The development of a new index for measurement of incisal/occlusal tooth wear

A number of indices have been developed for the measurement of tooth surface loss but they have not achieved universal acceptance. The aim of this study was to develop a new index suitable for the monitoring of incisal/occlusal tooth wear on serial study models. The new index recorded incisal/cuspal wear for individual teeth. Each tooth was scored on a six-point scale ranging from 0-5. Six assessors evaluated the index and it was applied to baseline and sequential models taken after 20 years. The study demonstrated the value of maintaining long-term dental records in the form of study models for monitoring progressive tooth wear.     

Cervical wear and occlusal wear from a periodontal perspective

Summary The aim of this study was to investigate whether cervical wear was associated with occlusal wear and clinical periodontal parameters in relatively older adults. A total of 30 patients, with multiple non‐carious cervical lesions (NCCLs) and without a disease or condition that could cause heavy tooth wear, were included in the study. The periodontal parameters including plaque index, probing pocket depth, gingival recession (GR) and tooth mobility were obtained from 641 teeth of which 475 (74·1%) displayed NCCLs. The levels of cervical wear and occlusal wear were determined according to a tooth wear index. Premolars were more likely to develop cervical wear than canines, molars and incisors. Cervical wear was significantly associated with less plaque accumulation and the presence of shallow pockets. The teeth with advanced GR and without increased mobility were 2·583 and 1·715 times more likely to develop deeper cervical lesions, respectively. Age and the level of occlusal wear were not linked to the bucco‐lingual depth of cervical wear. In conclusion, the significant association of advanced cervical wear with the relatively healthy periodontal status suggested the role of abrasion and its possible combined action with erosion in the aetiology of NCCLs. The rate of GR and the lack of tooth mobility could constitute predisposing factors for the progression of cervical wear because the exposed root surfaces could be more susceptible to abrasion and/or erosion, and the non‐mobile teeth resisting strongly against frictional forces, thus abrasive effects, could possibly develop cervical wear.     

牙齿磨损的病因学研究进展

牙齿磨损因其高发病率已成为继龋病、牙周病之后口腔领域又一高发疾病，受到了越来越多的关注。牙齿磨损是一种多病因疾病，其发生发展往往是多种因素共同作用的结果。近年来关于牙齿磨损病因学方面的研究较多，本文主要从腐蚀作用、牙齿自身状况、病理性磨损作用等方面作一综述。     

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提要：牙齿松动是牙周病主要的临床症状之一。如何治疗松动牙、防止牙周炎进行性加重、尽可能地保存牙齿、促进牙周组织的重建再生,是牙周科医生致力于解决的主要问题。经牙周基础治疗、去除危险因素、消除牙周组织炎症并建立平衡牙合后,多数患牙的松动度可不同程度减轻。而松动度较大的患牙经牙周治疗也很难恢复正常,并影响咀嚼功能,产生继发性牙合创伤,使得牙周组织破坏、吸收加剧。对动度较大的松动牙进行固定,消除其创伤,减轻牙合力负担,使之行使正常咬合功能,牙周膜接受功能性刺激,从而促进牙周组织的修复和愈合。因此,松牙固定是牙周治疗的必要措施。牙周炎的松牙固定是将单根或多根患牙与健康牙通过夹板连接成一个稳固的“多根牙”,建立起一个新的咀嚼单位。本文对牙周病的松动牙固定、各类牙周夹板在临床上的使用及夹板固定技术做一介绍。     

Stem cell‐based tooth and periodontal regeneration

Currently regeneration of tooth and periodontal damage still remains great challenge. Stem cell‐based tissue engineering raised novel therapeutic strategies for tooth and periodontal repair. Stem cells for tooth and periodontal regeneration include dental pulp stem cells (DPSCs), periodontal ligament stem cells (PDLSCs), stem cells from the dental apical papilla (SCAPs), and stem cells from human exfoliated deciduous teeth (SHEDs), dental follicle stem cells (DFSCs), dental epithelial stem cells (DESCs), bone marrow mesenchymal stem cells (BMMSCs), adipose‐derived stem cells (ADSCs), embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs). To date, substantial advances have been made in stem cell‐based tooth and periodontal regeneration, including dentin–pulp, whole tooth, bioroot and periodontal regeneration. Translational investigations have been performed such as dental stem cell banking and clinical trials. In this review, we present strategies for stem cell‐based tissue engineering for tooth and periodontal repair, and the translational studies.     

No association between incisal tooth wear and temporomandibular disorders

STATEMENT OF PROBLEM: Incisal tooth wear may be a sign of long-term bruxing behavior. Bruxism is purported to be a risk factor for temporomandibular disorders (TMD). PURPOSE: The purpose of this clinic-based case-control study was to investigate whether the wear of anterior teeth is associated with TMD. MATERIAL AND METHODS: Two hundred eight TMD patients and 172 control subjects were selected for participation. After exclusion of subjects with more than 1 missing premolar or molar zone in opposite arches, as well as subjects with missing or severely restored anterior teeth, 154 TMD patients and 120 control subjects were included in the study (age 31.2 +/- 13.4 years; range 13 to 76 years). Anterior tooth wear was assessed on casts with a 0 to 5 scale. A multiple logistic regression analysis, controlling for the effects of age and gender, was performed to investigate the relationship between tooth wear and TMD. RESULTS: An odds ratio of 0.76 (95% confidence interval: 0.51 to 1.15) indicated that after adjusting for gender and age, the odds in favor of TMD decreased an estimated 24% for each additional unit of the mean tooth wear score. This result was not significant (P=.20). CONCLUSION: Within the limitations of this study, incisal tooth wear (assessed on dental casts) was not significantly associated with TMD when the influence of age and gender was controlled. Based on these findings, a clinically relevant risk for TMD from incisal tooth wear can be excluded. Hence, the presented evidence does not support the idea that treatment of incisal tooth wear is indicated to prevent TMD.     

Longitudinal study on the relationship between serum albumin and periodontal disease

Aim: The purpose of this study was to evaluate the relationship between periodontal disease and the general health status in community‐dwelling elderly using the serum albumin concentration as a criterion index of the severity of underlying disease and nutrition. Material and Methods: Six hundred subjects aged 70 years underwent a baseline examination. Dental examinations were carried out at baseline and once a year for 4 years. Periodontal conditions were estimated for subjects with at least one remaining tooth. Clinical attachment levels at six sites of all teeth present were measured. A change in loss of attachment of 3 mm or greater in 1 year at each site was defined as periodontal disease progression. Data were analysed in subjects for whom data were available for 4 years. Results: Serum albumin concentration at baseline ranged from 3.4 to 5.0 g/dl with a mean of 4.3±0.2. When the analysis was stratified by smoking status, we found that serum albumin concentration had a significant effect on periodontal disease progression among non‐smokers (standardized regression coefficient=?0.16; p=0.017), using multiple regression analysis. Conclusions: The findings of the present study suggest that serum albumin concentration is a significant risk predictor of periodontal disease progression among elderly non‐smokers.     

Retrospective study of tooth loss in 92 treated periodontal patients

BACKGROUND/AIMS: In this retrospective study, the efficacy of periodontal therapy and maintenance in preventing tooth loss was evaluated. METHODS: The study included 92 patients with 2310 teeth diagnosed with chronic adult periodontitis and observed over a mean period of 6.7 years, with each patient receiving surgical therapy in two or more quadrants. The group was divided into two subgroups: those who complied with the recommended maintenance schedule and those whose compliance was erratic. Individual tooth prognosis was assigned according to radiographic parameters. RESULTS: At the completion of active periodontal therapy, 2184 teeth were present. During the maintenance period, 44 teeth were lost due to periodontal reasons. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.07/year. Molars were the teeth most frequently lost; canines the least. The number of teeth lost in the three prognostic categories was: one (0.07%) for teeth with good prognoses, 21 (3.63%) for questionable prognoses and 22 (11.34%) for hopeless prognoses. Patients complying erratically with supportive periodontal therapy were at a 5.6 times greater risk for tooth loss following active therapy than regularly compliant patients. Conclusions: The results demonstrated a low tooth mortality rate in periodontal patients following active treatment combined with a strict maintenance program.     

Enamel erosion and mechanical tooth wear in medieval Icelanders

Objectives: The Icelandic Sagas are an important source of information on the way of life and diet habits in Iceland and possibly other Nordic countries 1000 years ago. Archaeological human skull material worldwide has revealed extensive tooth wear, with the main cause believed to be coarse diet. From a graveyard near volcano Hekla, 66 skeletons dated from before 1104 were excavated. The purpose of this study was to determine the main causes of tooth wear in Icelanders 1000 years ago.

Materials and methods: Forty-nine skulls were available for research. Two methods were used to evaluate tooth wear and seven for age estimation. An attempt was made to determine the main causes of tooth wear in the light of likely diet and beverage consumption according to a computer search on food and drink customs described in the Icelandic Sagas. Results: Tooth wear was extensive in all groups, increasing with age. The highest score was on first molars, with no difference between sexes. It had all the similarities seen in wear from coarse diet. In some instances it had similar characteristics to those seen in erosion in modern Icelanders consuming excessive amounts of soft drinks. According to the Sagas, acidic whey was a daily drink and used for preservation of food in Iceland until recently. Conclusions: Since acidic whey has considerably high dental erosive potential, it is postulated that consumption of acidic drinks and food, in addition to a coarse and rough diet, played a significant role in the dental wear of ancient Icelanders.     

牙列重度磨损咬合重建修复治疗方法的探讨

目的 探讨牙列重度磨耗患者行固定义齿咬合重建修复的可行性.方法 结合1例牙列重度磨耗患者,咬合垫佩戴3个月后,制作过渡性修复体,口内观察1年,然后行上下颌固定义齿最终修复,经过这一序列诊疗过程完成咬合重建.结果 患者使用最终修复体2年,美观满意,咀嚼效率良好,无咀嚼系统肌肉及颞下颌关节不适症状.结论 牙列重度磨耗的固定义齿咬合重建修复是一个复杂的序列治疗过程,治疗效果是满意的.     

An investigation of some factors associated with occlusal tooth wear in a selected high-wear sample

The aim of the present study was to investigate the influence of some factors associated with occlusal tooth wear in a selected high-wear Swedish sample. The material comprised 59 persons having a mean age of 35 yr within the range 16–70 yr, the criteria for selection being a full or near-full complement of natural teeth, and the presence of definite clinical signs of occlusal wear. A dentition wear index, in addition to anterior, posterior, and arch subindices, was derived from a tooth-by-tooth evaluation of casts. Factors which were found to correlate significantly with increased occlusal wear were age, sex, self-perception of wear, number of teeth, and general health, as well as a number of variables from study-cast analysis. On the basis of the findings, not only is the multifactorial etiology of occlusal tooth wear a reality, but so, too, is the complex interdependence of these factors in the severity of wear.     

方丝弓矫治器加载与牙松动度提取参数关系的初步探讨

目的：研究FX－1型牙松动度测量系统提取参数与临床牙松动度的关系。进一步明确其临床实用价值。方法：受试者为安底二类错He畸形患者，男2人，女4人，受试牙为B区中切牙、B区第一前磨牙；方丝弓矫治器加载前后各测定1次，间隔8－11d；第一牙位测定7次，测量时间为上午10时；测量前后各拍摄X线片一张。结果：方丝弓矫治器加载前爱试牙临床松动度不足Ⅰ度，加载后均达到Ⅰ度；X线片示加载后除近牙颈部牙周膜腔略为增宽外，余无明显变化，方丝弓矫治器加载前后，参数S、K值的变化不具有统计学上的显著性差异，而参数t1,t2加载后经加载前增大，且具有统计学上的显著性差异，结论：牙松动度信号中的时间参数t1,t2能够早期监测临床牙松动度的改变。