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。     

牙齿磨耗及其并发症

牙齿磨耗是由龋、急性创伤及发育因素之外的原因造成的牙齿硬组织丧失。按病因、发病机制、临床表现等常将其分为二三类：磨耗、磨损和酸蚀。按程度及影响义分为生理性磨耗和病理性磨耗两类，本文重点阐述的是后者。磨耗牙齿、牙列的治疗是口腔科临床常见的问题，且有不断增长趋势。牙齿磨耗会对美观、牙齿软硬组织及颞下颌关节等造成损害，磨耗程度较重时严重影响人们的口腔健康，已引起国内外学者的关注，相关报道不断增加。本文重点就牙齿磨耗的病因、临床表现、并发症等方面的研究进展作一综述。     

中国夏代人牙齿磨耗的研究

目的 本文对河南二里头遗址出土的中国夏代人颅骨牙齿进行观察,以了解当时人类牙齿的何面磨耗情况,以便研究人类进化过程中咀嚼器官的变化.方法 对河南二里头考古遗址出土的中国夏代人类颅骨标本进行观察,共观察标本32个个体,其中男性22例,女性10例,年龄分为青年、中年和老年三组,共494颗牙齿,均为恒牙.按照Smith制定的8级分级标准,观察牙齿何面磨耗情况,结果 中国夏代人牙齿磨耗非常严重,全口牙齿的和何面磨耗平均为4.0级.前牙的何面磨耗平均为3.7级,最重的磨耗甚至达到7级;而后牙的何面磨耗平均为4.4级,最重的磨耗甚至达到8级.上颌第一磨牙磨耗最重,其次是下颌第一磨牙、上颌第一前磨牙及下颌尖牙.结论 中国夏代人年龄是磨耗的主要因素,而食物结构与生活方式及生存环境也是影响古人类牙齿磨耗程度或速率及磨耗方式的主要因素.     

牙齿磨耗的测量方法

牙齿磨耗常见于牙病诊疗中,是上下牙齿相互作用的结果,可导致由牙本质暴露引起的局部不适和牙冠变短引起的美观问题,甚至危及口腔功能.若不加以控制,磨耗可能导致咀嚼肌功能失调且伴随生活质量的下降和健康系统的恶化.寻找测量磨耗的最佳方法是研究牙齿磨耗的关键,本文就牙齿磨耗的指数分级测量法和牙齿磨耗定量测量法中的牙尖高度测量、二维测量、三维测量法及其在口腔正畸、口腔修复和口腔颌面外科中的应用进行综述.     

充填法治疗磨耗引起的牙齿敏感症

目的：比较确切有效的治疗由磨耗引起的牙齿敏感症的方法：方法：采用调整咬合关系,患牙制洞后以不同补料充填的办法进行。结果：银汞合金充填法的成功率为93.15%,光敏固化树脂充填法的成功率为76.32%。结论：充填法治疗磨耗引起的牙齿敏感症疗效肯定。充填料以银汞合金为好。     

糖尿病对大鼠牙齿磨耗影响研究

目的    研究糖尿病对大鼠牙齿磨耗程度的影响。方法    本研究于2013年4—5月在沈阳药科大学动物实验中心和中国医科大学实验设备处进行。将6 ~ 8周SD大鼠20只,随机分为2组：糖尿病组与对照组,每组10只。糖尿病组采用腹腔一次性注射链脲佐菌素方法建立大鼠糖尿病模型。两组大鼠相同条件下饲养,8周后处死后取上下颌骨,水浴干燥后体式显微镜下观察大鼠磨牙磨耗情况,数字显微成像仪相同观察条件下采集图像,观察牙齿磨损情况。采用图像分析软件测量每个磨牙各个牙尖的高度,即沿牙尖至对应牙根的牙体长轴上牙尖至釉牙骨质界的长度,对两组结果进行统计学分析。结果    形态学观察可见糖尿病大鼠牙本质暴露面积更大,牙尖高度有所降低,第三磨牙更为显著,牙尖相对尖锐陡峭。牙尖高度测量结果显示糖尿病组较对照组磨牙牙尖高度有所降低,相对而言上颌第三磨牙与下颌第一磨牙降低更为明显,上颌牙舌尖与下颌牙颊尖降低更为明显（P＜0.05）。结论    糖尿病大鼠在相同饮食条件下,牙齿磨耗较正常大鼠更为明显,糖尿病可促进大鼠牙齿磨耗。     

陕西长安区出土1000年前古人牙齿的磨耗状况分析

目的:调查距今约1 100～1 300年前古人牙齿的磨耗状况,以探求牙齿磨耗的发生发展趋势。方法:观察记录62例陕西长安区出土1 000年前人骨架的全部牙齿的磨耗状况,并进行统计学分析。结果:不同磨耗程度牙齿的构成比中,2度磨耗的比例最高(36.80%)。尖牙和第一磨牙的磨耗程度最重,第三磨牙的磨耗程度最轻。所有上下对称牙位牙齿之间的磨耗程度及上下颌牙齿总的磨耗程度差异均没有显著性(P>0.05)。随年龄的增长,牙齿磨耗程度逐渐加重(P<0.05)。男性各牙位牙齿的磨耗程度均高于女性(P<0.05)。结论:本研究反映了1 000年前古人牙齿磨耗的一般状况;分析了不同时期饮食结构、模式与牙齿磨耗之间的相互关系和演化发展规律。     

半坡博物馆馆藏六千年前人颌骨牙齿的磨耗状况分析

目的:调查六千年前新石器时期古人牙齿的磨耗状况,以探寻牙齿磨耗的规律及其演化发展趋势。方法:观察记录并统计了西安半坡博物馆馆藏76例人头颅骨全部牙齿的磨耗情况,用SPSS 12.0软件对全部的904个牙齿进行了统计学分析。结果:不同磨耗度牙齿的构成比中,2°磨耗的比例最高(37.06%)。左右上下对称牙位牙齿的磨耗基本相同。第一磨牙的磨耗程度最重,第三磨牙的磨耗程度最轻。不同年龄段牙齿磨耗度有显著性差异,随年龄的增长,牙齿磨耗度逐渐加重。每一牙位牙齿平均磨耗度男女性别间无显著性差异(P>0.05)。结论:新石器时代古人牙齿的总体磨耗程度较现代人重。     

新石器时期人类牙齿磨耗与饮食习惯

目的研究新石器时期人类牙齿磨耗的发病率、发病特点,及在牙齿的演化规律.方法选取新石器时期人类保存状态良好的牙齿1 861颗,进行磨耗等级观察、数据统计分析.结果新石器时期人类牙齿的平均磨耗级别是3.88级,磨耗程度第一磨牙大于第二磨牙、大于第三磨牙.结论新石器时期人类牙齿承受咀嚼压力大,可以推论当时的食物坚硬、颗粒粗糙,造成牙齿磨耗严重.     

充填法治疗磨耗引起的牙齿感觉过敏症

从1998—08～2000—08对90例病人268个患牙用修复法治疗，疗效肯定，报道如下。     

Influence of noise and vibrations on teeth abrasion

The purpose of the investigation was to determine the influence of noise and vibrations on teeth abrasion in textile workers. For testing purposes a random sample of 115 workers who were exposed to 99-105 decibels of noise, was selected. After thorough investigations it was found that noise was a detrimental stress--producing factor causing quite a number of diseases. Noise can be a stress-producing factor causing parafunctions. The parafunctions are a major aetiological factor that causes teeth abrasion. These investigations proved the correlation between the duration of noise and exposure to vibrations and patological abrasion of hard teeth tissues. The teeth abrasion was more frequent in textile workers who were long exposed to high level of noise.     

Dependence of the dentinal abrasion of human teeth on their microhardness

The dentin resistance against abrasion was studied as related to its microhardness. Sections of 15 intact teeth were investigated (central upper incisors). Water suspensions (40% weight-to weight) of dicalcium phosphate (DCP, FRG; and DKF-1 and DKF-2, USSR) were used as abrasives. Dentin microhardness was measured with a PMT-3 device, and abrasion assessed with profilographic technique. Dentin abrasion was related to its microhardness and to the kind of abrasive used. Dentin abrasion increased as its microhardness decreased. DCF showed minimal abrasive effect, DKF-2 had maximal effect with DKF-1 keeping the intermediate position.     

Microleakage of compomer restorations in primary teeth after preparation with bur or air abrasion

This study compared the degree of marginal leakage of a compomer in Class V cavities of human primary molars prepared by a conventional dental bur and air abrasion with or without acid etching. Fifty-six non-carious extracted primary molars were randomly divided into four groups (n=14) to be prepared by four techniques: Group-1: Bur followed by acid etching: Class V cavity preparations were placed on the buccal surfaces of each tooth using a high-speed handpiece. The preparations were 1.5-mm deep, 3-mm long and 2-mm wide, with the occlusal margin in enamel and the cervical margin extending 0.5 mm below the cementoenamel junction. The preparations were acid etched with 37% phosphoric acid starting at the enamel margins for 30 seconds and rinsed with water for 20 seconds. The preparations were then restored with Compoglass F. 2-Group 2: Bur: The preparations and the treatment procedures were the same as in Group 1, with the exception of 37% phosphoric acid application. Group 3: Air abrasion followed by acid etching: Class V cavity preparations were placed on the buccal surfaces of each tooth using a handpiece of an air-abrasive system (PrepStart, Danville Engineering). The system was supplied with dry compressed air at 80 psi. In all tests, the air-abrasion system was operated with an 80 degrees-angle handpiece tip and 50-mm aluminum oxide particles. A tip with a 0.38-mm inner diameter was used at a 2-mm distance. The treatment procedures were the same as in Groups 1 and 2. Group 4: Air abrasion: The preparations and treatment procedures were the same as in Group 3, with the exception of 37% phosphoric acid. After finishing the restorations, the teeth were stored in distilled water at 37 degrees C for 24 hours. The samples were thermocycled for 500 cycles between 5 degrees C and 55 degrees C with a dwell time of 30 seconds. The samples were then immersed in 0.5 percent basic fuchsin dye for 24 hours at 37 degrees C. The surface-adhered dye was then rinsed in tap water and the teeth were embedded in a chemically-activated acrylic resin and bisected longitudinally in a mesiodistal direction with a low speed diamond disk. Each section was examined under a stereomicroscope (Nikon, Tokyo, Japan) at 20x magnification. The data were analyzed statistically by Kruskal-Wallis analysis of variance to determine any statistical significant differences in microleakage scores among the groups at a p-value of 0.05. Also, the enamel versus cementum-dentin microleakage scores of each group were compared using z-test at the 0.05 significance level. There was no statistically significant difference among the groups (p>0.05), but a statistical difference between enamel and cementum-dentin surfaces was evaluated (p<0.05).