The management of anterior tooth wear using gold palatal veneers in canine guidance

Evaluation of occlusal bite force distribution by T-Scan in orthodontic patients with different occlusal characteristics: a cross sectional-observational study

BACKGROUND

The aim of orthodontic treatment, apart from esthetic and functional corrections, is uniform force distribution. Hence Occlusal analysis using a T scan gives scope for a precisely targeted treatment plan. The T-scan evaluation of occlusal force, time, and location of contacts from initial occlusal contact to maximum intercuspation enables the orthodontist to sequentially balance the occlusal forces on the right and left sides through specific treatment plan options.

OBJECTIVE

The current study aimed to determine the force distribution in the different individuals by using a T-Scan as well as the net discrepancies of forces generated at a maximum intercuspation position in the first molar region between the left and right sides of the mouth.

METHODS

This is a descriptive-correlational study that was carried out in Ras Al Khaimah College of Dental Sciences clinics and Ajman University clinics from January 2020 to September 2022 by using the convenience sampling technique. The T-scan III Novus was employed in this investigation to record multi-bite scans for several patients. T-scan was utilised to examine various malocclusions.

RESULTS

The present study consisted of 158 participants. Analysis of Variance (ANOVA) showed that there is a statistically significant difference in the percentage of force between the three types of malocclusions (I, II, and III) on the right molar side (B-16 and B-46) (p < 0.05). Moreover, the overall discrepancy showed a statistically significant difference in the three types of malocclusion classifications (p < 0.05). On the other hand, there was no statistically significant difference in the percentage of force between B-26 and B-36 (p > 0.05). Post hoc analysis showed a statistically significant difference in the percentage of force between malocclusion classes I and III on the right molar, with a mean difference of 4.11190 (p < 0.05). Similarly, there was a statistically significant difference in B-46 between Malocclusion Classes I and II, 4.01806 (p < 0.05). Additionally, post hoc analysis showed a statistically significant difference between malocclusion classes I and III, with a mean difference of -4.79841 (p < 0.05) on the right molar.

CONCLUSION

The T-Scan is a useful tool for assessing occlusal discrepancies and can be helpful during treatment planning and follow-up, especially for orthognathic surgery patients. A T-scan could be used in orthodontic therapy in a simple and efficient way. Also, it turned out to be a useful tool for diagnosing problems and gave us new information about how therapies work. In this study, T-Scan showed that it can measure occlusal forces in timing in an objective, accurate, and repeated manner. The current study found that T-Scan was better able to report the difference in the percentage of force on the right molar side than on the left side.

Deterioration of anterior resin composite restorations in moderate to severe tooth wear patients: 3-year results

OBJECTIVES

Deterioration in anterior resin composite restorations placed in tooth wear patients was investigated after 36 months.

MATERIALS AND METHODS

Data collected prospectively for 47 participants of the Radboud Tooth Wear Project were used (41 ± 8 years, 90% male, n = 270 restorations). Restorations were individually evaluated using intraoral photographs and 3D scans to rate modified FDI scores and to record the presence of degradation features. Four groups with distinct combinations of composites and techniques were assessed, and multivariable logistic regression models were used to analyze the data (p < 0.05).

RESULTS

For all groups together, early degradation signs were present at 1 month: irregularities (41.5%) and ditching (7.4%) were observed at the surface and adhesive interfaces. The frequency of irregularities decreased in the 36-month evaluation (37%), but ditching (12.2%) and fractures (10.7%) were more common. The most frequent deterioration (based on photographs) was observed for staining (44%) and loss of luster (31%). In 3D scans, the most frequent were for wear (25%), marginal adaptation (24%), and the presence of irregularities (19%). Canines had 5.5 times more chances of deterioration by ditching than incisors (p < 0.001). The differences between composites and restorative techniques were minor.

CONCLUSIONS

A continuous degradation process of restorations placed in tooth wear patients was observed in anterior teeth restored with different composites, with a progression of the deterioration over 36 months.

CLINICAL RELEVANCE

When placing anterior resin composite restorations in tooth wear patients, it could be important to establish realistic expectations and the need for checkup appointments.

The impact of etching time and material on bond strength of self-adhesive resin cement to eroded enamel

The purpose of this study was to assess the effect of pre-etching time and material on shear bond strength (SBS) of self-adhesive resin cements to eroded and sound enamel. Eroded enamel specimens were assigned into 5 groups (n=20 each) based on enamel surface treatment as follow: Group N, eroded enamel (without surface pre-treatment); Group PH15, 35% H₃PO₄ etching for 15 s; Group PH30, 35% H₃PO₄ etching for 30 s; Group L30, 20% lactic acid etching for 30 s and Group L60, 20% lactic acid etching for 60 s.Composite blocks were fabricated and cemented to enamel surfaces with one of two self-adhesive cements. Notched-edge SBS was assessed. Bond strength of self-adhesive cement to eroded enamel surface significantly enhanced following application of 20% lactic acid for 30 s.

Achieving Better Function through Combining Orthodontics and Restorative Dentistry in the Case of Dental Abrasions

This case report describes the orthodontic treatment used to prepare for restorative dentistry, aimed at the functional rehabilitation of an adult patient with Class I malocclusion, right posterior crossbite, and significant tooth wear on the palatal face of the maxillary canine to canine. The orthodontic treatment was performed with a total fixed appliance mini-expandex-type expander, associated with vertical elastics. Good dental intercuspation was obtained and enabled conditions for the restoration of the abrasions on the palatal surfaces of the maxillary incisors and canines and the tips of the buccal cusps of the maxillary right premolars and first molar. Excellent results were found during a 37-month follow-up.

The restorative management of tooth wear involving the aesthetic zone

The aim of this article is to describe a systematic approach that facilitates the establishment of a clear and appropriate diagnosis when a dentate patient presents with tooth wear involving their aesthetic zone. It will also detail the protocols that are required to allow for the development of an acceptable aesthetic prescription within the limits of the functional constraints presented by the patient (where active restorative intervention may be indicated), as well as to communicate the manner by which this information can be transferred to ultimately enable the successful and predictable rehabilitation of the affected areas. An overview will also be provided of the tooth-coloured dental materials and restorative techniques that have been commonly applied to deliver the predictable and effective dental care of worn teeth in the aesthetic zone.

Sleep bruxism: challenges and restorative solutions

Bruxism is a parafunctional activity related to clenching or grinding the teeth and tooth wear can be a consequence of sleep bruxism (SB). Management of severe tooth wear due to SB is a challenging situation because of the common reduced amount of remaining dental structure and loss of vertical dimension of occlusion. Rationale for the planning of oral rehabilitation of patients with SB presenting severe tooth wear should rely on evidence-based approaches; however, few studies have discussed properties of dental materials for SB rehabilitation and how to cosmetically manage severe tooth wear. This review aimed to provide an overview into bruxism cosmetic rehabilitation and how this can be implemented with good outcomes for the patient.