Occlusal Surfaces Of Teeth Research Articles

Prevalence and risk indicators for underlying dentin shadows among 12-year-old southern Brazilian schoolchildren.

This study aimed to assess the prevalence, extent, and associated factors of underlying dentin shadows (UDS) in the occlusal surfaces of permanent posterior teeth among 12-year-old schoolchildren from southern Brazil. A population-based cross-sectional study that included a representative sample of 1,528 schoolchildren was conducted in Porto Alegre, southern Brazil (participation rate: 83.2%). A questionnaire on sociodemographic characteristics, behavioral habits, and access to dental services was sent to parents/legal guardians of each student selected. Caries examination included the recording of non-cavitated and cavitated lesions, including the presence of UDS, as defined by the ICDAS Group (i.e., a shadow of discolored dentin visible through an apparently intact enamel surface that may or may not show signs of localized breakdown - ICDAS Code 4). The association between predictor variables and UDS prevalence was assessed using survey Poisson regression models. The prevalence of UDS was 6.3% (95%CI = 1.2 -11.3). The mean number of affected teeth among the schoolchildren presenting UDS was 1.51 (95%CI = 1.40 -1.61), ranging from 1 to 6. Type of school (public, PR = 2.23, 95%CI = 1.22 -4.07) and caries experience (DMFT 1-2, PR = 2.41, 95%CI = 1.15 -5.04; DMFT ≥ 3, PR = 3.09, 95%CI = 1.52 -6.27) were significantly associated with UDS prevalence. In conclusion, this population-based cross-sectional study found a low prevalence of UDS in the occlusal surfaces of the permanent posterior teeth of 12-year-old southern Brazilian schoolchildren. Overall caries experience and type of school were associated with UDS in this population.

Study of the effect of the occlusal surface of a natural tooth and fixed partial dentures supported by dental implants on the stress distribution by finite element analysis

To study the effect of the occlusal surface of a natural tooth, cement-retained and screw-retained fixed partial dentures supported by dental implants and the coefficient of friction on the stress distribution in the peri-implant bone at maximum and minimum principal stresses. Study of maximum and minimum principal stresses in models with natural teeth and artificial crowns supported by dental implants, taking into account the coefficient of friction using the finite element analysis. In models represented by fixed partial dentures supported by dental implants and a natural tooth, the maximum tensile stresses arise in the cortical bone in the cervical region of the artificial crown, and the maximum compressive stresses occur both in the cortical layer in the cervical region of the artificial crown and in the cervical region of the tooth. In models with two fixed partial dentures supported by dental implants or two natural teeth, the stress distributions in the cortical layers in the upper and lower jaw are almost identical. Modeling the antagonist and adding to the FEA model is important in order to determine the precise and realistic direction of the resulting force vector. Amplification of the number of contact areas should be considered when modeling the occlusal surface of artificial crowns supported by dental implants.

The effect of Fit-checking material and various subsequent cleaning methods on the wettability of the dentin surface: an in vitrostudy

Background: GC Fit-checker is a modified polyvinyl siloxane impression material exclusively used to check the internal fit and improve the marginal fit of indirect restorations. An unpolymerized organic film is known to be leftover on the bonding surfaces after the silicone disclosing procedure. Residual silicone film being hydrophobic may alter the wettability of the cement to the tooth/metal surface, thus having a detrimental effect on the bond strength and retention of the restoration. Aim: This study aimed to evaluate the wetting of luting liquid (GIC) to tooth dentin surface after application of Fit-checker and evaluate the efficiency of various surface treatments in removing the residual silicone film. Materials and Methods: Extracted human molars were mounted on the acrylic block, and the tooth occlusal surface was ground flat till the dentin exposure. All the specimens were assigned into five groups: Group 1: without application of Fit-checker (control group); Group 2: without any surface treatment after peeling off Fit-checker; Group 3: surface treatment with wet pumice; Group 4: 37% phosphoric acid treatment; Group 5: 10% polyacrylic acid treatment. Later, Type 1 Glass Ionomer Cement (GIC) liquid drop was placed on the dentin and photographs were made horizontally using a standardized procedure. Contact angles were measured using AUTOCAD software. Obtained values were statistically analyzed using the One-way ANOVA test and Tukey’s Post hoc test. Samples of each group were examined using the scanning electron microscope. Results: Statistically significant difference was observed among all the groups except between Group 4 and Group 2 (p > 0.05). SEM images of various groups showed a significant difference in roughness patterns. Conclusion: Surface treatment with pumice and the rotary brush was an effective method among the three in cleaning the residual silicone film.

Influence of morphological parameters of natural teeth and fixed partial dentures supported by dental implants on the time of occlusion

To study the effect of morphological parameters of natural teeth and fixed partial dentures supported by dental implants on the time of occlusion. The study of the morphological parameters of the first right upper and lower molars of natural teeth and fixed partial dentures supported by dental implants in the positions of the first molars of the upper and lower jaws, followed by determination of the relationship between the obtained data and the occlusion time using mathematical and statistical analysis. The study of the morphology of the occlusal surface of natural teeth and fixed partial dentures supported by dental implants did not reveal significant differences in the results of measuring the distances between the cusps of the upper and lower first molars, both natural teeth and fixed partial dentures supported by dental implants. However, the angles of the slopes of the cusps and the angles between cusps in natural teeth are sharper than those of artificial crowns. According to the correlation analysis in both groups, the relationship between the occlusion time and the morphological parameters of the lower molars was determined; the relationship between the morphological parameters of the upper molars and the occlusion time was not revealed.

Influence of Isolation Methods on Retention of Pit and Fissure Sealants in Young Permanent Teeth based on Simonsen’s Criteria: A Randomised Clinical Trial

Introduction: Pit and Fissure Sealants (PFS) are chemically-active liquid materials that are introduced into the occlusal surface of caries-susceptible teeth. These form a micro mechanically bonded, protective layer preventing access to caries-producing bacteria, from rest of the oral environment. Aim: To evaluate the retention of PFS placed on young permanent teeth using two isolation methods. Materials and Methods: This clinical study was carried out in the Department of Paediatric and Preventive Dentistry, at Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India. One hundred Permanent First Molars (PFM) from 25 healthy, cooperative children in the age group of 6-9 years were assigned by block randomisation into two groups (isolation type); each group containing the upper and lower PFMs of the right and left side receiving two different treatment modalities (split-mouth design). In Group I (n=50 teeth), the teeth received sealant with rubber dam isolation, and in Group II (n=50 teeth), with cotton roll isolation. The sealant was applied to all the PFMs as indicated. All the teeth were evaluated using Simonsen’s criteria at regular intervals of 3, 6, and 12 months. The data collected were subjected to statistical analysis using the SPSS statistical package (version 17) and statistical significance was set at 0.05. The difference in the retention of PFS with the two isolation methods was analysed using the Chi-square test. Results: After 12 months, the marginal integrity rate for sealants placed with a rubber dam and cotton roll isolation were 75% and 64%, respectively. The results were better in Group I than in Group II, although there were no statistically significant differences with respect to marginal integrity, discolouration, and anatomical failure. Conclusion: Retention of PFS in young permanent teeth was better with rubber dam than cotton rolls for isolation, though the results were not statistically significant.

Statistička analiza kriterijuma za procenu efikasnosti ispuna na stalnim zubima kod dece

Introduction: The effectiveness of caries treatment depends on many factors, such as the condition of dental tissues, the stage of root development, the period of dentition, the quality of preparation and isolation, the optimal choice of material for restoration. The problem of choosing the filling material is acute in each treatment of caries in children with mixed and permanent dentition. The aim: Todetermine and statistically substantiate parameters for choosing restorative material for permanent teeth in children with different stages of root development. Materials and methods: 248 children aged 7 to 11 (122 boys and 126 girls) and 246 children aged 12 to 17 (120 boys and 126 girls),students of Uzhhorod Secondary School №20 were examined. Restoration materials -"Polofil Supra" (VOCO, Germany) and "DyracteXtra" (Densply, USA). The following criteria were investigated: saliva pH, area of destruction of the occlusal surface of masticatory teeth, stage of root development, depth of the lesion and cavity topography, the acid resistance of the enamel. For the purpose of statistical justification of the selected parameters that pointed as significant in the choice of restorative materials, and for the analysis of the interrelations of the parameters studied, the Spearman correlation coefficient (r) was determined. The correlation coefficient was considered statistically significant when p <0.05. Results: For children aged 7-17 years to restore permanent teeth during the period of mixed and permanent dentition, the best materials in use were: "Polofil Supra" (VOCO, Germany) and "DyracteXtra" (Dentsply, USA). Conclusion: To restore permanent teeth in any stage of root development, it is rational to use a compomer material "DyracteXtra" (r = 0.80), and a composite material "Polofil Supra" -under the conditions of the formed root, at a pH level of more than 6.2, a high degree acid resistance of the enamel and the area of destruction of the occlusal surface less than 0.55 (r = 0.72).

3D analysis of occlusal surfaces of teeth and their contacts. Part II. Assessment of the degree of wear of occlusal surfaces

Of this study was to evaluate the informativeness of the developed tools for 3D analysis of occlusal surfaces and their mutual contacts on the example of tooth rows with different degrees of abrasion and bite features. The developed method of 3D analysis of occlusal contacts (in the range of 0-300 microns of occlusal surfaces separation) was tested in 50 people with different degrees of tooth abrasion. It is determined that the area of direct contacts (in the range of separation 0-50 microns) increases from 30 to 150% depending on the degree of abrasion of teeth during virtual optimization of contacts. The area of occlusal contacts increases as the teeth wear out, and the relief index decreases. With virtual alignment of abnormally placed teeth, the contact area also increases, with the exception of patients with tooth abrasion up to dentin. When teeth wear out, the proportion of direct contact zones increases relative to the total contact area and the proportion of near-contact zones decreases (200-300 microns). Four key indicators and ranges of their values for differential diagnosis of the degree of tooth abrasion were determined.

3D analysis of occlusal surfaces of teeth and their contacts. Part I. Development of a method for assessing the area of the occlusal surface, the severity of its relief and the histogram of contacts

The article is devoted to the development of methods and software for 3D analysis of the occlusal surface of teeth and occlusal contacts between antagonists. An algorithm for accurately determining the boundaries of the occlusal surface on the tooth surface for subsequent quantitative analysis: the area of the occlusal surface, the relief index, and the height of the cusps is presented. The area of not only direct contacts, but also near-contact zones in any of the selected surface separation ranges is quantified. Examples with geometric primitives and clinical examples explain the features and interpretation of 3D analysis datas obtained using the developed software.

3D analysis of occlusal surfaces of teeth and their contacts. Part III. Development of a method for assessing the balance of occlusal contacts

The aim of the study was to develop a technique for 3D analysis of the occlusal balance of teeth. The development was carried out on the basis of the Avantis 3D software («Avantis 3D» LLC, Russia) using teeth scans of 50 subjects with Class I and II (Division 1) malocclusion and different degree of tooth wear. The algorithm and formulas for calculating the balance of symmetry and antero-posterior occlusal balance are presented. The essential features of the technique and the interpretation of the obtained indicators are explained on different clinical cases. Statistical analysis of the results of measuring occlusal balance of patients with different degree of teeth wear and malocclusion is presented. It is determined that the balance of common contacts is more important than the balance of direct contacts. Alignment of teeth without noticeable wear provides a better occlusal balance then before. The occlusal balance of worn teeth after alignment may be not good and require selective grinding or restoration of their occlusal surfaces.

Difference in laminated mouthguard thickness according to the laminate order.

Mouthguard thickness should be maintained to prevent oral trauma by protecting the teeth and the surrounding soft tissue. The aim of this study was to examine the difference in laminated mouthguard thickness according to the laminate order. The mouthguard sheets used in this study were 2.0mm and 3.0mm ethylene-vinyl acetate. The sheets were pressure-formed using a pressure former, and the laminated mouthguard was fabricated. Two laminate conditions were examined. One condition used the 2.0-mm sheet for the first layer and the 3.0-mm sheet for the second layer (condition 2F3S) and the other condition used the 3.0-mm sheet for the first layer and 2.0-mm sheet for the second layer (condition 3F2S). The first layer was trimmed to cover the labial surface and incisal edge of the anterior teeth and the buccal and occlusal surfaces of the posterior teeth. The second layer was formed over the first layer. The mouthguard thickness was measured at the labial surface of the central incisor and the buccal and occlusal surfaces of the first molar. Differences in thickness by measurement region of mouthguards formed under different laminate conditions were analyzed by two-way analysis of variance. The mouthguard thickness was significantly different at the measured regions of the central incisors and the first molars (p<.01). The thickness at the labial surface of the central incisor and at the buccal and occlusal surfaces of the first molar became statistically significantly larger with the 3F2S condition than that for the 2F3S condition (p<.05 or p<.01). The thickness of the laminated mouthguard became larger when the sheet thickness of the first layer was greater. It is recommended to use the thicker mouthguard sheet as the first layer when fabricating a laminated mouthguard.

Effect of screw access channel on the fracture rate of lithium disilicate cement-retained implant-supported posterior crowns

Statement of problemWhether the presence of a screw access channel on the occlusal surface of a lithium disilicate cement-retained single tooth implant restoration reduces its fracture rate is unclear. PurposeThe purpose of this randomized controlled clinical trial was to compare the fracture rate of lithium disilicate cement-retained posterior single tooth implant restorations with or without screw access channels. The study also evaluated whether the crown dimensions and location of the occlusal screw access channel would affect the fracture rate. Material and methodsA split-mouth study was conducted where 40 participants having 2 implants placed to restore single missing posterior teeth with crowns were enrolled. Implants were randomly allocated into a conventional crown group or a screw access group, receiving cement-retained restorations fabricated from lithium disilicate glass-ceramic with and without an occlusal screw access channel. Crown dimensions were recorded in millimeters from the designing software program. Follow-up evaluations were made at 3, 6, and 12 months by observing visible cracks or fractures of the crowns. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Student and Welch t tests (α=.05). ResultsAfter a 12-month follow-up period, no crowns fractured or revealed visible cracks, resulting in a 100% success rate. No statistically significant differences were found between the conventional crown group and screw access channel group in all crown dimensions (P>.05). ConclusionsThe presence of an occlusal screw access channel did not affect the short-term fracture rate of lithium disilicate cement-retained single implant–supported posterior crowns. The amount of axial cantilever, occlusal ceramic thickness, and location of the screw access channel on the occlusal surface of the restoration have no effect on its fracture rate.

Placement of posterior composite restorations in United Kingdom dental practices: techniques, problems, and attitudes

To investigate the range of techniques used by U.K. general dental practitioners when placing posterior composites, their attitudes and opinions and problems encountered. A pre-piloted questionnaire was distributed to 500 UK GDPs selected at random from the U.K. Dentists Register requesting specific information on attitudes, use and problems encountered in relation to posterior composite placement. 254 useable replies were returned (response rate= 51%). Over 95% of respondents would consider placing posterior composites, but only 33% (n=84) would regularly or often place composite in the occlusal surface of a molar tooth. 62% of respondents (n=157) are influenced by articles in peer-reviewed journals when deciding to place a posterior composite, while 95% (n=241) reported that they are not influenced by advertising. Techniques for managing operatively exposed dentine vary, and are related to the depth of the dentine cavity: 79% (n=201) use a 'dentine-bonding' technique (i.e., no base/liner) approach for shallow cavities, while only 9% (n=23) would consider this approach for a deep dentine cavity. Only 10% of respondents (n=25) use a sectional metal matrix system for restoring occlusoproximal cavities, while 29% (n=74) use transparent matrix systems, and 61% (n=155) use a circumferential metal matrix system. More than one-half (52%, n=132) of practitioners reported they experienced problems with food packing in more than one in four posterior composites placed. Despite having been previously discouraged by financial guidelines and with probable limited exposure to posterior composite instruction at dental school, U.K. GDPs are placing posterior composites with reasonable reference to current best available evidence. Diverse opinions exist on the management of certain clinical scenarios, such as of operatively exposed dentine.

Accuracy of different tooth surfaces on 3D printed dental models: orthodontic perspective

BackgroundFew studies have been reported regarding the accuracy of 3D-printed models for orthodontic applications. The aim of this study was to assess the accuracy of 3D-printed dental models of different tooth surfaces.MethodsThirty volunteers were recruited from the hospital, and then their dental models were produced by means of oral scanning and a stereolithography-based 3D printer. Each printed model was digitally scanned and compared with the oral-scanned STL file via superimposition analysis. A color map was used to assess the accuracy of different surfaces (occlusal, buccal, lingual) of anterior and posterior teeth. The Tukey test was used to evaluate the differences between the superimposition.ResultsStatistically significant differences were found in the average deviations of different tooth surfaces (P < 0.05). The mean average absolute deviations of the occlusal surfaces of posterior teeth were greater than those of other surfaces. Percentages of points beyond the upper and lower limits of different tooth surfaces displayed the same results (P < 0.05).ConclusionsOcclusal surfaces, especially pits and fissures of posterior teeth on 3D printed maxillary dental models, showed greater distortions than those of other teeth and regions.

Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study.

Background: It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures.Objectives: To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture.Study Design: Observational longitudinal study.Methods: Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by regression analysis.Results: The evolution of 785 fissures (467 type 1a, 271 type 1b, 47 type 2) was recorded. Fissure characteristics were observed to remain unchanged, disappear, become longer, shorter, change in configuration or change in color. Partial crown fractures (22 maxillary, 50 mandibular) were recorded in 52 cheek teeth in 22/36 horses. Fifty-nine of these fractures evolved from previously observed fissures (24 type 1a, 29 type 1b, 6 type 2). All fissure types proved to be a significant risk factor for the development of a crown fracture (p < 0.001), with the highest odds for type 2 fissures (OR = 14.27; 95% CI = 4.88–41.71). Other significant risk factors were the time of follow-up (p < 0.001), mandibular teeth (p < 0.001) and the lingual side of a tooth (p < 0.001). All fractures were non-complicated.Main Limitations: Some horses were prematurely lost for follow-up, which perhaps influenced the results. A longer follow-up period would have also allowed an evaluation of the risk for pulp disease on the long term subsequent to partial crown fractures.Conclusions: The presence of a fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth, and time of follow-up proved to be significant risk factors for development of a cheek tooth crown fracture. Type 2 fissures showed the highest odds followed by type 1b fissures. The observed partial crown fractures demonstrated a low clinical impact whereby no tooth showed signs of development of endodontal disease.

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents.

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents.

Prevalence of Occlusal Morphological Patterns of Permanent Mandibular First Molar

Teeth are informative indicators for the study of human populations, serving as markers and thebases for comparisons of genetic origin. Mandibular first molar is represented as 36 or 46 in the FDI system.The occlusal surfaces of posterior teeth occlude with the opposing occlusal surfaces of posterior teeth. Theocclusal morphology differs in each posterior tooth. The occlusal aspect of posterior teeth is developed intocusps ( 5 or 4 or 6 ) and grooves ( Y or + or X pattern ). These cuspal patterns and groove patterns help inforensic identification in cases like gender determination and also to identify the ethnic background of anindividual. Variation in degree of expression and frequency of teeth in dentitions of different populationsis different which may be helpful for forensic identification. The aim of the study was to determine theprevalence of different occlusal morphological patterns of permanent mandibular first molars. The studyincluded a predominantly South Indian population. Approval was received from the Institutional ReviewBoard. Study was conducted with 100 participants who were randomly selected. The occlusal morphologypatterns (number of cusps and groove pattern) of left and right permanent mandibular first molar wereassessed from the photographs of the oral cavity and the date was recorded. Results showed that the mostprevalent number of cusps in permanent mandibular first molar was 5 cusps ( 71% ) and Most prevalentgroove pattern in permanent mandibular first molar was Y pattern. It was also observed that the combinationof the 5Y pattern was more prominent in females than in males.

Microtensile bond strength of Resin composite to Normal dentin and Caries - affected dentin with total-etch and self-etch bonding adhesives before and after thermocycling

Objectives: To measure the microtensile bond strength of total-etch and self-etch adhesives to intact and caries affected dentin. To check the effect of thermal cycling on the bond strength of these adhesives to caries affected and intact dentin. Materials and Methods: Thirty extracted carious human molars were assigned to two groups according to adhesive used i.e Adper Single Bond (Total etch) with P90 (Self-etch). The occlusal surface of teeth will be sectioned to expose dentin and built up with Filtek 90 composite (3M) to a 3 mm height. The teeth were then sectioned to obtain rods of 6mm length and 1mm width and 1 mm depth with dentin-composite interface located at the centre. The specimens were examined under microscope to separate caries–affected dentin and unaffected dentin into two groups. Half the specimens from each group were subjected to 3000 thermo cycles (5 deg Celsius to 55 deg Celsius). All specimens were subjected to microtensile bond strength testing in a special apparatus attached to the Universal testing machine. Results were recorded and data was statistically analyzed with Students unpaired ‘t’ test. Results: Students ‘t’ test showed that the values had a statistically significant difference observed between total etch (T.E) i.e. Adper Single Bond 2 and self etch (S.E) i.e. P 90; caries-affected dentin (CAD) and normal dentin (ND); with thermocycling and without thermocycling. Interpretation and Conclusion: The present study concludes that total-etch has a higher bond strength compared to self-etch. Bond strengths are higher to normal dentin than caries-affected dentin. Thermocycling lowers the bond strength values of all the groups.

A State-of-the-Art Review on the Wear of the Occlusal Surfaces of Natural Teeth and Prosthetic Crowns

This review focuses on the wear mechanisms of natural and restorative dental materials, presenting a comprehensive description and analysis of the works published in the last two decades on the wear at the interface of occlusal surfaces. Different groups of tribological pairs were considered: tooth-tooth, tooth-restorative material (tooth-ceramic, tooth-resin-based-materials, and tooth-metal), and restorative-restorative materials. The lack of standardization of the wear tests impairs the direct comparison of the obtained results. However, it was possible to infer about the main wear mechanisms observed on the different classes of dental materials. Concerning ceramics, their toughness and surface finishing determines the wear of antagonist tooth. Abrasion revealed to be the main wear mechanisms at occlusal interface. In the case of resin-based composites, the cohesion of the organic matrix and the nature, shape, and amount of filler particles greatly influences the dental wear. The protruding and detachment of the filler particles are the main causes of abrasion of antagonist enamel. Metallic materials induce lower wear on antagonist enamel than the other classes of materials, because of their low hardness and high ductility. Most of the studies revealed plastic deformation and adhesive wear as the main wear mechanisms. Overall, more research in this area is needed for a better understanding of the mechanisms involved at the occlusal surfaces wear. This would be essential for the development of more suitable restoration materials.

Dental microwear as a diet indicator in the seventeenth-century human population from Iasi City, Romania

The dental microwear analysis (DMA) focuses on diet reconstructions, being able to provide proxy indicators of some events regarding technological shifts in food processing and social hierarchy and differences between individuals. Although DMA approaches diet characterization in ancient times, medieval samples have received limited attention, especially in Eastern Europe. The aim of this article is to explore, identify, and describe within-group patterns of dental microwear variation depending on sex and anatomic position (i.e., left/right, superior/inferior). The bioarchaeological material belongs to the Princely Court Necropolis of the seventeenth century discovered in Iasi (Romania)—the former capital city of Medieval Moldavia. We analyzed the micromorphological features on the occlusal surface of the second molar tooth through scanning electronic microscopy and imaging. Quantification of the microwear features (i.e., fine and coarse scratches, small and large pits) along with their bidimensional measurements (i.e., length and width) has been subjected to multivariate analysis. Our results show heterogeneous distribution of the microwear features within the analyzed second molars. Although the general microwear profile is dominated by fine and coarse scratches, large pits are also present. We can generally characterize the food as abrasive and relatively hard. In females, there are two microwear profiles highlighted based on the molar laterality, which suggests the use of the right side of the oral cavity to process harder foods. In males, the microwear profile is homogeneous and does not differ by laterality; it shows a great affinity with the pattern of the female right molars.

Dentists clinical decision-making for erosive tooth wear: An online pilot study

ObjectiveErosive tooth wear (ETW) is an irreversible loss of dental hard tissue. This pilot study examined dentists’ ability to diagnose and manage ETW relative to sound and caries-affected teeth. MethodsDentists recruited through the Indiana Dental Association (N = 36) participated in an internet-based survey, containing twenty-two standardized images of buccal and occlusal surfaces of teeth (sound, ETW, or caries). For each image, they provided diagnosis (presence and differentiation) of dental condition, confidence in their judgment, management need, and likelihood to recommend specific management strategies. Dentists made these judgments for teeth with no, initial, moderate, or severe ETW/caries. ResultsDentists demonstrated poor detection of ETW compared to sound teeth and caries at each level of severity. The dentists were less confident, less able to correctly diagnose and manage ETW, and less likely to recommend most management strategies for ETW than caries at each level of severity. ConclusionsDentists had difficulty correctly diagnosing (both detection and differentiation) and managing ETW, across all severity levels and particularly in early stages. These difficulties were particularly apparent when compared to caries. The current results are clinically relevant given the importance of early diagnosis for ETW management.