Tooth Attrition Research Articles

Sympathomimetic effects of chronic methamphetamine abuse on oral health: a cross-sectional study.

BackgroundMethamphetamine, a highly addictive sympathomimetic stimulant, is currently widely abused worldwide and has been associated with devastating effects on oral health, resulting in the term “meth mouth”. However, “meth mouth” pathology is primarily based on case reports with a lack of systematic clinical evaluation. Therefore, we have conducted a systematic study to investigate (1) the pharmacological impact of methamphetamine on oral health with regard to saliva function, including the parameters saliva flow rate and total saliva production (ml/5 min) and the buffering capacity of saliva; (2) the contribution of the symptoms of bruxism and muscle trismus to potential oral health damage.MethodsWe assessed the data of 100 chronic methamphetamine abusers and 100 matched-pair comparison participants. Primarily, we conducted an anamnesis with all methamphetamine abusers with regard to saliva dysfunctions, jaw clenching and pain in the temporomandibular joint. Subsequently, in the first part of the clinical enquiry, we tested the saliva flow rate and the total saliva production (ml/5 min) by using the sialometry method and the buffer capacity of saliva by determining the pH-value. In the second part of the clinical enquiry, we evaluated bruxism symptoms with respect to generalized tooth attrition, dentine exposure and visible enamel cracks and examined a potential muscle trismus by measuring the maximal opening of the mouth.ResultsThe majority of methamphetamine abusers reported a dry mouth (72 %) and jaw clenching (68 %). Almost half of all methamphetamine abusers experienced pain in the temporomandibular joint (47 %). With regard to the clinical findings, methamphetamine abusers showed significantly lower total saliva production (ml/5 min) (p < 0.001), lower pH-values of their saliva (p < 0.001) and more bruxism symptoms (p < 0.001). However, we found no relevant trismus symptoms on comparing the two groups (p > 0.05).ConclusionsThe sympathomimetic effects of chronic methamphetamine abuse may lead to dry mouth and extensive bruxism and therefore can increase the risk for caries decay, periodontal lesions and tooth wear. Furthermore, a significant decline of saliva buffer capacity in methamphetamine abusers may trigger the risk for dental erosions. Methamphetamine abusers and practitioners should be aware of these symptoms.

Deterioration of teeth and alveolar bone loss due to chronic environmental high-level fluoride and low calcium exposure.

Health risks due to chronic exposure to highly fluoridated groundwater could be underestimated because fluoride might not only influence the teeth in an aesthetic manner but also seems to led to dentoalveolar structure changes. Therefore, we studied the tooth and alveolar bone structures of Dorper sheep chronically exposed to very highly fluoridated and low calcium groundwater in the Kalahari Desert in comparison to controls consuming groundwater with low fluoride and normal calcium levels within the World Health Organization (WHO) recommended range. Two flocks of Dorper ewes in Namibia were studied. Chemical analyses of water, blood and urine were performed. Mineralized tissue investigations included radiography, HR-pQCT analyses, histomorphometry, energy-dispersive X-ray spectroscopy and X-ray diffraction-analyses. Fluoride levels were significantly elevated in water, blood and urine samples in the Kalahari group compared to the low fluoride control samples. In addition to high fluoride, low calcium levels were detected in the Kalahari water. Tooth height and mandibular bone quality were significantly decreased in sheep, exposed to very high levels of fluoride and low levels of calcium in drinking water. Particularly, bone volume and cortical thickness of the mandibular bone were significantly reduced in these sheep. The current study suggests that chronic environmental fluoride exposure with levels above the recommended limits in combination with low calcium uptake can cause significant attrition of teeth and a significant impaired mandibular bone quality. In the presence of high fluoride and low calcium-associated dental changes, deterioration of the mandibular bone and a potential alveolar bone loss needs to be considered regardless whether other signs of systemic skeletal fluorosis are observed or not.

咬耗による咬合違和感を咬合再構成で改善した症例

症例の概要：患者は66歳男性．咬合違和感を主訴に当科を受診した．全顎的に進行した咬耗が認められ，それに起因した他覚的および自覚的な症状が見られた．咬合再構成を行い，その評価後，下顎全歯の歯冠修復を行った．クレンチングに対してスプリントの装着，半年毎の定期検診を行い，術後4年が経過している． 考察：適正な咬合高径と犬歯ガイドの付与，第二大臼歯の側方運動時の咬合干渉の除去した結果，主訴である咬合違和感が解消されたと考えられる． 結論：全顎的な咬耗による咬合違和感を訴える症例に対し，咬合再構成を行ったことで，咬合違和感やその他の諸症状が消失し患者の健康と満足が得られた．

Condylar Movement Assessment is Severe Attrition Patient Undergoing Orthodontic Treatment: Joint Vibrant Analysis Procedure

Orthodontic treatment of the patient with severe teeth attrition was performed with the provisional restorations to recover occlusal vertical dimension. The increase in VDO causes posterior mandibular rotation and the increase in overjet. The overjet correction is one of the main goals of the orthodontic treatment in these patients. The anterior mandibular position was obtained at the end of orthodontic treatment. Condylar positions were assessed immediately after the bite raising procedure and after the completion of treatment. Both CBCTs of the temporomandibular joints and the Joint vibration analysis (JVA) were performed. Coronal views of the CBCTs of TMJs and zoomed vibration views of the JVA of TMJs are essential in assessment of the condylar instability.

Frequency of Obstructive Sleep Apnea Syndrome in Dental Patients with Tooth Wear

To estimate the frequency of obstructive sleep apnea syndrome (OSAS) in dental patients with tooth wear, and to assess the role of dentists in the identification of patients at risk of OSAS. Dental patients with tooth wear and treated with occlusal splint were prospectively recruited to perform sleep study. The severity of tooth wear was established by the treating dentist before patient referral to sleep disorders unit. Sleep questionnaires, anthropometric measurements, and validated respiratory polygraphy were performed. All patients with dental wear were offered a sleepiness analysis. Of 31 recruited patients, 30 (77% males) participated in this study. Patients' mean age was 58.5 ± 10.7 years (range: 35-90 years) and the body mass index was 27.9 ± 3.4 kg/m(2). Tooth wear was mild in 13 patients, moderate in 8 and severe in 9. The mean apnea-hypopnea index (AHI) was 32.4 ± 24.9. AHI < 5 was reported in 2 patients, AHI of 5-29 in 17, and AHI ≥ 30 in 11. A statistically significant association was found between AHI severity and tooth wear severity (Spearman R = 0.505; p = 0.004). Tooth wear could be a tool to identify those patients at risk of having OSAS. This highlights the importance of dental professionals to identify and refer patients with OSAS.

Occlusal Rehabilitation of Severely Mutilated Dentition

ABSTRACTSevere caries, attrition, abrasion, erosions of anterior teeth lead to loss of anterior guidance. This in turn causes attrition of posterior teeth and loss of occlusal vertical dimension. To gain the space for esthetic rehabilitation in these cases is challenging task. The required space can be achieved by crown lengthening and increasing the occlusal vertical dimension within physiologic limits. Unmethodical alteration of vertical dimension may lead to temporomandibular joint (TMJ) and masticatory muscle problems. Careful treatment planning and stable occlusion are key point of successful treatment. This case report describes the methodical multidisciplinary approach used to treat severely mutilated dentition.How to cite this articleGurav SV, Ram SM, Khanna TS. Occlusal Rehabilitation of Severely Mutilated Dentition. J Contemp Dent 2015;5(1):48-52.

Esthetic and functional rehabilitation of a patient with bruxism using hobo′s twin table technique

A female patient aged 28 years reported to the Department of Prosthodontics and crown and bridge with a complaint of missing teeth in maxillary anterior region. An interdisciplinary approach was planned for rehabilitating the patient. The oral presentation showed severe attrition of the anterior teeth and loss of vertical dimension of occlusion. A full mouth rehabilitation was thus carried out using multidisciplinary approach along with Hobos twin table technique to restore the dentition to esthetic and functional needs and the patient was rehabilitated satisfactorily.

前歯部咬耗症による審美障害を改善した1症例

前歯部咬耗症による審美障害を改善した1症例

Management of myofacial pain with liquid oral splint

Occlusal splint therapy has been one of the conventional modalities of the management of temporomandibular disorders. However, it is important for a clinician to make an evidence.based decision on choosing the appropriate type of splint. Currently, the much-discussed one is the liquid supported the occlusal splints. A 19-year-old girl diagnosed with myofacial pain, presented with a chief complaint of the history of pain and headache which is severe early in the morning and continuous throughout the day since 1-month, also associated with the tenderness of masticatory muscles and attrition of the lower anterior teeth. The patient was provided with a liquid occlusal splint for a period of 3 months with check.up recalls at predefined intervals. Post the liquid occlusal splint therapy, the patient showed a significant decrease in both subjective and objective pain.

Prevalence of Temporomandibular Joint Disorder and Stress Related Dental Attritions Among Army Personnel

Background: Dental attrition is capable of causing toothache, temporomandibular disorders (TMDs), and vertical facial dimension loss. It may also harden prosthesis fabrication. The most frequent causes of this problem are stress and mental tensions. Objectives: However, there is no documented or published data on the prevalence of dental attrition and TMDs among army personnel. Nevertheless, by timely recognition of the susceptible cases, it is possible to prevent or stop the development of this condition. Patients and Methods: The participants were patients seeking general dentistry treatments in two military based centers in Tehran. Sample consisted of 200 army personnel and 200 civilian patients. All the participants were divided into three age groups: under 30, between 30 and 50, and above 50 years old. The examinations included dental attrition, temporomandibular joint (TMJ) click on opening or closing, limitation on mouth opening, pain on TMJ or chewing muscle or tenderness in palpation. The participants were also asked to declare whether they have contributed in the imposed war. Results: Dental attrition was significantly more frequent in army personnel than civilian population. Also the prevalence of such a problem was significantly more frequent in those participated at war. Considering other examinations, no statistically significant differences were seen between army personnel and lay persons. Conclusions: In order to prevent or treat dental attrition in susceptible army personnel, part-time wear of night guard may be prescribed. Keywords: Tooth Attrition; Military Personnel; Temporomandibular Joint Disorders

Comparative cross-sectional study of masticatory performance and mastication predominance for patients with missing posterior teeth

PurposeMissing posterior teeth can decrease masticatory function and cause horizontal mastication deviation, i.e., mastication predominance. Mastication predominance may lead to abnormal tooth attrition and temporomandibular disorders. This study evaluated masticatory performance and mastication predominance in patients with missing posterior teeth to investigate effects of missing posterior teeth on masticatory performance and mastication predominance. MethodsThirty volunteers with normal dentition (control group), 30 patients with unilateral missing posterior teeth (unilateral group), and 23 patients with bilateral missing posterior teeth (bilateral group) participated. Gummy jellies were used to evaluate participants’ masticatory performance, and electromyography was used to assess the degree of mastication predominance. Chewing gums, gummy jellies, and peanuts were used as foods of various hardnesses for evaluating mastication predominance. ResultsCompared with the control group, masticatory performance did not differ in the unilateral group but was significantly decreased in the bilateral group. With chewing gum and gummy jellies, the degree of mastication predominance was significantly increased in both unilateral and bilateral groups than the control group. With peanuts, the degree of mastication predominance was significantly increased in the unilateral group than the control group. ConclusionsAlthough masticatory performance was not decreased in the unilateral group, the degree of mastication predominance was increased. Decreased masticatory performance was observed in the bilateral group, and for foods with normal hardness and soft foods, the degree of mastication predominance was increased. These results suggested that mastication predominance should be considered in the recovery of masticatory performance in patients with missing posterior teeth.

Quantitative morphological analysis of bovid teeth and implications for paleoenvironmental reconstruction of Plovers Lake, Gauteng Province, South Africa

Fossil bovids are widely recognized as valuable ecological indicators, useful for reconstructing paleoenvironments associated with the hominins of Africa. Taxonomic identification of bovid remains in the Plio-Pleistocene fossil deposits of South Africa is based predominantly on dental remains, usually isolated teeth. However, factors such as age and degree of occlusal attrition of teeth often render taxonomic identification difficult. In addition, teeth of closely related bovid taxa can be particularly difficult to diagnose at the species level. Given that closely related bovid species often have differing ecological requirements, imprecise identification of bovids recovered from fossil sites can have significant ramifications when reconstructing environments. This study tests a method for accurately identifying bovid teeth using Elliptical Fourier Function Analysis in order to standardize their identification. The occlusal surfaces of maxillary and mandibular molars of bovid teeth from twenty extant species were digitized and the quantified tooth forms (size and shape) were statistically compared to other closely related bovids. Results indicated that all upper and lower teeth classified correctly using discriminant function analysis ≥85% of the time, suggesting that occlusal surface form can reliably differentiate between closely related, morphologically similar bovids.This method was applied to a sample of fossil bovid teeth previously identified as “medium-sized alcelaphine” from Plovers Lake, Gauteng Province, South Africa. Precise taxonomic identification of these alcelaphines result in the earliest recorded presence of Alcelaphus buselaphus and Connochaetes gnou in Gauteng Province, as well as potentially the earliest documented co-occurrence of these taxa alongside Connochaetes taurinus and Damaliscus dorcas in South Africa. Revising the paleoenvironment reconstructed for Plovers Lake suggests that it was likely not much more densely wooded than the area today. This contradicts the paleoenvironment previously inferred for the site, suggesting that overreliance on rare and/or small-bodied taxa in the initial report on Plovers Lake overemphasized the extent of woodlands that were indicated.

Anterior Teeth Mutilation and The Occurrence of Posterior Teeth Atrition in Siberut Island

The Mentawai ethnic group is accustomed to the practice of anterior teeth mutilation on males and females prior to reaching puberty age at Siberut Island, Mentawai Islands Regency, West Sumatra Province. Objective: of this research was to analyze the effects of anterior teeth mutilation on the teeth of the Mentawai ethnic, and prove that there is a correlation between anterior teeth mutilation and posterior teeth attritions. Material & method: There were 179 respondents who contributed to this study by applying accidental sampling method, consist of 96 respondents had anterior teeth mutilations and 83 non-mutilation respondents were found. Among respondents with anterior teeth mutilation, 53.07% of them had posterior teeth attritions. Only 0.56% of the respondent with anterior teeth mutilation did not have posterior teeth attrition. On the other hand, respondent without anterior teeth mutilation who got posterior teeth attritiona nd without posterior teeth attrition were almost similar (27.93% and 18.44%, respectively). Conclusion: the anterior teeth mutilation which is a ritual of Mentawai ethnic group and has been perfomred for generations, is significantly influent the occurrence of posterior teeth attrition. DOI: 10.14693/jdi.v16i2.96

Phasic jaw motor episodes in healthy subjects with or without clinical signs and symptoms of sleep bruxism: a pilot study

To investigate the association between each clinical diagnosis criterion for sleep bruxism (SB) and the frequency of jaw motor events during sleep. Video-polysomnography was performed on 17 healthy adult subjects (mean age, 26.7 ± 2.8 years), with at least one of the following clinical signs and symptoms of SB: (1) a report of frequent tooth grinding, (2) tooth attrition with dentine exposure through at least three occlusal surfaces, (3) morning masticatory muscle symptoms, and (4) masseter muscle hypertrophy. Episodes of rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored visually. These variables were compared with regards to the presence or absence of each clinical sign and symptom. In 17 subjects, 4.0 ± 2.5/h (0.1-10.2) RMMA and 1.0 ± 0.8/h (0-2.4) isolated tonic episodes were observed (total episodes: 5.0 ± 2.4/h (1.2-11.6)). Subjects with self-reported grinding sounds (n=7) exhibited significantly higher numbers of RMMA episodes (5.7 ± 2.3/h) than those without (n=10; 2.8 ± 1.8/h) (p=0.011). Similarly, subjects with tooth attrition (n=6) showed significantly higher number of RMMA episodes (5.6 ± 3.1/h) than those without (n=11; 3.2 ± 1.6/h) (p=0.049). The occurrence of RMMA did not differ between the presence and absence of morning masticatory muscle symptoms or muscle hypertrophy. Clinical signs and symptoms frequently used for diagnosing SB can represent different clinical and physiological aspects of jaw motor activity during sleep.

Full Mouth Rehabilitation of Severe Fluorozed Teeth with an Interdisciplinary Approach (6 Handed Dentistry)

Whenever the treatment revolves around structural balance and aesthetic harmony, the crux remains to be the periodontal health of the existing dentition. In such scenarios where restorations and aesthetics are of concern, biologic width (BW) is the initial and final frontier. Considering attrition of teeth, the resistance which is offered by them is definitely at a lower level as compared to teeth with adequate height. Clinical crowns of worn out teeth are seriously handicapped when it comes to bearing the occlusal loads, which can be brought back to normalcy by crown lengthening . Crown lengthening includes the surgical removal of soft and hard periodontal architecture to gain (vertical dimension) a supracrestal tooth length, thus allowing a longer clinical crown reestablishment of BW. This paper has described the full mouth rehabilitation of severe fluorozed and attrited teeth in a 35-year male with the use of an interdisciplinary approach (6 Handed Dentistry).

Full-mouth rehabilitation of a patient with reduced occlusal vertical dimension due to severe wear: a clinical report

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects. (J Korean Acad Prosthodont 2013;51:39-46)

Oral Tori Are Associated With Local Mechanical and Systemic Factors: A Case-Control Study

To estimate if various dental factors, medications, and medical conditions are associated with an increased risk for the presence of oral tori. Using a case-control study design, the investigators identified and adjudicated a sample of cases with torus palatinus (TP) and/or torus mandibularis (TM) during a 1.5-year period. The medical records were abstracted and data on dental factors, temporomandibular dysfunction (TMD), medications, and medical conditions were recorded. Risk estimates were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression analyses, and the P value was set at .05. The sample was composed of 66 subjects with TM, 34 subjects with TP, and 100 control subjects from the same database. Any form of oral torus (TP and/or TM) was associated significantly with TMD (AOR, 10.51; 95% CI, 4.46 to 24.78; P<.01) and tooth attrition (AOR, 5.22; 95% CI, 2.32 to 11.77; P<.01). TP was associated significantly with TMD (AOR, 4.14; 95% CI, 1.21 to 14.21; P<.05), tooth attrition (AOR, 38.18; 95% CI, 7.20 to 202.41; P<.01), and treated hypertension (AOR, 6.64; 95% CI, 1.31 to 33.57; P<.05). TM was associated significantly with TMD (AOR, 5.77; 95% CI, 2.38 to 13.98; P<.01), tooth attrition (AOR, 6.69; 95% CI, 2.78 to 16.14; P<.01), and a penicillin allergy (AOR, 4.45; 95% CI, 1.05 to 18.83; P<.05). This study provides clinical evidence showing significant associations between oral tori and various dental factors, medications, and medical conditions. These findings add to the list of environmental factors believed to contribute to the formation of oral tori.

Effect of occlusal splint therapy on maximum bite force in individuals with moderate to severe attrition of teeth

ObjectiveThe purpose of the pilot study was to determine the effect of restoring lost occlusal vertical dimension (OVD) due to attrition on maximum bite force in humans. MethodologyA total of 124 subjects in age range of 25–40 years, with moderate to severe attrition, having full complement of teeth were screened according to inclusion and exclusion criteria. After consent, occlusal vertical dimension was assessed by employing mechanical and physiological methods in the experimental group and a maxillary canine guided hard splint was fabricated for each subjects fulfilling inclusion criteria and with positive consent (78). Bite force in experimental group was measured before, immediately after delivery of splint and subsequently at an interval of four, eight, and twelve weeks. Due loss during follow up, only 50 subjects could be available for bite force recording till 12 weeks. Bite force of age, gender, height and weight matched controls with no signs of attrition was also measured for comparison. ResultsBite force of the experimental group was found to be significantly less than the matched controls (P=0.000) initially. After delivery of splint, bite force values increased progressively till twelve weeks. However comparison of bite force values of experimental group with control group showed no significant difference at end of eight (P=0.008) and twelve weeks (P=0.162). ConclusionIt was concluded that maximum bite force increases with restoration of lost vertical using splint therapy. A time period of 8–12 weeks is required to restore the maximum bite force value approximately similar to matched controls.

Craniofacial growth changes and dental attrition in the primary dentition

Presence of pronounced incisal and occlusal wear in primary dentition is fairly common in children. Several factors are implied, however, the possible correlation of craniofacial growth to the occurrence of severe incisal tooth wear in children has not been described to date. Thus, this study was aimed to find any association between the craniofacial growth changes and the occurrence of severe incisal wear in children. Twenty-seven sets of series of dental casts and corresponding lateral cephalograms are selected from the archive of Pediatric Dentistry, Department of Tokyo Medical and Dental University Hospital. Samples were divided into two groups based on the extent of incisal wear observed on the primary maxillary anterior teeth: slight attrition (N = 13) and severe attrition (n = 14) groups. Lateral cephalograms at early deciduous dentition at T1 (3.5 ± 0.6 years old) and late deciduous dentition at T2 (6.2 ± 0.6 years old) were manually traced and 17 linear and 22 angular measurements were measured with analyzing software (WinCeph ver.9). Annual growth rate for each sample was calculated to determine any significant difference between samples from two groups. Significant horizontal growth of the mandible with both the reduction of anterior tooth height and increase of posterior tooth height were found in the severe attrition group. Reduction of upper incisor angle to FH plane and upper dental arch length were also related with the attrition of teeth. The incisal tooth wear of deciduous teeth was significantly associated with the craniofacial growth changes.

Tooth attrition patterns in a group of Iraqi adults sample with different classes of malocclusion (A comparative study)

Background: Tooth attrition is wearing away of tooth structure during mastication. This study investigated tooth wear patterns in adults with different classes of malocclusion and compared them with normal occlusion. Materials and methods: The sample consisted of 363 subjects that were divided into 5 groups with an age range “18- 25” years: 85 normal occlusion, 128 class I with crowding, 90 class II division 1, 30 class II division 2 and 30 class III. Dental wear was assessed by using a modified version of the tooth wear index. Results: 1. The class I malocclusion group had statistically greater tooth wear in incisal surfaces of maxillary central and lateral incisors, and mandibular lateral incisors than did the normal occlusion. 2. The class II division 1 group had statistically greater tooth wear in the occlusal surfaces of maxillary second premolars, mandibular first and second premolars. Buccal surfaces of mandibular canines, mandibular second premolars and mandibular first molars than did the normal occlusion. 3. The class II division 2 malocclusion group had statistically greater tooth wear in labial surfaces of mandibular central and lateral incisors. Buccal surfaces of mandibular second premolars, mandibular first molars. Occlusal surfaces of maxillary first and second premolars and mandibular second premolars than did normal occlusion. 4. The class III malocclusion group had statistically greater tooth wear in the occlusal surfaces of maxillary first and second premolars than did normal occlusion. Conclusion: In conclusion subjects with normal occlusion and those with different classes of malocclusions have different tooth wear patterns.