procedures are commonplace nowadays, especially techniques that aim to increase lip volume. Full lips provide a youthful, healthy, feminine and sensual appearance. There are many techniques and materials used to recover the loss of contour that occurs with age.Case presentationAn unusual case of fat tissue accumulation following cosmetic upper lip augmentation in a 61 year-old female was reported. Surgical treatment was performed for esthetic concerns. Microscopically, the tissue removed was composed of muscle fibers and mature adipocytes.ConclusionUndesirable effects of esthetic treatment can occur and the clinician should be familiar with such complications to diagnose and manage them.

Summary of: An in vitro investigation of the erosive potential of smoothies

Recent health promotion campaigns have encouraged the public to consume at least five portions of fruit and vegetables per day. Many see consuming fruit smoothies as a way of achieving this. To ascertain the potential or otherwise for fruit smoothies to bring about dental erosion. Laboratory study. This was an in vitro investigation in which five varieties of shop bought fruit smoothies, including a 'thickie' were investigated, with respect to their initial pH, titratable acidity and effect upon exposure to the surface microhardness and profile of extracted human teeth. In addition their performance was compared to negative (Volvic™ water) and positive (orange juice) control drinks as well as a homemade smoothie, based upon the recipe of one of the commercially bought drinks, from which ingredient omissions were made. The majority of the drinks investigated had a baseline pH below the critical pH of enamel (5.5) and required comparable volumes of 0.1M NaOH to raise their pH to neutrality as the positive control. Only two drinks (Volvic™ still mineral water, the negative control, and the yoghurt, vanilla bean and honey 'thickie') displayed a higher pH, though to neutralise the thickie, a lesser quantity of alkali addition was required. The immersion of the tooth samples in the drinks brought about reductions in their surface hardness (expressed as a percentage change of median hardness) but these were only significant (p <0.001) for the cranberry, blueberry and cherry fruit smoothie and homemade strawberry and banana fruit smoothie. There was no reduction in surface hardness in the case of the teeth immersed in the thickie. Omission of certain ingredients from the homemade smoothie affected the magnitude of surface hardness reductions seen. With regard to the loss of surface contour of the tooth samples following immersion in the drinks, as assessed by depth loss, there were significant differences between the drinks (p = 0.0064) with the thickie and negative control not causing depth loss and the kiwi, apple and lime smoothie producing most depth loss (28.26 (5.45) μm). Within the limitations of this study some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly. This can be influenced by ingredient variations. In order to minimise the risk of developing dental erosion, without removing the claimed nutritional benefits of their consumption, their consumption should be confined to mealtimes.

An in vitro investigation of the erosive potential of smoothies

Recent health promotion campaigns have encouraged the public to consume at least five portions of fruit and vegetables per day. Many see consuming fruit smoothies as a way of achieving this. To ascertain the potential or otherwise for fruit smoothies to bring about dental erosion. Laboratory study.Method This was an in vitro investigation in which five varieties of shop bought fruit smoothies, including a 'thickie' were investigated, with respect to their initial pH, titratable acidity and effect upon exposure to the surface microhardness and profile of extracted human teeth. In addition their performance was compared to negative (Volvic(™) water) and positive (orange juice) control drinks as well as a homemade smoothie, based upon the recipe of one of the commercially bought drinks, from which ingredient omissions were made. The majority of the drinks investigated had a baseline pH below the critical pH of enamel (5.5) and required comparable volumes of 0.1M NaOH to raise their pH to neutrality as the positive control. Only two drinks (Volvic(™) still mineral water, the negative control, and the yoghurt, vanilla bean and honey 'thickie') displayed a higher pH, though to neutralise the thickie, a lesser quantity of alkali addition was required. The immersion of the tooth samples in the drinks brought about reductions in their surface hardness (expressed as a percentage change of median hardness) but these were only significant (p <0.001) for the cranberry, blueberry and cherry fruit smoothie and homemade strawberry and banana fruit smoothie. There was no reduction in surface hardness in the case of the teeth immersed in the thickie. Omission of certain ingredients from the homemade smoothie affected the magnitude of surface hardness reductions seen. With regard to the loss of surface contour of the tooth samples following immersion in the drinks, as assessed by depth loss, there were significant differences between the drinks (p = 0.0064) with the thickie and negative control not causing depth loss and the kiwi, apple and lime smoothie producing most depth loss (28.26 (5.45) μm). Within the limitations of this study some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly. This can be influenced by ingredient variations. In order to minimise the risk of developing dental erosion, without removing the claimed nutritional benefits of their consumption, their consumption should be confined to mealtimes.

Prevalence and risk factors for dental erosion among 11- to 14-year-old school children in South India

This cross-sectional survey was conducted to assess the prevalence and severity of dental erosion and to determine the potential risk factors for dental erosion among 11- to 14-year-old school children in South India. The total sample size for the study was 605, of which 303 school children were from private schools and 302 from public schools. A questionnaire was designed to record information about socio-demographic characteristics, oral hygiene practices, dietary habits and risk factors for dental erosion. Chi square test, bivariate analysis and Logistic regression analysis were performed to analyse the data. The children who consumed lemon several times a day (OR = 13.41, P < 0.001), and those who preferred carbonated drinks (OR = 2.80, P = 0.007) had a higher tendency to develop dental erosion. The overall prevalence of dental erosion was found to be low (8.9%). Erosion was found to be greater in posterior teeth (65.6%) than anterior teeth (34.4%). Loss of enamel only with loss of surface contour was observed in most (94.8%) of the cases. The prevalence of dental erosion was found to be low in school children. Private school children were affected more by dental erosion. Frequency of lemon consumption and consumption of carbonated drinks were identified as risk factors.