Dental erosion is characterized by progressively destroyed teeth, which has no relation to bacteria but to chemicals. Some internal factors, such as gastroesophageal reflux induced by bulimia, anorexia, gastrointestinal diseases, or drugs, and external factors, such as diet, drugs, and occupational acid exposure, are considered promotive factors for this disease. This article presents a patient suffering from severe dental erosion in the whole dentition, especially in the maxillary teeth, due to gastroesophageal reflux induced by glucocorticoid therapy for optic neuritis. This article discusses the mechanism between optic neuritis glucocorticoid therapy and dental erosion.
Humans ; Glucocorticoids/therapeutic use* ; Tooth Erosion/therapy* ; Gastroesophageal Reflux/complications*

Background: Relative Dentin Abrasivity (RDA), as set by ISO 11609, is a standardized measurement on the abrasiveness of toothpaste. There are no published RDA values for Philippine-brand toothpastes. This study evaluated the degree of abrasion of five Philippine-brand toothpastes.

Objective: To compare qualitatively and quantitatively the abrasivity of five Philippine-brand toothpastes (Brands X, U, H, HN, G) to two foreign-brand toothpastes Brand C (RDA 68) and Brand P (RDA 150).

Methods: Twenty-four bovine dentin samples were brushed with a slurry of each of the toothpaste using a toothbrushing machine. A profilometer, scanning electron microscope and a visual measuring scope were used to determine abrasivity through the before-and-after-brushing surface roughness.

Results: Ranked based on the difference of the means for surface roughness, before-and-after brushing, in decreasing order of abrasivity are: Brands P, X, U, H, C, HN, and G. Using Dunn's test-post hoc test for Kruskal-Wallis test at p ? 0.05, we showed that the abrasivity of Brands G, H, and HN were not significantly different from Brand C, and Brand X was not significantly different from Brand P. Brand U was significantly less abrasive than Brand P and significantly more abrasive than Brand C.

Conclusion: Brands G, H, and HN can be considered as low-abrasive toothpastes, Brand X a high abrasive toothpaste, and with Brand U was unclear as to category. Findings from qualitative data support the quantitative data.

Severely worn dentition seriously affects patient's esthetics and function. Its etiology is complex, differential diagnosis is difficult, treatment process involves multiple disciplines, and requires esthetic and functional rehabilitation. A "8-step sequential treatment" for the rehabilitation of severely worn dentition has been established. In recent years, digital technology has been increasingly applied to the esthetic and functional rehabilitation of severely worn dentition. This article will describe the application of digital methods in the 8-step sequential treatment of severely worn dentition.
Humans ; Tooth Wear/rehabilitation* ; Esthetics, Dental ; Dentition ; Digital Technology

OBJECTIVE: To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep. METHODS: Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects. RESULTS: Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients. CONCLUSIONS The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.
Adult ; Electromyography ; Humans ; Masticatory Muscles ; Polysomnography ; Sleep ; Sleep Bruxism ; Tooth Attrition

With the evolution of the computer-aided design/computer-aided manufacturing (CAD/CAM) technology, the intraoral scanners are playing an increasingly important role, as they are the first step towards a completely digital workflow. The CAD/CAM double scanning technique has been used to transfer the information from provisional restorations to definitive restorations. In this case, a 67-year-old male with esthetically compromised anterior teeth, generalized severe attrition of teeth, and reduced vertical dimension was treated with full mouth rehabilitation including a re-establishment of the lost vertical dimension of occlusion assisted by the crown lengthening procedure. The provisional restorations were fabricated using an intraoral scanner and the CAD/CAM double scanning technique. After the period of adaption, the definitive monolithic zirconia restorations were delivered. The CAD/CAM double scanning technique successfully transferred the occlusal and morphological characteristics, obtained from the provisional restorations, to the definitive restorations.
Aged ; Crown Lengthening ; Dentition ; Humans ; Male ; Mouth Rehabilitation ; Mouth ; Tooth ; Tooth Wear ; Vertical Dimension

BACKGROUND: Erosion is a gradual process that occurs fairly quickly, and the full extent of the erosive effects of acidic beverages is not yet clear. The present study aimed to determine the differences in the erosive potentials among four naturally acidic fruit nectars within the same range of titratable acidity and to determine the influence of the components of organic acids on tooth erosion. METHODS: Diluted fruit nectars (mandarin 1:1.1, orange 1:1.7, lemon 1:15, grapefruit 1:20) with the same range of titratable acidity (7.9 ml) and their corresponding organic acids (0.05%, 0.1%, 0.3%, and 0.5% citric acid, malic acid, and a citric and malic acid mixture [pH 2.8], respectively) were used. Specimens were placed in conical tubes with 50 ml of each of the test solutions for 1 hour. A microhardness test and scanning electron microscopy were used to measure enamel erosion. Acid separation was carried out using high-performance liquid chromatography to analyze the composition of each test solution. RESULTS: Similar decreases in the Vickers hardness number (VHN) were observed among the groups treated with the following diluted fruit nectars: diluted mandarin nectar (75.9 ΔVHN), diluted lemon nectar (89.1 ΔVHN), diluted grapefruit nectar (91.7 ΔVHN), and diluted orange nectar (92.5 ΔVHN). No statistically significant differences were found in the enamel surface hardness after erosion (p>0.05). Citric and malic acids were the major organic acids in the test fruits. The lemon and orange groups had the highest malic acid concentrations, and the mandarin group had the lowest malic acid concentration. CONCLUSION: The titratable acidity and the citric and malic acid contents of the fruits could be crucial factors responsible for enamel erosion. Therefore, fruit-based drinks should be regarded as potentially erosive.
Beverages ; Chromatography, Liquid ; Citric Acid ; Citrus paradisi ; Citrus sinensis ; Dental Enamel ; Fruit ; Hardness ; In Vitro Techniques ; Microscopy ; Microscopy, Electron, Scanning ; Plant Nectar ; Tooth Erosion

BACKGROUND: The market for vitamin drinks is expanding both in Korea and worldwide. However, it was difficult to find studies regarding the possibility of tooth erosion induction due to vitamin drinks. The purpose of the present in vitro study was to evaluate the effect of tooth erosion caused by a few commercial vitamin beverages on bovine teeth enamel in terms of erosion depth and fluorescence loss. METHODS: Three experimental groups (vitamin drinks), a positive control group (Coca-Cola), and a negative control group (mineral water) were established. Each group consisted of 5 specimens obtained from sound bovine teeth. The pH and titratable acidity of beverages were measured. Specimens were immersed in the beverages and artificial saliva for 6 and 18 hours, respectively. This cycle was repeated for 5 days. The depth of the tooth loss caused by tooth erosion (erosion depth) and maximum loss of fluorescence (Max ΔF) were measured using the microscope and quantified light-induced fluorescence-digital, respectively. For the statistical analysis, the Kruskal-Wallis test and ANOVA were used to compare the erosion depth and Max ΔF of the enamel surfaces. In addition, Spearman correlations were estimated. RESULTS: The pH of the three vitamin beverages ranged from 2.65 to 3.01, which is similar to that of the positive control group. All beverages, except mineral water, had sugar and acidic ingredients. Vitamin drinks and the positive control, Coca-Cola, caused tooth erosion lesions, and showed significant differences in erosion depth compared to mineral water (p<0.05). The vitamin beverages with low pH were associated with high erosion depth and Max ΔF. CONCLUSION: Vitamin drinks have the potential to cause tooth erosion.
Beverages ; Dental Enamel ; Fluorescence ; Hydrogen-Ion Concentration ; In Vitro Techniques ; Korea ; Mineral Waters ; Saliva, Artificial ; Tooth Erosion ; Tooth Loss ; Tooth ; Vitamins

PURPOSE: Aims to analyze the occlusal wear patterns in maxillary posterior teeth with palatal side abfractions and study the association between occlusal force and abfractions. MATERIALS AND METHODS: This study was conducted in a total of 308 teeth from 148 patients with palatal side abfractions in maxillary posterior teeth. The occlusal wears in maxillary premolars and molars with palatal side abfractions were classified and recorded. The classification was done by type of teeth, age, and gender, and in order to evaluate the statistical significance between groups, chi-square test was conducted (α = 0.05). RESULTS: Palatal side abfractions in maxillary posterior teeth were observed at the highest frequency in the 1st molars, and in all teeth with palatal side abfractions, more than one occlusal wear was observed. In classification by type of teeth, by age, and by gender, the occlusal wears in teeth with palatal side abfractions were observed at high frequency in cuspal inclined plane, central fossa, and marginal ridge, and there was a statistical significance (P < 0.05). CONCLUSION: Palatal side abfractions were observed at the highest frequency in maxillary 1st molars, and in all maxillary posterior teeth where palatal side abfractions were found, the occlusal wears were observed. And the occlusal wears were observed at high frequency in cuspal inclined plane, central fossa and marginal ridge. Such results show that abfraction is associated with occlusal force.
Bicuspid ; Bite Force ; Classification ; Humans ; Molar ; Tooth Attrition ; Tooth Fractures ; Tooth

Tooth wear is gradually increasing with increasing life expectancy. In particular, it is important to establish a treatment plan in the early stages so that it does not proceed to moderate or severe wear stages. It is essential to diagnose tooth wear accurately in order to plan a treatment for it. There are many risk factors including age, diet, and drugs which affects tooth wear. For the diagnosis of a tooth wear, appropriate index and evaluation method should be used. There were various tooth wear indices such as TWI, Lussi index, BEWE, and TWES. The evaluation method includes clinical examination, dental cast examination and clinical photographs. Recently, a 3D scanner is being used to assess tooth wear. The risk factors, tooth wear evaluation system, the methods of measuring tooth wear, and related literature were reviewed. The strengths and weaknesses of each index and evaluation methods were compared to derive a proper way to diagnose tooth wear.
Diagnosis ; Diet ; Life Expectancy ; Methods ; Risk Factors ; Tooth Wear ; Tooth

PURPOSE: To investigate and compare the surface roughness (SR), weight and height of monolithic zirconia (MZ), ceramometal (CM), lithium disilicate glass ceramic (LD), composite resin (CR), and their antagonistic human teeth enamel. MATERIALS AND METHODS: 32 disc shaped specimens for the four test materials (n=8) and 32 premolars were prepared and randomly divided. SR, weight and height of the materials and the antagonist enamel were recorded before and after subjecting the specimens to 240,000 wear-cycles (49 N/0.8 Hz/5℃/50℃). SR, height, weight, and digital microscopic qualitative evaluation were measured. RESULTS: CM (0.23 + 0.08 µm) and LD (0.68 + 0.16 µm) exhibited the least and highest mean difference in the SR, respectively. ANOVA revealed significance (P=.001) between the materials for the SR. Paired T-Test showed significance (P < .05) for the pre- and post-SR for all the materials. For the antagonistic enamel, no significance (P=.987) was found between the groups. However, the pre- and post-SR values of all the enamel groups were significant (P < .05). Wear cycles had significant effect on enamel weight loss against all the materials (P < .05). CR and MZ showed the lowest and highest height loss of 0.14 mm and 0.46 mm, respectively. CONCLUSION: MZ and CM are more resistant to SR against the enamel than LD and CR. Enamel worn against test materials showed similar SR. Significant variations in SR values for the tested materials (MZ, LD, CM, and CR) against the enamel were found. Wear simulation significantly affected the enamel weight loss against all the materials, and enamel antagonist against MZ and CM showed more height loss.
Bicuspid ; Ceramics ; Dental Enamel ; Evaluation Studies as Topic ; Glass ; Humans ; Lithium ; Tooth ; Tooth Wear ; Weight Loss