Occlusal tooth wear in the general population of Germany: effects of age, sex, and location of teeth

The Prevalence of Tooth Wear and Their Associated Etiologies Among Adult Subjects Visiting Umm Al-Qura University Dental Clinic in Makkah City, Saudi Arabia

In the past two decades, changing trends in socioeconomic status, dietary habits, and individual lifestyles of individuals have led to the emergence of tooth wear as an oral health problem. The present study aimed to investigate the prevalence and the associated etiologies of tooth wear in a convenience sample of adult patients visiting outpatient clinics of the Faculty of Dentistry at Umm Al-Qura University. This cross-sectional study was conducted on adult patients (18-40 years old) visiting outpatient clinics of the Faculty of Dentistry, Umm Al-Qura University. Two trained examiners visually assessed patients' tooth wear using Smith and Knight's Tooth Wear Index (TWI). Following the clinical examination, patients completed a self-administered questionnaire detailing risk factors such as the frequency of intake of acidic food and medicines, general health, chewing habits, dietary factors, and oral health-associated preventive behaviors. The resulting collected data were tabulated and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). The total prevalence of tooth wear was 74%, and the recorded mean wear score (TWI) was 0.380 ± 0.386; anterior teeth exhibited greater wear than posterior teeth. Numerous associations were recorded between tooth wear and the tested variables in demographics, habits, diet, and medications, but most of them were not statistically significant. When toothbrushing habits were explored, the only factors to played a significant role in abrading the tooth structure were the type of brush bristles used (P-value = 0.026) and the frequency of brush renewal (P = 0.043). Patients who frequently ate citrus fruits and other acidic foods recorded high wear scores (0.509 ± 0.311 and 0.508 ± 0.402, respectively), although the difference was not statistically significant. When chewing occurred on both sides of the mouth, less tooth wear was recorded than if chewing was on the right or left side only (0.371 ± 0.260, 0.422 ± 0.273, and 0.520 ± 0.419, respectively). The study data support an association between tooth wear and patient occupation, use of hard-bristled and new toothbrushes, eating of citrus and other acidic food, and chewing on one side, as all of these factors increased the risk of tooth wear.

Long-term occlusal tooth wear at the onset of permanent dentition

OBJECTIVES

This study quantified the long-term occlusal wear in the natural posterior teeth and the associations per tooth type within the dentition.

METHODS

The sample included 70 orthodontically treated subjects (52 females and 18 males; median age, 14.3 years), followed for a 12.7-year period. They were consecutively selected with no tooth wear-related criteria. Post-treatment (T1) and follow-up dental casts (T2) were scanned and superimposed through three-dimensional methods. Occlusal wear volume of posterior teeth and tooth wear patterns were investigated through non-parametric statistics and analysis of covariance.

RESULTS

There were no significant differences between contralateral teeth. The average occlusal wear per posterior tooth was 2.3 mm3, with 65.2% of teeth showing values greater than 1 mm3. Males, mandibular teeth, and first molars exhibited slightly greater wear levels than females (median, 2.57 and 2.21 mm3, respectively; p = 0.005), maxillary teeth, and first or second premolars, respectively. In all first premolars and in the mandibular second premolars, the buccal cusps were primarily affected with no other distinct patterns. There were weak to moderate correlations between tooth types, apart from certain strong correlations detected in males.

CONCLUSIONS

Posterior tooth wear was highly prevalent after a 13-year period starting at the onset of permanent dentition. The detected patterns are in accordance with the concept of canine guidance occlusion that is transforming into group synergy through function.

CLINICAL RELEVANCE

The widespread tooth wear occurrence and the high intra- and inter-individual variability underline the need for individual patient monitoring to identify high-risk patients at early stages.

Erosive Tooth Wear in Subjects with Normal Occlusion: A Pioneering Longitudinal Study up to the Age of 60

The aim of this study was to assess the erosive tooth wear (ETW) at early and mature adulthood in subjects with natural normal occlusion. The sample consisted of 23 untreated subjects with normal occlusion. Dental models were taken longitudinally from the same subjects at 13 (T0), 17 (T1) and 60.9 years of age (T2) at a university. Evaluation of ETW was performed using a modified Basic Erosive Wear Examination (BEWE) index. Interphase changes were evaluated using Friedman and Dunn's test. Ordinal logistic regression was used to assess the influence of sex, dental arch, tooth and dental surfaces on the erosive tooth wear. Linear regression was used to evaluate whether the ETW degree at T1 could discriminate the degree of ETW at T2. The significance level adopted was 5%. ETW showed a significant increase with aging. The median ETW index at T0, T1 and T2 was 2, 4 and 7, respectively. ETW was greater in males in the incisors and canines and on the incisal/occlusal and lingual tooth surfaces. No significant differences were found between the maxillary and mandibular arches. Subjects with severe ETW at mature adulthood had greater tooth wear at age 17. In conclusion, ETW significantly increased during aging in subjects with normal occlusion. The greater the degree of tooth wear at early adulthood, the greater the tooth wear at mature adulthood. Preventive care should be recommended during early adulthood in patients demonstrating erosive tooth wear in order to avoid worsening with aging.

Aging changes in maxillary anterior teeth in untreated individuals: an observational longitudinal study

OBJECTIVE

The aging of the occlusion and tooth wears influence the smile design This study aimed at evaluating the aging changes of maxillary anterior teeth in nontreated subjects.

METHODS

The sample comprised dental models of 23 subjects (13 male, 10 female) with normal occlusions, taken at 13 (T1), 17 (T2) and 61 (T3) years of age. The following variables were measured in the maxillary anterior teeth using digital dental models: crown width/height proportion, anterior view width, crown angulation, gingival and incisal steps between central/lateral incisors and central incisors/canines. Interphase comparisons were evaluated using repeated measures analysis of variance followed by Tukey tests or Friedman tests. Sexual differences were evaluated using t tests (P < 0.05).

RESULTS

From 13 to 61 years of age, a decrease of crown width/height proportion (P = 0.008 and P =  < 0.001, for the lateral incisor and canines, respectively) and mesiodistal angulation (P =  < 0.001, P = 0.001 and P = 0.025 for the central incisor, lateral incisor and canines, respectively) of the maxillary anterior teeth were observed. The steps of the gingival margin and the incisal steps decreased with aging.

CONCLUSIONS

From adolescence to late adulthood, untreated individuals with normal occlusions demonstrated changes in the maxillary anterior teeth that may impair the smile esthetics and attractiveness.

Survival and debonding resistance of posterior cantilever resin-bonded fixed dental prostheses for moderately and severely worn dentition during thermomechanical loading

OBJECTIVES

The purpose of this study was to investigate the survival rate, the debonding resistance, and the failure modes of different occlusal veneer designs when used as a retainer for posterior cantilever, resin-bonded fixed dental prostheses (RBFDPs) at two tooth wear levels.

METHODS

Four test groups were assigned: two groups with occlusal-proximal preparation (PT1 and PT2 for grade 2 and 3 wear), and two groups for occlusal-proximal and lingual preparation (PLT1 and PLT2 for grade 2 and 3 wear) Monolithic zirconia ceramic (3Y-TZP) RBFDPs were luted with an adhesive bonding system (Panavia V5). The specimens underwent a chewing simulation for 1.200.000 cycles with a load of 5 kg and thermocycling for 7500 cycles between 5 °C and 55 °C. The surviving restorations were debonded under quasi-static conditions. The results were analyzed with ANOVA.

RESULTS

The specimens exhibited a 100 % survival rate after thermomechanical fatigue loading. The debonding resistance was statistically significant higher for group PLT1 than for group PT1 (P = 0.004), and higher for group PT2 than group PT1 (P ≤ 0.001). However, the debonding resistance showed no statistically significant difference between groups PT2 and PLT2 (P = 0.343), and groups PLT1 and PLT2 (P = 0.222). Groups PT1 and PT2 showed favorable failure modes in 62.5 % and 0.00 % of the specimens, respectively. While groups PLT1 and PLT2 presented 25 % favorable failure modes.

SIGNIFICANCE

Occlusal veneers showed promising results as a retainer for cantilever RBFDPs. The lingual extension might increase debonding resistance. Nevertheless, conservative designs with lingual and proximal bevels are to be recommended, irrespective of the level of tooth wear.

Clinical outcomes and influence of material parameters on the behavior and survival rate of thin and ultrathin occlusal veneers: A systematic review

PURPOSE

Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review aims to investigate clinical observational findings and compare in-vitro outcomes of thin and ultrathin occlusal veneers using different materials and approaches.

METHODS

An electronic search of online databases, such as PubMed (MEDLINE), BioMed Central (BMC), Cochrane, and Scopus, was performed for the 2009 - Jun 2021 period, following the PRISMA 2020 criteria. The reports sought for retrieval were all the articles evaluating the clinical outcomes of permanent full-mouth rehabilitation, and all in-vitro records that investigated and compared fracture strength, survival rate, and modes of failure of ultrathin (0.3 - 0.6 mm), thin (0.5 - 0.8 mm), and thick (0.8-1.5 mm) occlusal veneer restorations, with regard to the available indirect restorative materials. The Newcastle Ottawa risk of bias criteria was used to judge the clinical studies and a modified consort statement was used for the evaluation of in-vitro studies. The data of the included studies were extracted and grouped based on the similarity of the outcomes and study protocols. Data heterogeneity determined the qualitative and quantitative grouping of the results.

RESULTS

Two clinical and 17 in-vitro studies were included. Data exhibited heterogeneity within the materials, variables, testing protocols and observation periods. Therefore, only qualitative synthesis of the results was feasible. Clinically used 1 mm lithium disilicate overlays and ultrathin one-step no-prep polymer infiltrated ceramic network (PICN) occlusal veneers exhibited very high success and survival rates. The analysis of in-vitro studies exhibited variable survival rates and fracture load values, based on materials, thickness, and restorative approaches used.

CONCLUSIONS

Within the limitations of this systematic review, it can be concluded that the clinical outcomes of thin and ultrathin occlusal veneers/overlays are auspicious. In-vitro experimental results support the usage of the thin and ultrathin occlusal veneers.

Dental size variation in admixed Latin Americans: Effects of age, sex and genomic ancestry

Dental size variation in modern humans has been assessed from regional to worldwide scales, especially under microevolutionary and forensic contexts. Despite this, populations of mixed continental ancestry such as contemporary Latin Americans remain unexplored. In the present study we investigated a large Latin American sample from Colombia (N = 804) and obtained buccolingual and mesiodistal diameters and three indices for maxillary and mandibular teeth (except third molars). We evaluated the correlation between 28 dental measurements (and three indices) with age, sex and genomic ancestry (estimated using genome-wide SNP data). In addition, we explored correlation patterns between dental measurements and the biological affinities, based on these measurements, between two Latin American samples (Colombians and Mexicans) and three putative parental populations: Central and South Native Americans, western Europeans and western Africans through PCA and DFA. Our results indicate that Latin Americans have high dental size diversity, overlapping the variation exhibited by the parental populations. Several dental dimensions and indices have significant correlations with sex and age. Western Europeans presented closer biological affinities with Colombians, and the European genomic ancestry exhibited the highest correlations with tooth size. Correlations between tooth measurements reveal distinct dental modules, as well as a higher integration of postcanine dentition. The effects on dental size of age, sex and genomic ancestry is of relevance for forensic, biohistorical and microevolutionary studies in Latin Americans.

Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)-A Cross-Sectional Study

Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 non-PTSD periodontal patients (Control group). The study group was further divided into two subgroups of individuals who received psychiatric medications (40 patients) or did not (60 patients). All patients underwent complete dental, oral, and periodontal examinations, including assessing signs of parafunction. Results: All PTSD patients had poor oral hygiene. The plaque index (PI) was higher in the PTSD group compared to the control group (0.72 ± 0.28 vs. 0.45 ± 0.29, respectively, p < 0.001). The decayed, missing, and filled teeth score (DMFt) was higher in the PTSD population than in the controls (19.97 ± 8.07 vs. 13.05 ± 6.23 p < 0.05). Severe periodontal disease was more common among the PTSD subgroup taking medications (med -group) (62.5%) compared to the nonmedicated group (non-med group) (30.0%) and the controls (27.2%) (p = 0.001). Heavy smoking was more prevalent in the medicated PTSD patients than in other groups. Conclusions: The present study shows higher morbidities in combat-induced PTSD patients, including oral, dental, and periodontal manifestations, especially in medicated patients.

Longitudinal 3D Study of Anterior Tooth Wear from Adolescence to Adulthood in Modern Humans

Simple Summary

Tooth wear is the loss of tooth substance during everyday functioning by means other than dental caries. It is expected at a certain level in every person, and it increases with age. In the last decades, due to the increased life expectancy and high patient demands, it has become an important problem modern dentistry has to face. However, the average amount of tooth wear among individuals remains controversial. The purpose of this clinical study was to precisely detect the extent of anterior tooth wear over a thirteen-year period, from adolescence to adulthood. The present study revealed the very high tooth wear occurrence in the population already at early adulthood and showed that wear monitoring at an individual level is important for dentists to enable the better understanding of the problem and allow timely targeted interventions for patients in need. These might be preventive, such as the prescription of mouth guards to limit grinding and the cessation of harmful habits that lead to tooth wear, or interceptive, such as the restoration of the lost tooth substance to stop the progress of the condition and improve esthetics and function.

Abstract

In modern humans, tooth wear can easily be observed as a loss of tooth substance, but its precise measurement is problematic. The aim of this longitudinal cohort study was to determine the precise amount of occlusal tooth wear in the anterior permanent dentition from adolescence to adulthood. Corresponding tooth crowns from serial 3D digital dental models of 72 individuals were best fit-approximated by applying novel, highly accurate 3D superimposition methods. The superimposed crowns were simultaneously sliced on intact structures, and the differences in the volumes of the subsequent occlusal parts were calculated. Over a thirteen-year period, there was an average loss of anterior occlusal surfaces of 1.58 mm³ per tooth. Tooth surface loss in at least one tooth was higher than 1 mm³ in 93.1% of the human subjects. Tooth wear severity differed by sex and tooth type, with males showing higher values versus females and upper canines versus other anterior teeth. The study revealed the endemic occurrence of occlusal anterior tooth wear, highlighting the need for monitoring of the condition in the population to identify high-risk patients and enable timely interventions. The novel methods applied here on 3D digital models are recommended for this.

3D Occlusal Tooth Wear Assessment in Presence of Limited Changes in Non-Occlusal Surfaces

The study aimed to develop an accurate and convenient 3D occlusal tooth wear assessment technique, applicable when surfaces other than the occlusal undergo changes during the observation period. Various degrees of occlusal tooth wear were simulated in vitro on 18 molar and 18 premolar plaster teeth. Additionally, their buccal and lingual surfaces were gently grinded to induce superficial changes and digital dental models were generated. The grinded and the original tooth crowns were superimposed using six different 3D techniques (two reference areas with varying settings; gold standard: GS). Superimposition on intact structures provided the GS measurements. Tooth wear volume comprised the primary outcome measure. All techniques differed significantly to each other in their accuracy (p < 0.001). The technique of choice (CCD: complete crown with 30% estimated overlap of meshes) showed excellent agreement with the GS technique (median difference: 0.045, max: 0.219 mm³), no systematic error and sufficient reproducibility (max difference < 0.040 mm³). Tooth type, tooth alignment in the dental arches, and amount of tooth wear did not significantly affect the results of the CCD technique (p > 0.01). The suggested occlusal tooth wear assessment technique is straightforward and offers accurate outcomes when limited morphological changes occur on surfaces other than the occlusal.

The Prevalence of Tooth Wear in an Adult Population from the Eastern Province of Saudi Arabia

Aim

To assess the prevalence of tooth wear in the Eastern Province of Saudi Arabia in an adult population and to identify potential contributing factors, such as sociodemographic factors.

Methods

This cross-sectional study included adults between 18 and 40 years, seeking routine dental care. A clinical examination using the tooth wear index (TWI) was performed. Each tooth was given a TWI score, followed by classifying participants according to different risk levels. This was followed by a self-administered questionnaire on demographic information and oral hygiene habits. Statistical analyses included univariate, bivariate, as well as multivariate to assess the risk of tooth wear in relation to possible risk factors. The tests used were odds ratios (ORs) with 95% confidence intervals (CIs) and p-values < 0.05 to be statistically significant.

Results

The prevalence of tooth wear and dentin exposure was 83.5% and 58.8%, respectively, with the mean affected teeth of 1.3 ± 0.6 and 0.2 ± 0.2. Both gender and education level were significantly associated with tooth wear at bivariate and multivariate levels (p < 0.05).

Conclusion

The prevalence of tooth wear among sampled adults in this study was high. There was a clear difference in rates of tooth wear for gender and education level. Early identification and prevention of tooth wear will help reduce signs and symptoms in later stages of life.

Awareness and Treatment Decisions on Tooth Wear among Jordanian Dentists and Prosthodontists: A Cross-Sectional Survey Study

Objectives

To assess the awareness, knowledge, and treatment decisions by dentists in Jordan regarding tooth wear.

Materials and Methods

A questionnaire was disseminated to a random sample of 200 general dentists and 100 prosthodontists working in the Ministry of Health, academia, private practices, and military services. Chi square and independent t-tests were performed for statistical analysis.

Results

Hundred and seventy-nine dentists and prosthodontists responded (59.7% response rate), of which 71.5% was females. 83.8% of the dentists reported they see patients with tooth wear. 61.5% registered wear lesions in the patient file, and 68.2% reported they find a probable cause of tooth wear. 87.2% of the dentists reported that bruxism is the most common cause in Jordan. 63.3% dentists treated their patients. 46.4% reported they “always” record a dietary history. 77.7% did not think that tooth wear is linked to caries. Low confidence levels were demonstrated among general practitioners in diagnosing and treating tooth wear. Regarding treatment decisions, most dentists decided to restore worn teeth with composite and to construct a night guard. Minimally affected anterior teeth were mostly treated with fluoride. Restoration of posterior worn teeth with overlay was suggested by one-third of the dentists.

Conclusion

The dentists and prosthodontists in Jordan are aware of tooth wear. However, examination and documentation were given a little priority by general dentists. On the other hand, there was an agreement among the dentists and prosthodontists on applying the minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for tooth wear especially as no standard treatment is available. Therefore, this study investigated the awareness and treatment decisions of a sample of dentists and prosthodontists in Jordan.

A cone-beam computed tomographic assessment of the proximity of the maxillary canine and posterior teeth to the maxillary sinus floor: Lessons from 4778 roots

INTRODUCTION

When tooth roots protrude into the maxillary sinus, apical root resorption and tipping may occur during horizontal tooth movement across the sinus floor. Three-dimensional cone-beam computed tomography (CBCT) images may provide detailed information without distortion and overlap. We evaluated the relationships between the maxillary tooth root apices and the maxillary sinus floor using CBCT.

METHODS

We evaluated 4778 roots from 76 men (aged 27.6 ± 10.4 [mean ± standard deviation] years; range, 18-69 years), and 225 women (aged 30.4 ± 12.0 years; range, 18-68 years). The positional relationships between the maxillary tooth root apices, including the canine, premolar (first and/or second), and molar (first and/or second), and the inferior wall of the maxillary sinus were comprehensively evaluated on 2 cross-sectional CBCT images (ie, the sagittal and coronal planes). These distances were measured in both images simultaneously.

RESULTS

The sagittal plane distances were significantly larger than coronal plane distances, except for the distobuccal root of the first molar. Pearson correlation test revealed a significant negative correlation between the distance and the patient's age.

CONCLUSIONS

Our study provides valuable information for planning orthodontic tooth movement through the maxillary sinus, which may help to predict the occurrence and severity of root resorption.

Effect of occlusal slope related to uneven attrition on root stress distribution and potential fracture

Background/purpose

Severely uneven occlusal attrition is thought to play an important role in the occurrence of spontaneous vertical root fracture (VRF), a frequent problem among Chinese people. This study evaluated the influence of occlusal slope related to uneven attrition on the root stress condition.

Materials and methods

A finite element model of the mandibular first molar was established. Two different occlusal slope patterns were simulated in 5 models: (A) sound tooth, (B) 0.5–1.5 mm and (C) 2–3 mm attrition increased buccally, and (D) 0.5–1.5 mm and (E) 2–3 mm attrition increased distally. A static load of 200 N was applied vertically or angled at 45° to the longitudinal axis. The von Mises stress was evaluated.

Results

Under vertical loading, more stress was transferred from the cervical to the middle root with attrition, especially the mesial root, while stress declined with attrition under oblique loading. Stress was mainly distributed in the buccal surface and mesial root with vertical loading, or in the lingual surface and distal root with oblique loading. The maximum von Mises with oblique loading was significantly higher than with vertical loading.

Conclusion

Uneven occlusal attrition made the middle of the mesial root bear more stress, increasing fracture risk under vertical load. This finding suggests that timely restoration of the sloped occlusal morphology in teeth with severe attrition should be recommended to prevent VRFs. Lateral loading was not a risk factor of typical vertical root fractures, but the high stress could cause distal root cervical fracture.

Prevalence, severity and explanatory factors of tooth wear in Arab populations

OBJECTIVES

The aim of this study was to assess the prevalence and severity of tooth wear and related risk indicators in six Arab countries.

METHODS

This multicenter, multinational cross-sectional study was conducted among 2924 participants between the ages of 18-35 years old from six Arab countries. Calibrated dentists assessed tooth wear using the Basic Erosive Wear Examination Index (BEWE). Participants were also asked to complete a questionnaire that assessed their dietary and oral health habits. Each participant was identified by the sextant with the highest BEWE score in the upper and lower jaws.

RESULTS

Odds ratios were estimated for correlates of tooth wear anterior and posterior regions. Oman had the highest prevalence of BEWE score 3 (N = 255 (60.2%)). Overall, the highest BEWE score 3 was observed on the incisal edge of the upper anterior teeth (N = 602 (20.6%)) and in the lower left posterior region (sextant 6) on the occlusal surface (N = 466 (15.9%)). Correlates of severe tooth wear in both regions were eating or drinking more than six times per day, age and education. Drinking soft drinks "once a day" was significantly associated with severe tooth wear in the posterior region (OR: 1.3, 95% CI:1.05, 1.6). Brushing teeth more than twice a day was inversely associated with tooth wear in the anterior region (OR:0.75, 95% CI: 0.57,0.97).

CONCLUSION

The prevalence of tooth wear in Arab populations is relatively high, specific preventive and therapeutic measures should be developed to target people at higher risk of this condition.

CLINICAL SIGNIFICANCE

Tooth wear is now regarded as a significant oral health problems, dentists should advise their patients about dietary and oral health habits that can lead to severe tooth wear.

Tooth wear and gingival recession in 210 orthodontically treated patients: a retrospective cohort study

Aim

To assess the association between tooth wear (TW) and gingival recession (GR).

Materials and Methods

Two hundred and ten orthodontically treated participants (100 males) were evaluated. GR and TW were rated independently by four raters on plaster models at four time points: before treatment (T1), mean age 13.8 years (SD = 3.7); after treatment (T2), mean age 16.7 years (SD = 3.9); 3 years after treatment (T3), mean age 19.7 years (SD = 4.2); and 7 years after treatment (T4), mean age 23.9 years (SD = 4.8). Univariable and mulitvariable random effects logistic regression analyses were performed with scores for GR as dependent variables and with TW, age, gender, dental segments (maxillary and mandibular anterior and posterior segments), time points, and Angle classification as independent variables. Method reliability was assessed with kappa statistics.

Results

Mandibular incisors, mandibular and maxillary first premolars and maxillary first molars were most vulnerable to GR. The prevalence of GR increased during the observation period. At T1 20.5% participants had one or more recession sites, at T4 85.7 % of the participants had at least one GR. There was evidence of association between moderate/severe TW and GR-for a tooth with moderate/severe wear, the odds of recession were 23% higher compared to a tooth with no/mild wear (odds ratio 1.23; 95% CI: 1.08-1.40; P = 0.002). Age, dental segment, and time were also significant recession predictors, whereas gender was not.

Conclusions

There is evidence that moderate/severe TW is associated with the presence of gingival recession. Clinical significance of this can be limited.

Esthetic evaluation of natural teeth in anterior maxilla using the pink and white esthetic scores

BACKGROUND

Natural teeth in the anterior maxilla are critical in determination the esthetic outcome of single implant prosthesis.

PURPOSE

The present study aimed to explore aesthetics of natural teeth in the anterior maxilla using the Pink Esthetic Score/White Esthetic Score (PES/WES) index. Additionally, inherent weak spots of natural teeth and high-risk parameters of prostheses were also considered.

MATERIAL AND METHODS

This cross-sectional study was performed by photographic analysis.

RESULTS

A total of 102 subjects and 306 teeth (the right incisor, lateral incisor and canine) were included. The grand means of the PES and WES were 12.92 and 8.75, respectively. The score of soft tissue margin, soft tissue contour and outline/volume of the crown were significantly lower than other variables. The PES and WES showed a downward trend with age. Most of the PES/WES values of the females exceeded those of the males.

CONCLUSION

The average level of natural teeth in PES and WES assessment were around 13 and 9, respectively. The soft tissue margin, soft tissue contour and outline/volume of the crown were high-risk parameters for the esthetic outcomes of implant reconstructions. Underlying factors, such as age and gender, contributed to the esthetics of natural teeth change.

Analysis of the width ratio and wear rate of maxillary anterior teeth in the Korean population

PURPOSE

The purpose of this study was to compare the width ratio of maxillary anterior teeth according to age in the Korean population and to evaluate the maxillary central incisor width-to-length (W/L) ratio, given differences in age and gender.

MATERIALS AND METHODS

Ninety-three Korean adults were divided into 3 groups (n = 31) by age. Group I was 20 - 39 years old, Group II was 40 - 59 years old, and Group III was over 60 years of age. After taking an impression and a cast model of the maxillary arch, the anterior teeth width ratio and central incisor W/L ratio were calculated from standard digital images of the cast models using a graph paper with a digital single lens reflex (DSLR) camera. The calculated ratios were compared among all groups and central incisor W/L ratio were analyzed according to age and gender. All comparative data were statistically analyzed with one-sample t-tests, one-way ANOVAs with Tukey tests, and independent t-tests.

RESULTS

No significant differences in maxillary anterior teeth ratios were found among the age groups. The maxillary central incisor W/L ratios in Group III were the greatest and were significantly higher than those in the other groups. The central incisor W/L ratio of men was higher than that of women in Group II.

CONCLUSION

Maxillary anterior teeth width ratios were similar in all age groups in the Korean population. The maxillary central incisor was observed as worn teeth in the group over 60 years of age, and a significant difference between genders was found in 40 to 50 year olds.

Tooth wear: a cross-sectional investigation of the prevalence and risk factors in Beijing, China

Objectives:

The aim of this study was to evaluate the epidemiology of tooth wear in Beijing and to establish appropriate preventive measures.

Materials and Methods:

This cross-sectional analysis involved a questionnaire survey conducted for 1,812 individuals aged 12–74 years in Beijing. Subjects were local residents living in the region for >6 months before the survey. Subjects were evaluated using clinical examinations with the basic erosive wear examination index and a self-administered questionnaire. Statistical analyses were performed using SPSS software.

Results:

The prevalence of maxillary tooth wear was 84.9% for the molars, 68.9% for the premolars, 74.1% for the canines and 97% for the incisors. In the mandible, the corresponding prevalence rates were 85.2%, 59.3%, 78.6% and 97.4%, respectively. The occlusal, incisal and cervical surfaces showed more frequent wear compared with the other surfaces. Age, acidic beverages, xerostomia and brushing habits were identified as risk factors for tooth wear (P<0.05).

Conclusions:

Tooth wear is common in Beijing. Specific preventive measures should be recommended for individuals reporting excessive consumption of fruits and/or acidic beverages, and those with xerostomia. In particular, incisor wear should be carefully monitored in individuals of all age groups.

Prevalence and Indicators of Tooth Wear among Chinese Adults

Numerous epidemiological studies have focused on the prevalence and related indicators of tooth wear. However, no sufficient studies have been conducted with Chinese adults. The purpose of this study was to assess the prevalence of tooth wear and identify related indicators among adults aged 36 to 74 years in Wuhan City, P.R. China. A cross-sectional and analytic study was conducted with 720 participants, aged 35–49 yrs and 50–74 yrs, in 2014. Each age group included 360 participants, of which 50% were males and 50% were females. All participants completed a questionnaire before examination. Tooth wear was assessed using the modified Basic Erosive Wear Examination (BEWE) index. The data were analyzed using the chi-square test and binary logistic regression analysis. The prevalence of tooth wear was 67.5% and 100% in the 35–49 and 50–74 age groups, respectively. The prevalence of dentin exposure was 64.7% and 98.3%, respectively. A significantly higher prevalence of tooth wear and dentin exposure was found in the 50–74 yr group than in the 35–49 yr group (p < 0.05). Critical indicators of tooth wear and dentin exposure included high frequency of acidic drinks and foods consumption, low socio-economic status, and unilateral chewing. The frequency of changing toothbrushes and the habit of drinking water during meals were associated with tooth wear. In addition, the usage of hard-bristle toothbrushes and consuming vitamin C and aspirin were found to be linked with dentin exposure. In conclusion, the prevalence of tooth wear and dentin exposure observed in Chinese adults was high, and the results revealed an association between tooth wear and socio-behavioral risk indicators.

The prevalence and risk indicators of tooth wear in 12- and 15-year-old adolescents in Central China

BACKGROUND

Tooth wear has been investigated in numerous countries, and the prevalence has varied. However, the data on tooth wear in China are scarce. The aim of this study was to describe the prevalence of tooth wear and to investigate the relative indicators associated with tooth wear in 12- and 15-year-old adolescents in Wuhan City, Hubei Province, Central China.

METHODS

A cross-sectional descriptive study was undertaken among 720 adolescents in Hubei Province, Central China. The age groups in this study were 12- and 15-year-old, and each group consisted of 360 participants in which females and males represented 50 % each. A modified version of the Basic Erosive Wear Examination (BEWE) tooth wear index was used for the buccal, cervical, occlusal/incisal and lingual surfaces of all of the teeth in the 720 adolescents. All of the participants were asked to answer a questionnaire consisting of questions about their current and historical dietary habits and oral hygiene.

RESULTS

The prevalence of tooth wear was 18.6 and 89.4 % in 12- and 15-year-old adolescents, respectively. The prevalence rates of dentin exposure were 1.9 and 5.6 %, respectively. A significantly higher prevalence of tooth wear and dentin exposure in 15-year-old adolescents was found than in 12-year-old adolescents (p < 0.001 and p = 0.011). Several factors such as drinking soft drinks and fruit juices immediately after sports, taking aspirin, reflux, unilateral chewing, tooth brushing once daily or less often, duration of brushing less than 2 min and swimming in the summer were found to be associated with tooth wear.

CONCLUSIONS

Tooth wear in 12- and 15-year-old adolescents in Central China is a significant problem and should receive greater attention. The prevalence of tooth wear increases with age and associated with socio-behavioral risk factors.