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

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

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

Excessive wear causes many complications when untreated, so that accurate diagnosis, analysis and predictive treatment plan should be made, and through evaluation of vertical dimension and stepwise treatment, a stable inter-arch relationship can be set. For the long-term success of implant treatment, ideal position and angle of implant is important, and its importance increases especially in multiple implant cases. Therefore, thorough diagnosis and planning, accurate surgery and prosthodontic procedures are significant. In this case, a 68-year-old male patient with a loss of vertical dimension due to multiple tooth loss and overall tooth wear was planned with systematic analyses from the pre-treatment stage to rehabilitate vertical dimension. Full-mouth fixed rehabilitation with computer tomography guided implant surgery was performed to the newly set vertical dimension and attained satisfactory outcomes both functionally and esthetically.
Aged ; Dentition* ; Diagnosis ; Humans ; Male ; Rehabilitation* ; Tooth Loss ; Tooth Wear ; Tooth* ; Vertical Dimension*

In the oral cavity, the teeth undergo wear and corrosion throughout their lives. Progressive and constant tooth wear is a natural phenomenon of aging, but wear and corrosion due to specific factors are pathological factors. It can cause pathological damage of the occlusal surface, aesthetic problems, dimensional loss and jaw joint disorders. This case is a 26-year-old female patient with general tooth abrasion and erosion on the entire dentition. Diagnostic wax-up was fabricated based on the information including digital facial analysis, physiological stabilization, and evaluation of anterior crown length. Through the digital analysis, the necessary guides for crown lengthening were prepared and the mastication function and esthetics were evaluated by using temporary crowns. Definitive prosthesis was fabricated with the zirconia restorations. The results were satisfactory when they were observed 3 months of follow-up.
Adult ; Aging ; Corrosion ; Crown Lengthening ; Crowns ; Dentition ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Jaw ; Joints ; Mastication ; Mouth Rehabilitation ; Mouth ; Prostheses and Implants ; Tooth Abrasion ; Tooth Erosion ; Tooth Wear ; Tooth

This study reported the treatment of a patient with excessive worn dentition and limited maxillo-mandibular space for restoration, utilizing the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. After the thorough examination of the patient's occlusal vertical dimension (OVD), full mouth rehabilitation was planned with increase of the OVD. The patient was satisfied with the provisional restorations establishing the increased OVD. The horizontal and vertical data of the patient's jaw relation that the provisional restorations contained were transferred to the definitive metal ceramic fixed prostheses by double scanning and three-dimensional printing. After the fixed restorations were cemented to the abutments, electronic surveying and three-dimensional printing were used to fabricate metal frameworks for the patient's removable partial dentures. The mandibular definitive removable prostheses were delivered to the patient's mouth and the full mouth rehabilitation procedures were completed. The digital technologies used for this case produced fixed and removable restorations satisfactory in masticatory, phonetic and aesthetic functions to both the patient and the dental clinician.
Ceramics ; Computer-Aided Design ; Dentition ; Denture, Partial, Removable ; Humans ; Jaw ; Mouth Rehabilitation ; Mouth ; Printing, Three-Dimensional ; Prostheses and Implants ; Tooth Wear ; Vertical Dimension

Excessive tooth wear can cause irreversible damage to the occlusal surface and can alter the anterior occlusal relationship by destroying the structure of the anterior teeth needed for esthetics and proper anterior guidance. The anterior deep bite is not a morbid occlusion by itself, but it may cause problems such as soft tissue trauma, opposing tooth eruption, tooth wear, and occlusal trauma if there are no stable occlusal contacts between the lower incisal edge against its upper lingual surface. The most important goal of treatment is to form stable occlusal contact in centric relation. In this case report, patients with decrease in vertical dimension and anterior deep bite due to maxillary posterior tooth loss and excessive tooth wear were treated full mouth rehabilitation with increased vertical dimension to regain the space for restoration and improve anterior occlusal relationship and esthetics. The functional and aesthetic problems of the patient could be solved by the equal intensity contact of all the teeth in centic relation (CR), anterior guidance in harmony with the functional movement, and restoration of the wear surface beyond the enamel range.
Centric Relation ; Dental Enamel ; Esthetics ; Humans ; Mouth Rehabilitation ; Mouth ; Overbite ; Tooth Eruption ; Tooth Loss ; Tooth Wear ; Tooth ; 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