Tooth Wear Research Articles

Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature.

Diet, nutrition, and oral health are closely linked. Malnutrition is a challenging health concern in older adults that is associated with physical decline affecting their daily activities and quality of life. The aim of this review is to provide an evidence-based summary of the relationship between diet and nutrition and oral health in older adults and its implications. The World Health Organization has declared healthy ageing a priority of its work on ageing. The American Dental Association confirmed the bidirectional relationship between diet and nutrition and oral health. The literature shows that diet and nutrition are related to oral diseases, including dental caries, periodontal diseases, tooth wear, and even oral cancer. Insufficient nutritional intake and poor dietary habits increase the risk of oral diseases, such as dental caries, in older adults. On the other hand, in older adults, poor oral conditions such as periodontal disease may induce pain, infection, and tooth loss, affecting nutritional intake. Surveys have shown that older adults, in particular, those in disadvantaged communities, suffered from nutritional deficiencies or imbalances affecting their oral health. In addition, the current literature shows that malnutrition is associated with frailty, hospitalization, mortality, and morbidity. Good oral health and functional dentition are essential to maintain sufficient nutritional intake among older adults and reduce the risk of malnutrition. Therefore, integrating oral health into general health care service in older adults is imperative to improve their nutritional and oral health status to achieve healthy ageing.

Interaction between Hexametaphosphate, Other Active Ingredients of Toothpastes, and Erosion-Abrasion in Enamel in vitro

Sodium hexametaphosphate (HMP) as toothpaste additive is claimed to reduce erosive tooth wear and to stabilize stannous ions. However, little is known about the impact of concentration and its interactions with fluoride (F) or stannous+fluoride ions (F/Sn) on enamel erosion and erosion-abrasion. In a 10 day cyclic in vitro erosion-abrasion model, 320 flat human enamel specimens were divided into ten groups (n = 32 each) and daily subjected to six erosive challenges (0.5% citric acid, 2 min) and two toothpaste suspension applications (2 min, 1:3 F-free toothpaste:mineral-salt solution, 0.23% sodium gluconate). Half of specimens per group were additionally brushed twice/day (200 g, 15 s) during suspension immersion. Nine suspensions contained HMP (0.25%, 1.75%, 3.25%), either on its own or combined with F (373 ppm F⁻) or F/Sn (800 ppm Sn²⁺, 373 ppm F⁻). One suspension contained sodium gluconate only (NegContr). After 10 days, specimens’ surfaces were analysed with profilometry, energy dispersive X-ray spectroscopy, and scanning electron microscopy. Tissue loss (µm, mean ± standard deviation) in NegContr was 10.9 ± 2.0 (erosion), 22.2 ± 1.6 (erosion-abrasion). Under erosive conditions, only 0.25% HMP in any combination and 1.75% HMP with F/Sn reduced loss significantly (−28% to −54%); 3.25% HMP without F and F/Sn increased loss significantly (+35%). With additional abrasion, no suspension reduced loss significantly compared to NegContr, instead, in groups without F and F/Sn or with 3.25% HMP loss was increased (+15% to +30%). Conclusively, at higher concentrations, HMP increased erosive tooth wear and seemed to reduce anti-erosive effects of fluoride and stannous ions.

Etiology, Diagnosis and Treatment of Bruxism in Children: A Review of the Literature

Bruxism, a parafunctional habit often linked to stress, anxiety, or medical conditions, causes various symptoms such as jaw pain, headaches, tooth wear and potentially temporomandibular joint disorders. While bruxism is prevalent in children, the literature remains unclear on its characteristics in this age group, prompting further review and investigation. The prevalence and onset of bruxism in children varies greatly between different studies and populations, with rates ranging from 6.5% to 88% and while most studies do not report a significant difference between boys and girls, some have found higher rates in one gender or the other. Bruxism has multiple causative factors including dental malocclusion, temporomandibular joint problems, emotional and psychological disorders, sleep disorders, nutritional deficiencies, medical problems, stress and heredity. However, the correlations between these factors and bruxism are multifactorial and sometimes contradictory. Bruxism diagnosis relies on patient history, clinical examination and diagnostic criteria, with polysomnography for nocturnal cases and BiteStrip® devices as alternatives, while diagnosing children presents challenges due to the lack of valid diagnostic means and the inadvisability of polysomnography. The recognition of stressors and application of psychological stress reduction methods have also been found to have a significant effect in reducing or eliminating the signs of bruxism in children. Treatment approaches for childhood bruxism vary and may include dental information, correction of malocclusion, occlusal splints, drugs and psychological methods. The use of hard occlusal splints has been found to prevent dental wear and reduce the frequency of bruxism in some studies, but further research is needed. The aim of this review is to summarize the characteristics of bruxism in childhood.

Advanced Dental Rehabilitation in Case of Severe Tooth Wear Caused by Gastroesophageal Reflux Disease and Bruxism During COVID-19 Pandemia: A Case Report

Stomatological manifestations of psychosomatic diseases can be associated, culminating in advanced oral alterations. These psychosomatic changes have also increased during the COVID-19 pandemic. In this perspective, parafunctional habits, such as bruxism and clenching, and gastro-oesophageal reflux disease can develop major dental destruction. Thus, various types of treatment are required in the rehabilitation of these patients. The purpose of this article is to present the case of a patient who developed severe tooth wear due to the association between gastro-oesophageal reflux disease and bruxism, during the COVID-19 pandemic. The patient was treated with a bite raising, direct composite restorations and removable prostheses.

Co-occurrence of periodontal lesions and dental wear in incisor and masticatory teeth in two sheep flocks in Brazil.

Periodontitis and tooth wear are multifactorial diseases with distinct etiopathogenesis that affect the health, feed efficiency and welfare of sheep. This study evaluated the co-occurrence of tooth wear and periodontal lesions in 129 ewes from two Brazilian flocks, clinically classified the lesions and presence of dental calculus, and identified potential pathogens in the dental biofilm of 63 ewes by polymerase chain reaction. Of the 129 ewes included in the study, 75 presented periodontal lesions, while all animals presented tooth wear and dental calculus. Of the animals with periodontal lesions, 16.2% had lesions in incisor teeth and 52.7% in masticatory teeth. Regarding excessive tooth wear, 38.6% had severe wear on the incisor teeth and 89.1% on the masticatory teeth. Ewes older than 36 months had a higher frequency of periodontal lesions in incisor teeth (p<0.001) and a greater amount of dental calculus (p < 0.001), but there was no association between tooth wear and animal age. Fusobacterium nucleatum, Tannerella forsythia and Fusobacterium necrophorum predominated in periodontal lesions. This study is limited by the small sample size and lackof diagnostic imaging to assess periodontal disease. The co-occurrence of periodontal lesions and excessive dental wear involving both the incisor and masticatory teeth suggests that although the two diseases have different aetiologies, they likely have common risk factors.

Inter- and intra-variability in tooth wear progression at surface-, tooth- and patient-level over a period of three years: A cohort study: Inter- and intra-variation in tooth wear progression

ObjectiveTo explore the variability of tooth wear progression at the surface-, tooth- and patient-level over a period of three years three years using in vivo 3D-measurements of full dentitions amongst patients with moderate to severe tooth wear and without demand for restorative rehabilitation. MethodsFifty-five eligible patients with moderate to severe tooth wear had intra-oral scans taken using either the 3 M True Definition Intraoral Scanner or the 3 M Lava Chairside Oral Scanner. The maximum height loss (µm) per cusp/incisal/palatal surface at unrestored surfaces was measured using the 3D Wear Analysis (3DWA)-protocol with Geomagic Qualify, resulting in sixty-four measurements per dentition. Data was visualized using box plots. Correlation was calculated between tooth wear progression rates of different tooth types and surfaces. ResultsThirty patients with scans at intake and after three years were included (38 ± 8 years, 77% M, 23% F). Mean observation time was 3.1 ± 0.2 years. Surface measurements (N = 1,615) showed a high deviation and a high number of outliers at all surfaces, indicating large variability amongst the surfaces, tooth types and patients with tooth wear progression rates. Correlations between regions were very low: anterior-molar region -0.219, anterior-premolar region 0.116 and premolar-molar region 0.113. Correlations between the surfaces of molars were also low (between 0.190 and 0.565). ConclusionsIn a group of patients with moderate to severe tooth wear, large differences in wear progression were found within and amongst patients. Tooth wear progression is therefore highly individualized and can be very localized. Clinical significanceThis study confirms the necessity of individual management of patients with moderate to severe tooth wear. Effective monitoring of tooth wear is important when deciding the timing and need for restorative intervention. Clinical Trial Registration NumberNCT04790110

Orthodontic treatment before restoration of dentition defects

Dentition defects damage the integrity of the dental arch, affecting smile esthetics and oral function. Compared to restorative treatment, pre-restoration orthodontic treatment overcomes the limitations of a single method, effectively avoiding excessive wear of natural teeth, reducing the number of units for restorative production to a certain extent, and potentially improving facial shape and occlusal relationship, which maximizes the therapeutic effect. This article explores the key points of pre-restoration orthodontic treatment for different types of dentition defects in terms of malocclusion manifestations, treatment objectives, treatment methods, and maintenance recommendations from the perspective of combined orthodontic restoration treatment.

Tooth Wear and Periodontal Status in a Cluster of Middle-Aged Adults in Northern Greece

The present observational study aims to investigate the prevalence of tooth wear (TW) in a cluster of Northern Greek adults aged 35–44 years and, additionally, to assess any probable associations and interrelationships between TW and periodontal condition and sociodemographic factors. A cross-sectional design was embraced identically to our previous study on senior citizens. A sample of 531 individuals was considered, and they were examined according to WHO guidelines for national pathfinder surveys by three calibrated dentists-examiners in different urban and rural areas of Northern Greece. Simplified Tooth Wear Index (TWI), Community Periodontal Index (CPI), Attachment Loss (AL) and simplified Oral Hygiene Index (OHI-S) were screened and calculated in a patient-level approach. TW is quite prevalent among middle-aged adults in Northern Greece, although it remains lower compared to older age groups. All the aforementioned periodontal indices were correlated significantly with TW; moreover, a tendency was detected for there to be more tooth wear in older age participants within the specific age group, in men as compared with women, in persons with lower educational levels and in those residing in rural areas.

The longevity of tooth-coloUred materials used for restoration of tooth wear: an evidence-based approach.

Patients with tooth wear are commonly encountered in general dental practice. When indicated, restorative rehabilitation is often accompanied by a request from the patient for an aesthetic, tooth-coloured outcome. This article seeks to provide an evidence-based approach, focussing on the longevity of the materials which can be used for the restorative treatment of tooth wear, as well as their modes of failure and observed performance.

Bruxism in children: What do we know? Narrative Review of the current evidence.

Bruxism is a repetitive masticatory muscles activity whose definition is being thoroughly reviewed in recent years. As in adults, two different forms of bruxism exist in children, namely awake and sleep bruxism. Scarcity of data, however,still persists about paediatric bruxism and no clear consensus has been developed. Therefore, the current review overviews the literature on bruxism in children tries to outline the state of art about this condition METHODS: Bruxism affects from 5% to 50% of the worldwide paediatric population. Sleep disturbances, parafunctional habits and psycho-social factors emerged to be the most likely associated factors with paediatric bruxism. Bruxism is characterised by several signs and symptoms variously combined, such as tooth wear and fractures, teeth impressions on soft tissues, temporomandibular disorders, headaches, behavioural and sleep disorders. About diagnosis, the most reliable tool in children remains the report of teeth grinding by parents or caregivers which must be accompanied by oral interview and accurate clinical examination. Electromyography and sleep polysomnography, albeit suitable in the diagnostic process, are not easy-to-use in children and are not strongly recommended. Currently, no evidence exists to support any kind of therapeutic options for bruxism in children. Management should be based on the identification of the underlying condition and conservative approaches are recommendable. Notwithstanding the high prevalence, several aspects need to be further assessed in paediatric bruxism. Parental reports are still the most suitable diagnostic tool and conservative approaches are recommended in the management. Bruxism should be considered through a biopsychosocial model, and sleep, personality traits, stress and headaches are the factors towards whom research questions must be addressed to improve diagnosis and management.

Childhood and Adolescents Sleep Bruxism Treatment: A Systematic Review.

Introduction Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. Objectives A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Materials and methods Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. Results The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( M. Officinalis ), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Conclusion Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( M. Officinalis ) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.

Audit on recording of tooth wear in primary dental care

Audit on recording of tooth wear in primary dental care

Mandibular Distalisation for Tooth Wear in Patients Requiring Mandibular Protrusion for Sleep Apnoea.

Pathological tooth wear is an increasing concern and may require intervention and occlusal rehabilitation. Often the treatment includes distalisaton of the mandible to restore the dentition in centric relation. Obstructive sleep apnoea (OSA) is another condition treated my mandibular repositioning but in this case by an advancement appliance. The authors have a concern that there could be a group of patients with both conditions where distalisation for their tooth wear management would be contrary to their OSA treatment. This paper aims to look at this potential risk. A literature search was carried out using the following keywords (OSA or sleep apnoea or apnea or snoring or AHI or Epworth score) and for tooth surface loss (TSL or distalisation or centric relation or tooth wear or full mouth rehabilitation). No studies were identified which considered the effect of mandibular distalisation on OSA. There is a theoretical risk that dental treatment involving distalisation may adversely affect patients at risk of OSA or worsening their condition due to the modification of airway patency. Further study is recommended.

Evaluation of Fracture Resistance of Occlusal Veneers Made of Different Types of Materials Depending on Their Thickness.

The aim of this study is to assess the fracture resistance of occlusal veneers made of various materials depending on their thickness. In total, 120 occlusal veneers were examined. The restorations were made of four ceramics: leucite LC (IPS Empress Esthetic), hybrid HC (Vita Enamic), lithium disilicate LDC (IPS e.max Press), and zirconium oxide ZOC (Ceramill Zolid HT). A total of 30 veneers were made of each material, 10 for each of the three thicknesses: 1 mm, 1.5 mm, 2 mm. The restorations were cemented on identical abutments duplicated from the developed phantom tooth 35 (KaVo) with composite cement (All Bond Universal). The samples prepared in this way were subjected to a compressive strength test in a universal testing machine. Statistical analysis of the results was performed. The average fracture resistance of occlusal veneers made of zirconium oxide ceramic was 1086-1640 N, of lithium disilicate ceramics 456-1044 N, of hybrid ceramics 449-576 N, and of leucite ceramics 257-499 N. Occlusal veneers made of ceramics, zirconium oxide and lithium disilicate, had the highest resistance to fractures. Restorations made of leucite ceramics turned out to be the least resistant to forces. The greater the thickness of the ceramic occlusal veneers, the greater their fracture resistance.

Comparison of Marginal Fracture Between Conventional and Bonded Amalgam Restorations in Posterior Permanent Molar Teeth.

Background/objectives Dental amalgam has been a successful restoration for over a century. However, restoration failures due to secondary caries, fractured teeth or restorations, marginal deficiencies, tooth wear, and secondary caries remain significant concerns. Amalgam-bond, known for its ability to bond amalgam to the tooth structure and prevent percolation, forms a strong bond with vital dentin. This study aimed to compare the outcome of marginal fractures in bonded amalgam and conventional amalgam posterior restorations among patients at a tertiary care dental hospital. Materials and methods Sixty consecutive patients aged 25-35 years, meeting the inclusion and exclusion criteria, participated in this study. A thorough history, clinical examination, and standardized periapical radiographs were conducted. Patients were divided randomly into two equal groups, group A and group B. Group A received bonded amalgam restorations, while group B received conventional amalgam restorations. Polishing was performed at a recall visit after seven days, and a follow-up evaluation was done after two months. The final assessment of marginal fractures was recorded after six months. Results After six months, 28 (46.7%) patients showed no marginal fractures, including 11 males and 17 females. On the other hand, 32 (53.3%) patients exhibited marginal fractures, comprising 17 males and 15 females. The clinical success rate of group A was better than group B (p = 0.001). Conclusion Bonded amalgam demonstrates a high success rate and should be a routine choice for treating carious permanent molars in dental practice.

Injectable composites in modern practice

The improvement in bonding protocols has allowed composite to be a viable alternative to indirect restorations in the management of tooth wear. Although highly conservative of tooth structure, the literature would describe composites as a ‘medium-term’ treatment option, with high patient satisfaction. Their survival has been quoted at five years when used in the treatment of tooth wear at an increased OVD.4 The evidence relates to paste composites, which were not nano-filled. It is clear that there is plenty of scope for research on nano-filled injectable composites in tooth wear cases. They offer a truly conservative treatment option and allow for a highly predictable aesthetic and occlusal outcome through the injection moulding technique.

Obstructive sleep apnea: a follow-up program in its relation to temporomandibular joint disorder, sleep bruxism and orofacial pain

ObjectiveTo evaluate the correlation between obstructive sleep apnea (OSA) and temporomandibular joint (TMJ) morphology, tooth wear condition, orofacial pain through a follow-up program.Materials and methodsSeventy one OSA patients were divided into three groups according to their (apnea hypopnea index) AHI: mild group (n = 23), moderate group (n = 24), and severe group (n = 24). All patients had OSA therapies around six months after confirm the diagnosis of OSA. The tooth wear score and orofacial pain condition of all patients were recorded via clinical examination. Cone beam computed tomography (CBCT) images were also taken when confirm the diagnosis of OSA (T0), 6 months after the diagnosis (T1), and 6 months after the OSA treatment (T2). Parameters indicating the condylar morphology and joint space were evaluated. The differences of clinical symptoms and TMJ conditions among T0, T1 and T2 time point were detected in the three groups respectively. The changes in T1-T0 and T2-T1 of all descriptions among three groups were also compared. The correlations between AHI and clinical symptoms were detected with Spearman correlation analysis.ResultsIn mild group, there was no difference in all clinical symptoms and TMJ morphology among the three time points. Both in moderate and severe group, the condylar volume, superficial area, wear score, visual analogue scales (VAS), and R value (indicating condyle position) displayed significant differences among the three time points (P < 0.05). From T0 to T1, mild group displayed fewer decreases in the condylar volume and superficial area and fewer increases in wear score than that in moderate and severe group (P < 0.05). From T1 to T2, there was a greatest reduction in severe group for R value, and significant difference in the description of VAS and R value were found among the three groups. AHI was negatively correlated condylar volume and condylar superficial area, and was positively correlated with tooth wear score and VAS (P < 0.05).ConclusionModerate to severe OSA will aggravate orofacial pain and tooth wear, affect TMJ volume and superficial area, even change the location of condyles. Appropriate OSA therapies may be effective ways to alleviate these adverse effects in long-term.

Treatment planning for patients with tooth wear.

Providing restorative dental care for patients with tooth wear can, at times, seem complex and demanding. The key to this process lies in a systematic approach that breaks down the component parts. In this chapter, the importance of a comprehensive assessment at the outset will be highlighted. This should include identification of the patient's chief complaint, taking a thorough history, completing the clinical examination, undertaking any special tests and arriving at clinical diagnoses. Together, this information will influence the treatment planning process, identify appropriate treatment concepts and options available and the individual stages that may be involved. The process should be both holistic and thorough to enable the patient and clinician to build a clear pathway and vision. In parallel, and with patient input throughout, it is essential to manage patient expectations as best as possible whilst remaining pragmatic and honest about treatment outcomes, longevity of restorations and the risks of failure.

Total Rehabilitation Using Adhesive Dental Restorations in Patients with Severe Tooth Wear: A 5-Year Retrospective Case Series Study.

Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials. The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria. Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences (p < 0.005) on the survival of the restorations. According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.

Analysis of wear mechanism and sawing performance of carbide and PCD circular saw blades in machining hard aluminum alloy

High-efficiency sawing is widely applied in primary and secondary machining sectors, but it faces limitations due to saw tooth life and manufacturing constraints. This research investigates the wear mechanism, wear characteristics, and sawing performance of carbide and polycrystalline diamond (PCD) saw teeth when machining hard aluminum alloy. The results show that the sawing forces with PCD saw teeth are less than those of carbide teeth, yielding better surface quality and longer tool life. The wear mechanisms of saw teeth of two materials with different tooth types are classified and characterized finely. Carbide teeth are subject mainly to abrasion and adhesion at the cutting edges, while adhesion, corrosion, and diffusion primarily contribute to flank face wear. PCD teeth mainly suffer from abrasion and micro-chipping on the cutting edges and faces. A comprehensive description of the wear evolution of carbide and PCD teeth is presented, with the cutting heat being the primary cause of carbide tooth wear and the presence of hard particles in the workpiece causing PCD tooth wear by SEM and EDS analysis. The friction coefficient of the PCD teeth is considerably lower than that of the carbide teeth by sliding friction and wear tests, which also proves its more superior thermal stability and wear resistance during wear evolution analysis. Systematic research analyzes and discusses the wear mechanism and wear characteristics of saw teeth in high-speed sawing process, which can further enhance the understanding of the saw tooth wear to provide theoretical guidance for saw tooth design and manufacturing.