Assessment and management of dental erosion

Dental erosion following clopidogrel administration in a dog: A case-based study

A 10-year-old neutered male Chihuahua presented with unilateral dental erosion that occurred after several months of oral medications mixed with honey. A pH test was performed on all oral medications administered to the dogs to determine the cause of enamel erosion. Among the medications, the only acidic medication was clopidogrel (pH 2.65). To evaluate the effect of clopidogrel on the tooth surface under the same conditions as in the present patient, an additional preliminary study was designed in which two extracted teeth of another dog were immersed in a clopidogrel-honey mixture or only in honey. After a 3-week soaking of the extracted tooth in the clopidogrel-honey mixture, field-emission scanning electron microscope analysis revealed a rougher surface, whereas energy-dispersive X-ray spectroscopy analysis showed a reduced Ca/C ratio compared to the control tooth. In this case, prolonged exposure of the tooth surface to clopidogrel may be a cause of dental erosion.

The Effect of a Deproteinizing Pretreatment on the Bonding Performance and Acid Resistance of a Two-step Self-etch Adhesive on Eroded Dentin

OBJECTIVES

This study evaluated how deproteinization using sodium hypochlorite (6% NaOCl) or hypochlorous acid (50 ppm HOCl) with or without the subsequent use of an arylsulfinate salt-containing agent (Clearfil DC Activator; DCA; Kuraray Noritake Dental) affects the micro-tensile bond strength (μTBS) and formation of an acid-base resistant zone (ABRZ) of a two-step self-etch adhesive on eroded dentin.

METHODS

Coronal dentin surfaces of sound human molars were exposed to 48 cycles of demineralization (1% citric acid; 5 minutes) and remineralization (buffer solution with pH=6.4; 3.5 hours). They were then assigned to experimental groups according to the pretreatment used: none (negative control), NaOCl, NaOCl+DCA, HOCl, and HOCl+DCA. Sound dentin surfaces with no pretreatment were used as a positive control. The dentin surfaces were bonded with Clearfil SE Bond 2 (Kuraray Noritake Dental), and μTBS was measured either after 24 hours or 20,000 thermal cycles (TC). The μTBS data were statistically analyzed using a mixed-model analysis of variance (ANOVA) and t-tests with Bonferroni correction. Failure mode was determined with scanning electron microscopy (SEM), which was also used for the observation of ABRZ.

RESULTS

Among experimental groups, there was no significant difference between the negative control, HOCl, and HOCl+DCA after 24 hours, but the HOCl-pretreated groups exhibited significantly higher μTBS than the negative control after TC (p<0.01). Pretreatment with NaOCl and NaOCl+DCA resulted in significantly higher μTBS (p<0.001), but the highest μTBS was measured on sound dentin (p<0.001). TC decreased μTBS significantly in all groups (p<0.001) except for sound dentin and NaOCl+DCA (p>0.05). Adhesive failures prevailed in eroded groups, whereas cohesive failures were predominant on sound dentin. ABRZ was recognized in all groups but marked morphological differences were observed.

CONCLUSIONS

The combined use of 6% NaOCl and the arylsulfinate salt-containing agent partially reversed the compromised bonding performance on eroded dentin, while the effect of 50 ppm HOCl was negligible.

Exploring the Perception and Awareness of Dental Students and Interns in Managing and Treating Pregnant Patients

Background Undergraduate dental students and interns express reluctance to deal with pregnant women in the dental office due to the fear of medical consequences on the fetus. This study aims to explore the knowledge, attitudes, and practices of dental students and interns regarding the dental considerations of pregnant women in three dental schools in Saudi Arabia. Methodology This cross-sectional study was performed between October and December 2023 and targeted the clinical academic years of dental students and interns at three dental schools in Saudi Arabia, namely, Taibah University, Umm Al-Qura University, and Qassim University. Using the convenience sampling method, 223 students were invited to respond to a questionnaire constructed from previously published studies and reviewed by experts in the field. It consisted of 15 questions divided into four sections. Descriptive analysis and chi-square test were conducted to assess the difference between the different sociodemographic groups and students' educational levels with the significance level set at p-values <0.05. Results Overall, 223 complete responses were received, with a response rate of 97%. Demographics included 99 (44.40%) males and 124 (55.60%) females, with a reasonable distribution across academic years. Knowledge assessment findings revealed that 114 (51%) participants acquired adequate knowledge. Regarding participants' attitudes, 112 (50%) found the curriculum-centered information sufficient. In addition, 173 (77.6%) participants chose lectures/books as their preferred source of information. Almost 138 (61.9%) participants did not feel confident in managing pregnant women. The chi-square test revealed that educational level significantly impacts the knowledge and practice of the participants, regardless of their gender (p < 0.05). Conclusions Both students and dental interns showed adequate-to-good levels of knowledge and attitude. Both need more exposure to clinical situations with pregnant women during their undergraduate dental training programs to boost their confidence level and enhance their readiness to practice dental procedures with such a group of patients after graduation.

Metallic Dental Implants Wear Mechanisms, Materials, and Manufacturing Processes: A Literature Review

OBJECTIVES

From the treatment of damaged teeth to replacing missing teeth, dental biomaterials cover the scientific interest of many fields. Dental biomaterials are one of the implants whose effective life depends vastly on their material and manufacturing techniques. The purpose of this review is to summarize the important aspects for metallic dental implants from biomedical, mechanical and materials science perspectives. The review article will focus on five major aspects as mentioned below. Tooth anatomy: Maximizing the implant performance depends on proper understanding of human tooth anatomy and the failure behavior of the implants. Major parts from tooth anatomy including saliva characteristics are explored in this section. Wear mechanisms: The prominent wear mechanisms having a high impact on dental wear are abrasive, adhesive, fatigue and corrosion wear. To imitate the physiological working condition of dental implants, reports on the broad range of mastication force and various composition of artificial saliva have been included in this section, which can affect the tribo-corrosion behavior of dental implants. Dental implants classifications: The review paper includes a dedicated discussion on major dental implants types and their details for better understanding their applicability and characteristics. Implant materials: As of today, the most established dental implant materials are SS316L, cobalt chrome alloy and titanium. Detailed discussion on their material properties, microstructures, phase transformations and chemical compositions have been discussed here. Manufacturing techniques: In terms of different production methods, the lost wax casting method as traditional manufacturing is considered. Selective Laser Melting (SLM) and Directed Energy Deposition (DED) as additive manufacturing techniques (AM) have been discussed. For AM, the relationships between process-property-performance details have been explored briefly. The effectiveness of different manufacturing techniques was compared based on porosity distribution, mechanical and biomechanical properties.

SUMMARY

Despite having substantial research available on dental implants, there is a lack of systematic reviews to present a holistic viewpoint combining state-of-the-art from biomedical, mechanical, materials science and manufacturing perspectives. This review article attempts to combine a wide variety of analyzing approaches from those interdisciplinary fields to deliver deeper insights to researchers both in academia and industry to develop next-generation dental implants.

Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review

A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

Evaluating the pH of Various Commercially Available Beverages in Pakistan: Impact of Highly Acidic Beverages on the Surface Hardness and Weight Loss of Human Teeth

The objectives of this study were to investigate the pH of common beverages and to evaluate the effects of common acidic beverages on the surface hardness and weight loss of human tooth specimens. A total of 106 beverages were conveniently purchased from supermarkets in Karachi, Pakistan. Prior to evaluation, beverages were refrigerated or stored at room temperature in accordance with the manufacturers’ recommendations. Beverages were categorized into six groups: ‘Sports and Energy drinks’, ‘Water’, ‘Fruit Juices and Drinks’, ‘Sodas’, ‘Milk and Flavored Milk’ and ‘Teas and Coffee’. Using a pH meter, the pH of each beverage was measured in triplicate at room temperature. In addition, the influence of five highly acidic beverages on the weight loss and surface hardness of human tooth specimens was evaluated using gravimetric analysis and the Vickers hardness tester, respectively. ‘Sports and Energy drinks’, ‘Fruits Juices and Drinks’ and ‘Sodas’ were the most acidic beverage categories, with a pH range of 3.00−5.00. A total of 33% of beverages tested in this study were highly acidic (pH less than 4.00), 29% of beverages were moderately acidic (pH 4.00−4.99) and 31% were mildly acidic (pH 5.00−6.99). Significant weight loss was observed in all immersed specimens compared to control counterparts (p < 0.05). Similarly, for surface hardness, five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi and Tang Orange) significantly decreased the surface hardness of specimens (p < 0.05). The pH levels of commonly available beverages in Pakistan are highly acidic, which may encourage loss of minerals from teeth; hence, affecting their surface hardness.

Does the Application of Additional Hydrophobic Resin to Universal Adhesives Increase Bonding Longevity of Eroded Dentin?

This paper evaluates the effect of an additional hydrophobic resin coat (extra HL) associated with universal adhesives on sound and eroded dentin and evaluated immediately or after 2 years of water storage to improve the microtensile bond strength (μTBS) and nanoleakage (NL) when compared to the use of universal adhesives only. Sixty-four molars were assigned to eight groups using the following combinations: 1. dentin substrate, including sound and eroded dentin; 2. treatment, including the control and extra HL and storage time (immediately and after two-years of storage). Two universal adhesives (Prime & Bond Active or Scotchbond Universal) were evaluated. Before restoration, half of the teeth were subjected to soft-drink erosion. Composite buildups were bonded; specimens were stored (37 °C/24 h), sectioned into resin−dentin bonded sticks and tested for microtensile bond strength and nanoleakage using SEM (immediately and after two-years of storage). Three-way ANOVA and Tukey’s test (α = 0.05%) were used. In the immediate testing, the application of extra HL did not increase microtensile bond strength values compared with the control group in either substrate (p > 0.05). However, extra HL significantly decreased nanoleakage values when applied to eroded and sound dentin (p = 0.0001). After two years, the application of extra HL produced significantly higher microtensile bond strength and lower nanoleakage values than the control group for both adhesives (p = 0.0001). In all cases, sound dentin showed higher microtensile bond strength and lower nanoleakage values than eroded dentin (p = 0.000001). An extra HL increased the bond strength and reduced nanoleakage in eroded dentin after two-years of storage.

Prevalence and risk factors of erosive tooth wear among young adults in the Singapore military

OBJECTIVES

Erosive tooth wear (ETW) is defined as the irreversible chemo-mechanical loss of dental hard tissues without plaque or bacteria and has been a growing phenomenon in the general population worldwide. The aim of this study was to determine the prevalence of ETW and the associated risk factors among young military personnel in Singapore.

MATERIALS AND METHODS

This cross-sectional study consisted of a questionnaire and clinical examination of military personnel between 18 and 25 years. The questionnaire collected information on demographics, medical and dental history, lifestyle and dietary habits. Tooth wear was clinically evaluated using the Basic Erosive Wear Examination (BEWE) index. The participants were profiled into four risk categories (none, low, moderate, severe) based on the sum score. Multivariable logistic regression analysis was performed to determine the risk factors associated with the presence of ETW.

RESULTS

Out of 1296 participants evaluated, 21.8% of them had ETW. The anterior sextants were more affected by erosion than posterior sextants for both arches. The risk factors significantly associated with ETW were GERD (OR = 2.83, p = 0.041), presence of self-reported TMD symptoms (OR = 2.51, p < 0.001), acidic food (OR = 2.03, p < 0.001) and drinks (OR = 3.07, p < 0.001), high caries risk (OR = 4.59, p < 0.001) and toothbrush stiffness (OR = 4.67, p < 0.001).

CONCLUSION

ETW is prevalent among the young military population, with over half of the population at a risk of ETW. Gastric reflux disease, TMD, acidic diet, dental caries susceptibility and the use of stiff toothbrushes were identified as significant risk factors.

CLINICAL RELEVANCE

A large proportion of young military personnel exhibited mild to moderate risk of ETW. Dental professionals can identify risk-susceptible individuals at a young age and educated them with preventive measures and dietary interventions to prevent the progression of the condition.

Awareness and knowledge of dental erosion and its association with beverage consumption: a multidisciplinary survey

BACKGROUND

Erosive tooth wear has significant impacts on oral and general health. This study aimed to measure the awareness of dental erosion to establish the relationships among sociodemographic factors, awareness and knowledge of dental erosion, and beverage consumption behaviours, in a sample of university students in Australia.

METHODS

All undergraduate students enrolled in the targeted programs at an Australian University were invited. A total of 418 students consented to participate. Each was assessed with an online questionnaire.

RESULTS

The awareness rate of dental erosion was 92.1%. Soft drinks and fruit juice were most often perceived as acidic beverages by the respondents. The students of greater age, and studying pharmacy, paramedicine, physiotherapy or science, were less likely to be aware of dental erosion. Those students that were aware of dental erosion also had better knowledge of dental erosion, which was associated with a reduced quantity of daily acidic beverage consumption as well. The students that predominantly resided overseas had less knowledge of dental erosion. The students that were of greater age, that were studying clinical science, pharmacy, medical science, paramedicine, or science, and that correctly identified more types of acidic beverages, more often consumed acidic beverages in high-risk patterns.

CONCLUSIONS

Erosive tooth wear is a relevant matter in dentistry, nutrition and public health. Within a university setting, the effect of education on oral health literacy and beverage consumption behaviour is confirmed. Dental and health professionals should actively educate the individuals and communities about dental erosion and motivate them to change acidic beverage consumption behaviours.

Contemporary diagnosis and management of dental erosion

OBJECTIVE

This article is aimed at providing an overview of the topic of erosive tooth wear (ETW), highlighting the clinical signs, diagnosis, and management of dental erosion.

OVERVIEW

With the increased prevalence of ETW, it is important that oral health professionals are able to recognize the early signs. Early clinical signs of dental erosion are characterized by loss of enamel texture, a silky glossy appearance, and sometimes a dulling of the surface gloss, referred to as the "whipped clay effect, cupping, and restorations 'standing proud'." The progression of ETW should be monitored by means of diagnostic models or clinical photographs. ETW can be as a result of acid attack of extrinsic or intrinsic origin.

CONCLUSION

There is an increase of ETW that is being recognized by the profession. The first step in diagnosing and management is to recognize as early as possible that the process is occurring. At that point a determination of whether the primary etiology is either intrinsic or extrinsic should be made. If these findings are confirmed, appropriate prevention, and management strategies can be adopted followed by appropriate restorative therapy.

CLINICAL SIGNIFICANCE

The prevalence of ETW continues to increase. It is therefore important that oral health care providers have a better understanding of the etiology, pathophysiology, and management of this condition. This review aims to provide the guidelines for diagnosis and management of dental erosion.

A systematic review of dietary acids and habits on dental erosion in adolescents

BACKGROUND

Dental erosion is the dissolution of dental hard tissues caused by acids of a non-bacterial origin. Dietary acids are considered the predominant and most controllable factor.

AIM

To synthesise the literature on the effects of dietary acids and habits on dental erosion in the permanent dentition of 10- to 19-year-old adolescents.

MATERIALS AND METHODS

An electronic literature search was undertaken in Cochrane, MEDLINE, CINAHL, Dentistry & Oral Sciences Source via EBSCOhost, and Embase with no restriction on the date of publication.

RESULTS

The initial search identified 449 articles, and 338 remained after removal of duplicates. Seventy-seven articles remained after screening of titles and abstracts, and 52 were eligible for the full-text review. A considerable variety of beverages, food, and dietary habits were reported as risk factors for dental erosion. The most consistent findings implicated the erosive potential of carbonated beverages and the consumption of acidic drinks at bedtime.

CONCLUSIONS

Although results were not consistent between cohort and cross-sectional studies, this review suggests certain dietary risk factors may contribute to dental erosion in adolescents. There is a need for more high-quality cohort studies to establish more conclusive evidence on the role of dietary acids and habits on dental erosion.

Antierosive Effect of Topical Fluorides: A Systematic Review and Meta-Analysis of In Situ Studies

BACKGROUND:

The effectiveness of the application of topical fluorides in prevention of erosive tooth wear has been an issue of controversy in the literature. The objective of this systematic review was to assess in situ studies investigating the effects of using topical fluorides on prevention of erosive tooth wear

MATERIAL AND METHODS:

Two electronic databases PubMed/MEDLINE and Cochrane Central Register of Controlled Trials were searched. Eligibility criteria included in situ-controlled studies that assessed the effect of the erosive process without additional tooth brushing. The search involved English-written articles only. A total of 684 potentially relevant titles and abstracts were found after removal of duplicates, of which 22 full-text articles were selected. Seventeen studies were included in the qualitative synthesis of which 6 studies included in the meta-analysis. The following data were obtained for each study: authors, year of publication, country, study design, periods of study, duration, blinding, interventions (type/concentration/form), tooth substrate, location of the intraoral appliance, number of samples attached to each appliance, type of acidic media used for erosive challenge, duration of erosive challenge, subjects (number/age/sex), reported side effects -if any-, measuring device, amounts of tissue loss.

RESULTS:

The risk of bias of the included studies was assessed using the Cochrane Collaboration tool for assessing the risk of bias. A meta-analysis of the present study was performed using Comprehensive Meta-Analysis version 2.2.048 software.

CONCLUSION:

The use of oral hygiene products containing AmF/NaF/SnCl2 or NaF may be effective in the prevention of erosive tooth wear.

Prevalence of Dentinal Hypersensitivity and Dental Erosion among Competitive Swimmers, Kerala, India

Background

Professional swimmers face a hidden occupational hazard due to improper maintenance of pool. Ill maintained pools can lead to erosive effects on dental health and thus needs to be evaluated.

Methodology

Fifty-six competitive swimmers from two training centers were contacted and surveyed for swimming exposure and oral health. A visual analog scale was used to rate the tooth sensitivity. Dental erosion and dental caries were recorded according to WHO oral health assessment criteria (2013). The dentinal hypersensitivity experience was assessed using the dentine hypersensitivity experience questionnaire - 15 (DHEQ-15). Data were analyzed using Chi-square test and multivariate analysis.

Results

The prevalence of dentinal hypersensitivity and dental erosion was found to be 69.6% and 48.2%, respectively. The common surfaces affected by dental erosion were palatal surfaces of maxillary anterior, followed by lingual surfaces of mandibular anterior. There was a direct association between duration of the stay in pool and dental erosion. The DHEQ-15 questionnaire revealed that more than 80% of the participants never felt these sensations had any serious long-term effects on oral health.

Conclusions

Oral health professional must understand dental erosion among competitive swimmers as an occupational oral health hazard and provide early counseling and necessary invasive and noninvasive care.

[Tooth Erosions Associated with Gastroesophageal Reflux: Cause, Prevention and Restorative Therapy]

Tooth Erosions Associated with Gastroesophageal Reflux: Cause, Prevention and Restorative Therapy Abstract. Dental erosions are caused by the recurring contact of solutions which are unsaturated in tooth minerals,ith hard tooth substances. This initially leads to softening and later to an irreversible loss of hard tooth substance. Erosion is observed particularly with excessive consumption of acidic foods (e.g. soft drinks or citrus fruits) but also in connection with gastrointestinal (gastroesophageal reflux disease) or psychosomatic diseases (anorexia nervosa or bulimia nervosa). The aim of this article is to define dental erosions, their causes, prevalence and consequences as well as possible preventive measures. Based on a clinical example of a patient with reflux-related erosions, a therapy option with direct composite tooth build-up is presented.

Dental erosion caused by Granny Smith apples: An evidence-based case report and 1-year follow-up

Apples, if indiscriminately consumed without appropriate preventive measures to check erosion, can cause accelerated wear of the teeth.Dentists must be fully aware of the intrinsic and extrinsic factors that cause erosive tooth wear. Management strategy for tooth erosion depends on the severity of erosion, esthetics, function, and patient's preference.

Three-Year Effects of Deproteinization on the In Vitro Durability of Resin/Dentin-Eroded Interfaces

Objective:

To evaluate the effect of sodium hypochlorite on the immediate and three-year bonding properties of a resin-eroded dentin interface produced by one of two adhesive strategies.

Methods and Materials:

Forty-eight molars were randomly assigned to six experimental groups, according to the combination of the adhesive strategy (etch-and-rinse and self-etch) and the dentin surface (control groups without erosion, eroded dentin surface [ED], and eroded dentin surface + NaOCl 5.2% [ED + NaOCl]). After completing restoration, specimens were stored in water (37°C) for 24 hours and then sectioned into resin–dentin beams (0.8 mm2) to be tested under tension (0.5 mm/min) immediately thereafter or after three years of water storage. To assess nanoleakage (NL), specimens were immersed in silver nitrate solution and examined by scanning electron microscopy at both time points. The dentin-etching pattern was examined under a scanning electron microscope. Data were subjected to appropriate statistical analysis (α=0.05)

Results:

In both strategies, a more pronounced and significant reduction of the microtensile bond strength (μTBS) values was observed for the ED groups (p=0.0001) after three years. However, in the ED + NaOCl group, μTBS values were maintained after three years of water storage. Furthermore, application of NaOCl to eroded dentin significantly reduced the immediate NL values and also preserved these values after three years of water storage for both adhesive strategies (p&gt;0.05). When considering the ED group, a superficial removal of the smear layer and enlarged lumen tubules in comparison to control were present. However, for ED + NaOCl, there was a total removal of the smear layer and significant numbers of collagen fibrils were exposed.

Conclusion:

The use of NaOCl may maintain the long-term stability of a resin-eroded dentin interface formed by etch-and-rinse and self-etch adhesives.

Interarch comparison of intraoral pH and temperature: a pilot study

Purpose of study:

The severity of tooth wear is known to have an association with intraoral pH and temperature depending on the site.

Objective:

To compare the intraoral pH and temperature between the maxillary and mandibular arch.

Methods:

Fourteen participants (mean age=25.8 years) wore a custom-made intraoral appliance fitted with a pH probe and thermocouple for 24 h while carrying out normal activities including sleep. All participants wore a maxillary appliance; four participants repeated the process and wore the mandibular appliance. Measurements were taken from the palatal aspect of the upper central incisors and lingual aspect of the lower canines. Both qualitative and quantitative statistical analyses were conducted.

Results:

The mean intraoral pH from the maxilla was 7.32 (±0.52) and 7.07 (±0.26) for the mandible. During daytime, there was no statistical significance difference between the two arches (P=0.12). During sleep, there was a significant difference (P<0.001) between the mean pH of the maxilla, 7.0 (±0.46), and mandible, 6.46 (±0.31). The fluctuation patterns of pH and temperature from both arches were similar, but the maxilla showed more variations. The mean temperature from the mandible was slightly higher (36.18 °C (±0.96)) than the maxilla, 33.12 °C (±5.51) during daytime; however, there was no statistically significance difference in temperature between the arches during daytime (awake) or sleep (P=0.27).

Conclusion:

The results showed that there is significant difference in mean intraoral pH between the maxilla and the mandible during sleep, but not during the day and this difference may be associated variations in tooth wear between the arches.

Efeito de diferentes fotopolimerizadores e meio de imersão na rugosidade e na cor de um compósito nanoparticulado

Resumo Introdução O consumo excessivo de refrigerantes parece alterar as propriedades dos compósitos e essa alteração pode estar relacionada à unidade fotopolimerizadora. Objetivo Avaliar a alteração da rugosidade superficial (ΔR) e da cor (ΔE) de um compósito polimerizado por diferentes fotopolimerizadores, imerso em água destilada ou Coca-Cola®. Metodologia Sessenta amostras da resina nanoparticulada (FiltekMR Z350 XT, 3M) foram distribuídas de acordo com as diferentes unidades de fotopolimerização: a) luz halógena de quartzo-tungstênio-halogênio (QTH); b) Luz de Emissão Diodo - LED 1 com ponteira de polímero; c) LED 2 com ponteira de fibra ótica. Metade de cada grupo (n=10) foi mantida em água destilada ou imersa em Coca-Cola® 2×/dia por 20 minutos, durante 14 dias. Os dados foram submetidos aos testes Mann-Whitney e Kruskal-Wallis (p≤0,05). Resultado A ΔR não foi significante entre os grupos: em água: QTH = 0,006; LED 1 = 0,019; LED 2 = 0,010 (p=0,33); em refrigerante: QTH = 0,021; LED 1= 0,011; LED 2 = 0,030 (p=0,86). A ΔE não foi significativa entre os fotopolimerizadores: em água: QTH = 1,40; LED 1 = 1,80; LED 2 = 1,60 (p=0,31); em refrigerante: QTH = 2,51; LED 1= 1,91; LED 2 = 2,61 (p=0,41), mas foi significante comparando os meios de imersão (p=0,01), exceto para LED 1 (p=0,54). Conclusão As unidades fotopolimerizadoras não interferiram na rugosidade superficial e na cor da resina composta nanoparticulada. Os mergulhos diários em refrigerante não alteraram a lisura, mas alteraram a cor de modo visualmente perceptível, mas clinicamente aceitável, conforme os parâmetros da literatura científica.

Short-pulse Er:YAG laser increases bond strength of composite resin to sound and eroded dentin

This study evaluated the influence of the irradiation with a short-pulse Er:YAG laser on the adhesion of composite resin to sound and eroded dentin (SD and ED). Forty-six samples of occlusal dentine, obtained from human molars, had half of their surface protected, while the other half was submitted to erosive cycles. Afterward, 23 samples were irradiated with Er:YAG laser, resulting in four experimental groups: SD, sound irradiated dentine (SID—Er:YAG, 50  μs 50  μs , 2 Hz, 80 mJ, and 12.6  J/cm 2 12.6  J/cm2 ), ED, and eroded irradiated dentin (EID—erosion + Er:YAG laser). A self-etching adhesive system was used, and then cylinders of composite resin were prepared. A microshear bond strength test was performed after 24 h storage (n=20 n=20 ). The morphology of SD and ED, with or without Er:YAG laser irradiation, was evaluated under scanning electron microscopy (n=3 n=3 ). Bond strength values (MPa) were subjected to analysis of variance followed by Tukey’s test. Statistically significant differences were found among the experimental groups: SD (9.76±3.39  B 9.76±3.39  B ), SID (12.77±5.09 A 12.77±5.09 A ), ED (5.12±1.72 D 5.12±1.72 D ), and EID (7.62±3.39 C 7.62±3.39 C ). Even though erosion reduces the adhesion to dentin, the surface irradiation with a short-pulse Er:YAG laser increases adhesion to both ED and SD.

Association of erosion with timing of detection and selected risk factors in primary dentition: a longitudinal study

OBJECTIVE

The aims of this study were to determine the prevalence of erosion in a birth cohort at 24, 36, and 48 months and to investigate risk factors for erosion.

METHODS

One hundred and fifty-four children from a birth cohort were followed at 24, 36, and 48 months of age.

RESULTS

Of the 154 children examined, 0% (0/154), 7% (11/154), and 28% (40/154) had erosion detected for the first time at 24, 36, and 48 months, respectively (P < 0.001). A cumulative total of 51 (33%) children and 256 (8%) teeth had erosion by the age of 48 months. There were no significant associations between erosive lesions first detected at 36 months and oral hygiene behaviour, medical conditions, or dietary habits reported at the 24- or 36-month examinations (all P > 0.05). In contrast, erosive lesion first detected at 48 months was positively associated with the use of a feeding bottle reported at the 36-month examination (P = 0.026).

CONCLUSIONS

The prevalence of dental erosion in young children increased with age, with clinically detectable lesions forming between 24 and 36 months of age. Erosive lesions first detected at 48 months were positively associated with the use of a feeding bottle reported at 36 months.

Factors affecting the dental erosion severity of patients with eating disorders

BACKGROUND

Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior.

METHODS

A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared.

RESULTS

Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food.

CONCLUSIONS

While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.

Root caries: a periodontal perspective

BACKGROUND AND OBJECTIVE

A prevailing dental problem in the periodontal patient is root caries. Specifically, periodontal involvement often results in root surfaces becoming exposed and at risk for this condition. Periodontal therapy often leads to increased gingival recession as well, and the associated increased root caries risk may compromise the long-term success and survival of periodontally treated teeth.This narrative review will address the topic of root caries in the periodontal patient, focusing on unmet research needs.

MATERIAL AND METHODS

The Medline database was searched to identify items dealing with root caries, in terms of clinical features, diagnosis, pathogenic mechanisms and histopathology, as well as epidemiology, focusing then on the relationship between root caries and periodontal disorders.

RESULTS

Although there is extensive literature on root caries, consensus is lacking regarding certain aspects, such as diagnostic criteria, prevalence within populations and indisputable risk factors. Advancing age could be an aggravating factor in susceptibility to root caries for the periodontal patient; however, definitive evidence in this regard is still missing. Similarly, full awareness of the increased risk of root caries in patients with periodontal disease or long-term periodontal treatment appears to be still lacking.

CONCLUSION

Research regarding root caries in age-specific (elderly) periodontal patients is needed. Improved oral hygiene practices, locally applied preventive measures, good dietary habits and regular dental check-ups are crucial approaches to prevent both periodontal disease progression and root caries. Periodontal patients with root exposure should follow a strict root caries prevention protocol, as an integral component of their periodontal maintenance therapy.