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Loomans B, Mendes FM, Vinayahalingam S, Xi T, Opdam N, Kreulen CM, Pereira-Cenci T, Cenci MS. Challenges in conducting clinical research in primary care dentistry. J Dent 2024; 144:104958. [PMID: 38522408 DOI: 10.1016/j.jdent.2024.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024] Open
Abstract
The integration of dentistry into primary health care is crucial for promoting patient well-being. However, clinical studies in dentistry face challenges, including issues with study design, transparency, and relevance to primary care. Clinical trials in dentistry often focus on specific issues with strict eligibility criteria, limiting the generalizability of findings. Randomized clinical trials (RCTs) face challenges in reflecting real-world conditions and using clinically relevant outcomes. The need for more pragmatic approaches and the inclusion of clinically relevant outcomes (CROs) is discussed, such as tooth loss or implant success. Solutions proposed include well-controlled observational studies, optimized data collection tools, and the integration of artificial intelligence (AI) for predictive modelling, computer-aided diagnostics and automated diagnosis. In this position paper advocates for more efficient trials with a focus on patient-centred outcomes, as well as the adoption of pragmatic study designs reflecting real-world conditions. Collaborative research networks, increased funding, enhanced data retrieval, and open science practices are also recommended. Technology, including intraoral scanners and AI, is highlighted for improving efficiency in dental research. AI is seen as a key tool for participant recruitment, predictive modelling, and outcome evaluation. However, ethical considerations and ongoing validation are emphasized to ensure the reliability and trustworthiness of AI-driven solutions in dental research. In conclusion, the efficient conduct of clinical research in primary care dentistry requires a comprehensive approach, including changes in study design, data collection, and analytical methods. The integration of AI is seen as pivotal in achieving these objectives in a meaningful and efficient way.
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Affiliation(s)
- Bac Loomans
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands.
| | - F M Mendes
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands; Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - S Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - T Xi
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - Njm Opdam
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - C M Kreulen
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - T Pereira-Cenci
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - M S Cenci
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
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Maier E, Crins L, Pereira-Cenci T, Bronkhorst E, Opdam N, Galler K, Loomans B. 5.5-year-survival of CAD/CAM resin-based composite restorations in severe tooth wear patients. Dent Mater 2024; 40:767-776. [PMID: 38458918 DOI: 10.1016/j.dental.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/25/2024] [Accepted: 03/02/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Aim of this prospective study was to assess full mouth rehabilitation of severe tooth wear patients using minimally invasive CAD/CAM resin-based composite (RBC) restorations and direct veneers by evaluating restoration survival up to 5.5-years. METHODS Twenty-two patients with generalized severe tooth wear with functional and/or esthetic problems were included. Following minimally invasive preparation, CAD/CAM RBC restorations (LAVA Ultimate,3M) were adhesively luted, direct RBC veneers (Filtek Supreme XTE, 3M) were applied in the aesthetic region. Patients were recalled after 1m,1y,3y,5y and seen in between recalls by their general dentists or at the clinical study center if complaints occurred. Failures were categorized as F1 (severe deficiencies requiring replacement/extraction), F2 (localized deficiencies requiring re-cementation/repair) and F3 (small chippings requiring refurbishment/monitoring). Survival of indirect restorations was evaluated using lifetables and Kaplan-Meier-graphs, distinguishing between failure categories and tooth type (front teeth=FT, premolars=PM, molars=M). F1 + F2 and F1 + F2 + F3 failures were analyzed using Cox regression on the variables tooth type/ location, age, gender and VDO increase (p < 0.05). RESULTS 568 indirect restorations and 200 direct veneers in 21 patients evaluated for up to 5.5-years. For indirect restorations, 96 failures were recorded (F1:6;F2:41;F3:49) and annual failure rates were 0.29%(FT), 1.56%(PM), 2.93%(M) for F1 +F2 and 0.53%(FT), 2.42%(PM), 6.11%(M) for F1 + F2 + F3. Reasons for failure were chipping fracture (48), adhesive fracture (32), complete debonding (7), caries (4), endodontic treatment (1) and reasons unknown (documentation general dentists, 4). Molar tooth type had a statistically significantly increased probability of failure compared with front teeth and premolars for F1 + F2 + F3 (p < 0.006). Direct veneer restorations showed 18 failures (F1:2;F2:9;F3:7). SIGNIFICANCE Minimally invasive CAD/CAM RBC restorations combined with direct RBC veneers showed an acceptable clinical mid-term survival for restorative rehabilitation of severely worn dentitions.
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Affiliation(s)
- Eva Maier
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Germany; Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands.
| | - Luuk Crins
- Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Tatiana Pereira-Cenci
- Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Kerstin Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - Bas Loomans
- Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
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Martins DDS, Pegatin GM, Bergantin BTP, Leone CCLD, Boteon AP, Wang L, Rios D, Honório HM. Are S-PRG composites able to resist against erosive and abrasive challenges and protect surrounding enamel in situ? J Dent 2024; 142:104874. [PMID: 38307488 DOI: 10.1016/j.jdent.2024.104874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This study evaluated the resistance of S-PRG (Surface Pre-Reacted Glass-ionomer) composites and other restorative materials against erosive and abrasive challenges and their protective effect on enamel adjacent to the restorations. MATERIALS AND METHODS Bovine enamel blocks were prepared and randomized into 12 groups, including 6 types of material, each of them subjected to erosion_e or erosion+abrasion_ea: Beautifil II (S-PRG); Beautifil Bulk Restorative (S-PRG); Filtek Z250 XT; Filtek Bulk Fill; EQUIA Forte; Riva Light Cure. Cavities were prepared in the middle of enamel blocks and restored with the materials. Initial profiling measurement was performed on the material and on adjacent enamel (100, 200, 300, 600 and 700 μm from the restoration margin). Palatal intraoral appliances with the restored enamel blocks were used by the volunteers (n = 10). During 5 days appliances were immersed in 2.5 % citric acid for 2 min; 6 × /day (erosion_e). For ea condition, blocks were brushed for 1 min after each acid immersion. Final profile assessment was performed. Data were analysed by two and three way ANOVA followed by Tukey's test (p < 0.05). RESULTS Material wear: Riva Light Cure showed the highest wear followed by EQUIA Forte and then all resin composites, including the ones with S-PRG (p = 0.000). Enamel wear: there was significant interaction among type of restorative material, wear condition and distance (p = 0.014), enamel around materials showed similar wear (p = 0.983) and the enamel subjected to ea exhibited highest wear (p = 0.000). CONCLUSION SPRG based composites showed resistance against erosive and abrasive challenges but were not able to protect enamel adjacent to the restorations. CLINICAL SIGNIFICANCE S-PRG composites exhibit resistance to material wear comparable to resin composites. However, they have shown an inability to effectively protect the adjacent enamel under in situ erosive-abrasive conditions, despite the presence of mineral-loss-preventing ions surrounding materials.
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Affiliation(s)
- Daiana da Silva Martins
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Giovana Mosella Pegatin
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Bianca Tozzi Portaluppe Bergantin
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Camilla Cristina Lira Di Leone
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Ana Paula Boteon
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
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van Sambeek RMF, de Vos R, Crins LAMJ, Bronkhorst E, Mehta SB, Pereira-Cenci T, Loomans BAC. Perception of oral health related quality of life and orofacial aesthetics following restorative treatment of tooth wear: A five-year follow-up. J Dent 2023; 136:104626. [PMID: 37473829 DOI: 10.1016/j.jdent.2023.104626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVES Non-carious tooth wear often has a multifactorial etiology and may lead to functional or aesthetically related problems. The most common complaints associated with tooth wear are dissatisfaction with dental appearance and a negative impact on the experienced Oral Health Related Quality of Life (OHRQoL). The aim of this study was to investigate the change in OHRQoL and the perception of aesthetics, following restorative treatment of moderate to severe tooth wear patients, with a five-year follow-up. METHODS An explorative study, based on prospective data, was performed. OHRQoL and the perception of aesthetics were measured with the OHIP-NL and OES-NL. These questionnaires were completed before treatment, one month after treatment, and at 1-, 3- and 5-years post-treatment. Treatment involved full mouth reconstruction with composite resin restorations. The data was analysed as repeated measures by using a linear mixed-effects model. RESULTS One hundred and twenty-three tooth wear patients that received restorative rehabilitation were included (97 males, 26 females, 37.5 ± 8.8 years-old). Data showed a statistically significant increase in both experienced OHRQoL and orofacial appearance after restorative treatment. The OHIP-scores remained stable over time, while the OES-scores slightly decreased during the years after treatment. Regarding the seven domains of the OHIP, the largest difference in OHIP-score was found in the domain of 'Psychological Discomfort'. The mean overall OHIP-score was 1.8 at baseline and 1.3 at the 5-years recall. The mean OES score increased from 41.8 at baseline to 66.1 at the 5-years follow-up. CONCLUSIONS Tooth wear patients reported significant improvements in their OHRQoL and their perception of orofacial aesthetics after restorative treatment. This increase remained at least five years post-treatment. CLINICAL SIGNIFICANCE The clinical impact of restorative treatment for tooth wear patients is considerable. This paper emphasizes the need to include a discussion of the patient related outcome measures when planning care.
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Affiliation(s)
- Roos M F van Sambeek
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands.
| | - Rien de Vos
- Amsterdam University Medical Center, Department of Medical Education, Amsterdam, the Netherlands
| | - Luuk A M J Crins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands
| | - Ewald Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands
| | - Shamir B Mehta
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands; King's College London Faculty of Dentistry, Oral & Craniofacial Sciences, Guy's Campus, London
| | - Tatiana Pereira-Cenci
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands
| | - Bas A C Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, the Netherlands
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Mehta SB, Banerji S, Crins L, Opdam N, Loomans BAC. The longevity of tooth-coloUred materials used for restoration of tooth wear: an evidence-based approach. Prim Dent J 2023; 12:43-53. [PMID: 37705477 DOI: 10.1177/20501684231193595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Patients with tooth wear are commonly encountered in general dental practice. When indicated, restorative rehabilitation is often accompanied by a request from the patient for an aesthetic, tooth-coloured outcome. This article seeks to provide an evidence-based approach, focussing on the longevity of the materials which can be used for the restorative treatment of tooth wear, as well as their modes of failure and observed performance.
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Affiliation(s)
- Shamir B Mehta
- Shamir B. Mehta BDS, BSc MClinDent (Prosthodontics), PhD Dip. FFGDP(UK), FCGDent, FDSRCS(Eng), FDSRCPS(Glas), FDFTEd Professor of Aesthetic Dentistry, College of Medicine and Dentistry/Ulster University; Visiting Professor Radboud University Medical Centre; Senior Clinical Teacher, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
- Subir Banerji BDS, MClinDent (Prosthodontics), PhD, FDS, RCPS(Glasg), FCGDent, FICD Programme Director MSc Aesthetic Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Associate Professor, Department of Prosthodontics, Melbourne Dental School, The University of Melbourne, Australia
- Luuk Crins DDS PhD candidate, Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Niek Opdam DDS, PhD Associate Professor in Restorative Dentistry and Cariology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Bas A. C. Loomans DDS, PhD Professor in Oral Function and Restorative Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Subir Banerji
- Shamir B. Mehta BDS, BSc MClinDent (Prosthodontics), PhD Dip. FFGDP(UK), FCGDent, FDSRCS(Eng), FDSRCPS(Glas), FDFTEd Professor of Aesthetic Dentistry, College of Medicine and Dentistry/Ulster University; Visiting Professor Radboud University Medical Centre; Senior Clinical Teacher, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
- Subir Banerji BDS, MClinDent (Prosthodontics), PhD, FDS, RCPS(Glasg), FCGDent, FICD Programme Director MSc Aesthetic Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Associate Professor, Department of Prosthodontics, Melbourne Dental School, The University of Melbourne, Australia
- Luuk Crins DDS PhD candidate, Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Niek Opdam DDS, PhD Associate Professor in Restorative Dentistry and Cariology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Bas A. C. Loomans DDS, PhD Professor in Oral Function and Restorative Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Luuk Crins
- Shamir B. Mehta BDS, BSc MClinDent (Prosthodontics), PhD Dip. FFGDP(UK), FCGDent, FDSRCS(Eng), FDSRCPS(Glas), FDFTEd Professor of Aesthetic Dentistry, College of Medicine and Dentistry/Ulster University; Visiting Professor Radboud University Medical Centre; Senior Clinical Teacher, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
- Subir Banerji BDS, MClinDent (Prosthodontics), PhD, FDS, RCPS(Glasg), FCGDent, FICD Programme Director MSc Aesthetic Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Associate Professor, Department of Prosthodontics, Melbourne Dental School, The University of Melbourne, Australia
- Luuk Crins DDS PhD candidate, Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Niek Opdam DDS, PhD Associate Professor in Restorative Dentistry and Cariology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Bas A. C. Loomans DDS, PhD Professor in Oral Function and Restorative Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Niek Opdam
- Shamir B. Mehta BDS, BSc MClinDent (Prosthodontics), PhD Dip. FFGDP(UK), FCGDent, FDSRCS(Eng), FDSRCPS(Glas), FDFTEd Professor of Aesthetic Dentistry, College of Medicine and Dentistry/Ulster University; Visiting Professor Radboud University Medical Centre; Senior Clinical Teacher, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
- Subir Banerji BDS, MClinDent (Prosthodontics), PhD, FDS, RCPS(Glasg), FCGDent, FICD Programme Director MSc Aesthetic Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Associate Professor, Department of Prosthodontics, Melbourne Dental School, The University of Melbourne, Australia
- Luuk Crins DDS PhD candidate, Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Niek Opdam DDS, PhD Associate Professor in Restorative Dentistry and Cariology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Bas A. C. Loomans DDS, PhD Professor in Oral Function and Restorative Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Bas A C Loomans
- Shamir B. Mehta BDS, BSc MClinDent (Prosthodontics), PhD Dip. FFGDP(UK), FCGDent, FDSRCS(Eng), FDSRCPS(Glas), FDFTEd Professor of Aesthetic Dentistry, College of Medicine and Dentistry/Ulster University; Visiting Professor Radboud University Medical Centre; Senior Clinical Teacher, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
- Subir Banerji BDS, MClinDent (Prosthodontics), PhD, FDS, RCPS(Glasg), FCGDent, FICD Programme Director MSc Aesthetic Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Associate Professor, Department of Prosthodontics, Melbourne Dental School, The University of Melbourne, Australia
- Luuk Crins DDS PhD candidate, Department of Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Niek Opdam DDS, PhD Associate Professor in Restorative Dentistry and Cariology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Bas A. C. Loomans DDS, PhD Professor in Oral Function and Restorative Dentistry, Radboud University Medical Centre, Nijmegen, the Netherlands
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Ferrando Cascales Á, Sauro S, Hirata R, Astudillo-Rubio D, Ferrando Cascales R, Agustín-Panadero R, Delgado-Gaete A. Total Rehabilitation Using Adhesive Dental Restorations in Patients with Severe Tooth Wear: A 5-Year Retrospective Case Series Study. J Clin Med 2023; 12:5222. [PMID: 37629264 PMCID: PMC10455517 DOI: 10.3390/jcm12165222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials. MATERIALS AND METHODS The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria. RESULTS Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences (p < 0.005) on the survival of the restorations. CONCLUSION According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.
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Affiliation(s)
- Álvaro Ferrando Cascales
- Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos, 135 Guadalupe, 30107 Murcia, Spain; (Á.F.C.); (R.F.C.)
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, University CEU Cardenal Herrera, C/Santiago Ramón y Cajal, s/n, Alfara del Patriarca, 46115 Valencia, Spain;
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY 10010, USA;
| | - Daniela Astudillo-Rubio
- Division of Prosthodontics, School of Dentistry, Universidad Católica de Cuenca, Cuenca 010107, Ecuador; (D.A.-R.); (A.D.-G.)
| | - Raúl Ferrando Cascales
- Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos, 135 Guadalupe, 30107 Murcia, Spain; (Á.F.C.); (R.F.C.)
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Andrés Delgado-Gaete
- Division of Prosthodontics, School of Dentistry, Universidad Católica de Cuenca, Cuenca 010107, Ecuador; (D.A.-R.); (A.D.-G.)
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Kosewski P, De Angelis F, Sorrentino E, Mielczarek A, Buonvivere M, D’Arcangelo C. Effect of the Abutment Rigidity on the Wear Resistance of a Lithium Disilicate Glass Ceramic: An In Vitro Study. J Funct Biomater 2023; 14:395. [PMID: 37623640 PMCID: PMC10455685 DOI: 10.3390/jfb14080395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Lithium disilicate (LDS) glass ceramics are among the most common biomaterials in conservative dentistry and prosthodontics, and their wear behavior is of paramount clinical interest. An innovative in vitro model is presented, which employs CAD/CAM technology to simulate the periodontal ligament and alveolar bone. The model aims to evaluate the effect of the abutment rigidity on the wear resistance of the LDS glass ceramic. Two experimental groups (LDS restorations supported by dental implants, named LDS-on-Implant, or by hybrid ceramic tooth replicas with artificial periodontal ligament, named LDS-on-Tooth-Replica) and a control group (LDS-Cylinders) were compared. Fifteen samples (n = 15) were fabricated for each group and subjected to testing, with LDS antagonistic cusps opposing them over 120,000 cycles using a dual axis chewing simulator. Wear resistance was analyzed by measuring the vertical wear depth (mm) and the volume loss (mm3) on each LDS sample, as well as the linear antagonist wear (mm) on LDS cusps. Mean values were calculated for LDS-Cylinders (0.186 mm, 0.322 mm3, 0.220 mm, respectively), LDS-on-Implant (0.128 mm, 0.166 mm3, 0.199 mm, respectively), and LDS-on-Tooth-Replica (0.098 mm, 0.107 mm3, 0.172 mm, respectively) and compared using one-way-ANOVA and Tukey's tests. The level of significance was set at 0.05 in all tests. Wear facets were inspected under a scanning electron microscope. Data analysis revealed that abutment rigidity was able to significantly affect the wear pattern of LDS, which seems to be more intense on rigid implant-abutment supports compared to resilient teeth replicas with artificial periodontal ligament.
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Affiliation(s)
| | - Francesco De Angelis
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
| | - Edoardo Sorrentino
- Department of Innovative Technologies in Medicine & Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy;
| | - Agnieszka Mielczarek
- Department of Conservative Dentistry, Medical University of Warsaw, 02091 Warsaw, Poland;
| | - Matteo Buonvivere
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
| | - Camillo D’Arcangelo
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
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8
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Pimentel ES, França FMG, Turssi CP, Basting RT, Vieira-Junior WF. Effects of in vitro erosion on surface texture, microhardness, and color stability of resin composite with S-PRG fillers. Clin Oral Investig 2023:10.1007/s00784-023-04968-6. [PMID: 36995429 DOI: 10.1007/s00784-023-04968-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES To evaluate the effect of acid erosion on different physical properties of resin composite with S-PRG (surface pre-reacted glass) fillers, by conducting simulations of intrinsic and extrinsic sources. MATERIALS AND METHODS Cylindrical samples (Ø6 vs. 2 mm) of a conventional nanohybrid resin composite (Forma, Ultradent) and of a nanohybrid resin composite with S-PRG filler (Beautifil II, Shofu) were exposed to erosive cycling (5 days), based on (n=12) remineralizing solution (control); 0.3% citric acid (pH=2.6); or 0.01 M hydrochloric acid (pH=2). Roughness (Ra), microhardness (KHN), and color (CIEL*a*b*, CIEDE2000, and Vita scale (SGU)) factors were analyzed at the initial and final time points, and the general color changes (ΔEab, ΔE00, ΔSGU) were calculated. Final images were obtained using scanning electron microscopy (SEM). The data were evaluated by generalized models, Mann-Whitney, Wilcoxon, Kruskal-Wallis, and Dunn tests (α=0.05). RESULTS Regarding KHN, there was no difference between the groups or the time periods (p = 0.74). As for Ra, there was a significant increase in the Ra of both composites after cycling with hydrochloric acid, but only the resin composite with S-PRG filler showed a change in Ra after cycling with citric acid (p = 0.003). After cycling with citric and hydrochloric acid, the highest Ra values were found for the resin composite with S-PRG filler (p < 0.0001), corroborating the result of images (SEM) indicating loss of filler and porosities in this material. The resin composite with S-PRG filler showed higher ΔEab and ΔE00, in addition to more negative ΔSGU values and lower L* values after exposure to both acids, compared to the control (p < 0.05). CONCLUSION The acidic conditions altered the roughness and color stability of the materials tested, pointing out that the resin composite containing S-PRG filler showed greater degradation of its physical properties than the conventional resin composite. CLINICAL RELEVANCE Bioactive materials are relevant, considering that their properties interact with dental hard tissues; however, the S-PRG-based resin composite showed greater degradation under acidic conditions than the conventional resin composite.
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Affiliation(s)
- Eliene Soares Pimentel
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Fabiana Mantovani Gomes França
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Cecilia Pedroso Turssi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Roberta Tarkany Basting
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil
| | - Waldemir Francisco Vieira-Junior
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira, 13, Campinas, SP, CEP, 13045-755, Brazil.
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9
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Mehta SB, Loomans BAC, van Sambeek RMF, Pereira-Cenci T, O'Toole S. Managing tooth wear with respect to quality of life: an evidence-based decision on when to intervene. Br Dent J 2023; 234:455-458. [PMID: 36964376 PMCID: PMC10038795 DOI: 10.1038/s41415-023-5620-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 03/26/2023]
Abstract
Patients with more severe forms of tooth wear may require restorative rehabilitation. The decision to commence treatment must be taken carefully and there are a multitude of factors to consider. Alongside the clinical signs and symptoms typically associated with tooth wear, there is also the need to assess the impact of the condition on the patient's oral health-related quality of life. As part of the discussions relating to the attainment of informed consent for the restoration of the worn dentition, not only is it relevant to appropriately appraise the risks, benefits, costs, reasonable alternatives and likely prognosis of the proposed treatments, but to also elaborate on the expected impact of the intervention on the patient's oral health-related quality of life. The aim of this article is to review the evidence relating to the impact of the quality of life with the management of tooth wear, with the introduction of the concept of an evidence-based approach to decision-making when planning care.
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Affiliation(s)
- Shamir B Mehta
- Department of Dentistry, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, Guy´s Campus, London, UK; College of Medicine and Dentistry, Birmingham Campus, Ulster University, UK.
| | - Bas A C Loomans
- Department of Dentistry, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Roos M F van Sambeek
- Department of Dentistry, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Tatiana Pereira-Cenci
- Department of Dentistry, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Saoirse O'Toole
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, Guy´s Campus, London, UK
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10
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Ning K, Bronkhorst E, Crins L, van der Meer W, Pereira-Cenci T, Yang F, Leeuwenburgh S, Loomans B. Wear behaviour of direct composite restorations in tooth wear patients: a 5-year clinical study. J Dent 2022; 127:104354. [PMID: 36351488 DOI: 10.1016/j.jdent.2022.104354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the wear behaviour of direct composite restorations after 5 years and associated patient factors. METHODS 38 patients (6 females, 32 males; 35.2 ± 7.6y) from the Radboud Tooth Wear Project with generalized moderate to severe tooth wear were treated with direct composite restorations on all teeth. Ethical approval was sought and granted before the study was undertaken. Intraoral 3D scans were recorded at 1 month (baseline) and 5 years (recall) after treatment. The amount of height loss was measured at six index teeth (first molars and upper central incisors). Patient factors (age, vertical dimension of occlusion increase, bite force, aetiology score, jaw position and bearing/ non-bearing cusps) were included in the analysis. Multilevel multiple regression with bootstrapping was used to analyse the influence of these factors on wear behaviour of restorations. Observer reliability was tested by paired t-tests and Band-Altman plots (p<0.05) RESULTS: After 5 years, the mean height loss was 0.23± 0.19 mm for incisors and 0.43± 0.24 mm for molars (p≤0.001). Patient factors did not show any significant influence on height loss of the composite restorations, while bearing cusps showed significant more wear compared to non-bearing cusps (p≤0.001). The observer reliability tests confirmed the repeatability (correlation of 0.809, DME 0.103). CONCLUSIONS Wear of composite restorations is a significant and relevant factor over time in patients treated with severe tooth wear. Within the limitations of this clinical study, patient factors were found not to have a significant effect on wear behaviour of direct composite restorations.
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Affiliation(s)
- Ke Ning
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Ewald Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Luuk Crins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Wicher van der Meer
- University of Groningen, University Medical Center Groningen, Department of Orthodontics, Groningen, the Netherlands; W.J. Kolff Institute of Biomedical Engineering and Materials Science, Groningen, the Netherlands
| | - Tatiana Pereira-Cenci
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Fang Yang
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Sander Leeuwenburgh
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Bas Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands.
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11
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Lima VP, Crins LAMJ, Opdam NJM, Moraes RR, Bronkhorst EM, Huysmans MCDNJM, Loomans BAC. Deterioration of anterior resin composite restorations in moderate to severe tooth wear patients: 3-year results. Clin Oral Investig 2022; 26:6925-6939. [PMID: 35879624 DOI: 10.1007/s00784-022-04647-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Verônica P Lima
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves 457, Pelotas, RS, 96015-560, Brazil. .,Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands.
| | - Luuk A M J Crins
- Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands
| | - Niek J M Opdam
- Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands
| | - Rafael R Moraes
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves 457, Pelotas, RS, 96015-560, Brazil
| | - Ewald M Bronkhorst
- Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands
| | - Marie-Charlotte D N J M Huysmans
- Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands
| | - Bas A C Loomans
- Radboud Institute for Health Sciences, Department of Dentistry, Radboud University Medical Center, Ph. van Leydenlaan 25, NL 6500 HB, P.O. Box 9101, Nijmegen, 6525 EX, The Netherlands
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Menezes-Silva R, Fernandes P, Bueno LS, Vertuan M, Rios D, Bresciani E, Borges A, de Lima Navarro MF. Crown Reconstruction of Erosive Wear Using High-viscosity Glass Ionomer Cement: A Case Report. Oper Dent 2022; 47:239-246. [PMID: 35604838 DOI: 10.2341/20-210-s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 11/23/2022]
Abstract
The aim of this clinical report is to present a possible alternative treatment, with 24-month follow-up, for restoring tooth loss due to extensive erosive tooth wear. A 21-year-old male patient, complaining of intense sensitivity in the maxillary posterior teeth, and presenting severe wear on maxillary premolar and molar teeth due to gastroesophageal reflux, sought care in the university clinics. The planned treatment was to refer for medical treatment and perform restorations with the high-viscosity glass ionomer cement Equia Forte (GC Corporation, Tokyo, Japan), aiming to restore the dental anatomy and to consequently decrease the pain symptomatology. A silicone guide, obtained from a diagnostic waxing, was used during the restorative approach considering the patient's occlusion. After all the clinical steps of the restorative technique, an occlusal adjustment of restorations was performed. During monthly recalls up to 24 months, the treatment was stable and in service. In addition, the patient reported no pain and improved chewing, leading to a better quality of life.
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Affiliation(s)
- R Menezes-Silva
- *Rafael Menezes-Silva, PhD, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Phm Fernandes
- Paulo Henrique Martins Fernandes, DDS, PhD student, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - L S Bueno
- Lígia Saraiva Bueno, DDS, PhD, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M Vertuan
- Mariele Vertuan, DDS, PhD student, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - D Rios
- Daniela Rios, DDS, PhD, associate professor, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - E Bresciani
- Eduardo Bresciani, DDS, PhD, associate professor, Institute of Science and Technology, UNESP, Sao Jose dos Campos, Brazil
| | - Afs Borges
- Anna Flavia Borges, DDS, MSc, PhD, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M F de Lima Navarro
- Maria Fidela de Lima Navarro, DDS, PhD, professor, Bauru School of Dentistry, Bauru, Brazil Bauru, Brazil
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13
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Maier E, Grottschreiber C, Knepper I, Opdam N, Petschelt A, Loomans B, Lohbauer U. Evaluation of wear behavior of dental restorative materials against zirconia in vitro. Dent Mater 2022; 38:778-788. [PMID: 35459553 DOI: 10.1016/j.dental.2022.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/23/2021] [Accepted: 04/01/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate two-body wear (2BW) and three-body wear (3BW) of different CAD/CAM and direct restorative materials against zirconia using a dual-axis chewing simulator and an ACTA wear machine. METHODS 3 CAD-CAM resin-based composite or polymer infiltrated ceramic network blocs, 1 lithium disilicate CAD-CAM ceramic (LS2), 3 direct resin composites, amalgam and bovine enamel were tested. For 2BW, 8 flat specimens per material were produced, grinded, polished, stored wet (37 °C, 28d) and tested (49 N, 37 °C, 1,200,000 cycles) against zirconia. For 3BW, specimens (n = 10) were stored accordingly, and tested against a zirconia antagonist wheel (3Y-TZP, d = 20 mm, h = 6 mm; 200,000 cycles, F = 15 N, f = 1 Hz, 15% slip) in millet seed suspension. Wear resistance was analysed in a 3D optical non-contact profilometer, measuring vertical wear depth and volume loss for 2BW and mean wear depth and roughness (Ra) for 3BW. Vickers hardness (15 s, HV2) was measured. Statistical analysis was performed using non-parametric tests (Mann-Whitney-U test, p < 0.05). RESULTS 2BW and 3BW have a different impact on material surfaces. Similar wear resistance was observed for direct and indirect resin based materials with analogous filler configurations in both methods. Bovine enamel exhibited the best wear resistance in 2BW, but the least wear resistance in 3BW against zirconia. Regarding 2BW, a direct/indirect composite material pair of the same manufacturer showed the significantly highest mean volume losses (2.72/2.85 mm³), followed by LS2 (1.41 mm³). LS2 presented the best wear resistance in 3BW (mean wear depth 2.85 µm), combined with the highest mean Vickers hardness (598 MPa). No linear correlation was found between Vickers hardness and both wear testing procedures. The zirconia antagonists showed no recordable signs of wear. SIGNIFICANCE Dental restorative materials behave differently in 2BW and 3BW laboratory testing. Vickers hardness testing alone cannot hold for a correlation with wear behavior of materials. Micromorphological investigation of material composition can reveal insights in wear mechanisms related to variations in filler technologies.
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Affiliation(s)
- Eva Maier
- Friedrich-Alexander Universität Erlangen-Nürnberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Laboratory for Dental Biomaterials, Erlangen, Germany; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Christine Grottschreiber
- Friedrich-Alexander Universität Erlangen-Nürnberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Laboratory for Dental Biomaterials, Erlangen, Germany
| | - Ines Knepper
- Friedrich-Alexander Universität Erlangen-Nürnberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Laboratory for Dental Biomaterials, Erlangen, Germany
| | - Niek Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
| | - Anselm Petschelt
- Friedrich-Alexander Universität Erlangen-Nürnberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Laboratory for Dental Biomaterials, Erlangen, Germany
| | - Bas Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
| | - Ulrich Lohbauer
- Friedrich-Alexander Universität Erlangen-Nürnberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Laboratory for Dental Biomaterials, Erlangen, Germany
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14
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Rehabilitation of Worn Dentition with Direct Resin Composite Restorations: A Case Report. Dent J (Basel) 2022; 10:dj10040051. [PMID: 35448045 PMCID: PMC9032751 DOI: 10.3390/dj10040051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022] Open
Abstract
The incidence of tooth wear has steadily increased in all Western populations during the past decades. A through-care strategy, extendable for a lifetime, has become crucial to prevent the extensive loss of sound dental structure and to make an eventual retreatment affordable in the long term. An interceptive treatment using resin composite materials and no-preparation approaches meets these requirements. Moreover, continual developments in digital dentistry makes possible to predict the treatment plan for the restorative rehabilitation of the mouth. The availability of digital resources allows clinicians to increase predictability for excellent esthetics and good functional results. This article provides a step-by-step description of a full-mouth additive rehabilitation achieved by employing digital workflows and direct resin composite restorations. A comprehensive functional and esthetic evaluation of the treatment is proposed and discussed.
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Bueno MG, Tribst JPM, Borges ALS. Canine guidance reconstruction with ceramic or composite resin: A 3D finite element analysis and in vitro wear study. J Prosthet Dent 2022; 127:765.e1-765.e9. [DOI: 10.1016/j.prosdent.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
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Bergantin BTP, Di Leone CCL, Cruvinel T, Wang L, Buzalaf MAR, Borges AB, Honório HM, Rios D. S-PRG-based composites erosive wear resistance and the effect on surrounding enamel. Sci Rep 2022; 12:833. [PMID: 35039516 PMCID: PMC8764067 DOI: 10.1038/s41598-021-03745-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/26/2021] [Indexed: 11/09/2022] Open
Abstract
This study evaluated Surface Pre-Reacted Glass-ionomer (S-PRG)-based-composites' surface resistance against erosive wear and their protective effect on surrounding enamel. Bovine enamel was randomized into 12 groups (n = 10/group) [erosion (e) or erosion + abrasion (a)]: nanohybrid-S-PRG-based composite (SPRGe/SPRGa), nanohybrid-S-PRG-based bulk-fill (SPRGBFe/SPRGBFa), nanoparticle-composite (RCe/RCa), nanohybrid-bulk-fill (BFe/BFa), Glass Hybrid Restorative System (GHRSe/GHRSa), and resin-modified glass-ionomer-cement (RMGICe/RMGICa). Cavities were prepared and restored. Initial profile assessment was performed on material and on adjacent enamel at distances of 100, 200, 300, 600, and 700 μm from margin. Specimens were immersed in citric acid (2 min; 6×/day for 5 days) for erosion. Erosion + abrasion groups were brushed for 1 min after erosion. Final profile assessment was performed. Two-way ANOVA and Tukey-test showed: for erosion, the GHRSe and RMGICe presented greater material wear compared to the other groups (p = 0.001); up to 300 μm away from restoration, GHRSe and SPRGBFe were able to prevent enamel loss compared to RMGICe and other composite groups (p = 0.001). For erosion + abrasion, none of the materials exhibited a significant protective effect and S-PRG-based groups showed lower wear than RMGICa and GHRSa, and higher wear than composites (p = 0.001). S-PRG-based-composites can diminish surrounding enamel loss only against erosion alone, similarly to GIC, with advantage of being a more resistant material.
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Affiliation(s)
- Bianca Tozi Portaluppe Bergantin
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Camilla Cristina Lira Di Leone
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Alessandra Buhler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
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17
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Alhammadi S, Milosevic A. The Restoration of Severe Generalized Dental Erosive Wear using Direct Composite: A Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
This case report describes a conservative restorative approach in the management of severe generalized tooth wear.
Case report:
The male, aged 57 years, was mainly concerned with the poor appearance of his teeth with short and discolored upper incisors. History revealed that he suffered from gastric reflux for 25 years, for which he was prescribed Ranitidine and was advised to self-medicate with cider vinegar. Furthermore, he divulged that he ground his teeth at night and during the day and had a high intake of carbonated cola drinks. On examination, dentine was exposed in several areas, and to a significant extent, on the incisal aspects of the lower incisors, the palatal surfaces of the upper incisors, and the occlusal surfaces of the molars. Mandibular tori were present.
The primary diagnosis was erosive tooth wear with elements of attrition and abrasion. The intervention included dietary advice and restoration with direct composite resin at an increased occlusal vertical dimension of 1.5mm on the retruded axis. The patient reported no functional problems and was pleased with the aesthetic result.
Conclusion:
Vinegar is promoted to have health benefits, especially with respect to glucose response, but the dental implications are overlooked. This paper reviews the literature on vinegar as a medicament and considers its role as a co-factor for erosion in this case. The clinical steps used to restore the eroded dentition by direct composite are described. The use of this approach is a safe, conservative and successful treatment option without recourse to complex and biologically costly conventional alternatives. The application of direct composite in tooth wear cases meets the European consensus requirements.
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18
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Crins LAMJ, Opdam NJM, Kreulen CM, Bronkhorst EM, Sterenborg BAMM, Huysmans MCDNJM, Loomans BAC. Randomized controlled trial on the performance of direct and indirect composite restorations in patients with severe tooth wear. Dent Mater 2021; 37:1645-1654. [PMID: 34497023 DOI: 10.1016/j.dental.2021.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/09/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The study aimed to evaluate survival and failure behavior of Direct Composite Restorations (DRC) and Indirect Composite Restorations (ICR) on molars and anterior teeth, in a Randomized Controlled Trial (RCT). METHODS Patients with generalized severe tooth wear were included, and randomly assigned to one of 2 protocols: (1) DCR: All teeth were restored with directly applied micro-hybrid composite restorations (Clearfil AP-X, Kuraray) for load bearing areas and nano-hybrid composite restorations (IPS Empress Direct, Ivoclar Vivadent) for buccal veneers; (2) ICR: First molars were restored with indirect composite 'tabletop' restorations and maxillary anterior teeth were restored with indirect palatal veneer restorations (Clearfil Estenia C&B, cemented with Panavia F, Kuraray). Remaining teeth were restored directly. Restorations were evaluated after 3 years, focusing on clinical acceptability. Statistical analysis was performed using Kaplan Meier curves, Annual Failure Rates (AFRs), and univariate Cox regression analyses (p < 0.05). RESULTS 41 patients (age: 36.6 ± 6.6y) were evaluated after 3 years (40.0 ± 2.2 m). 408 restorations on first molars and palatal veneers on maxillary anterior teeth were part of this RCT, with 220 DCRs and 188 ICRs. No differences in survival between treatment modality for palatal veneers for any failure criteria were found. Tabletop restorations on first molars showed a considerable higher failure rate for ICR compared to DCR (p = 0.026, HR: 3.37, 95%CI = 1.16-9.81). SIGNIFICANCE In this RCT, directly applied composite restorations showed superior behavior compared to the indirect composite restorations, when used in the molar region.
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Affiliation(s)
- L A M J Crins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands.
| | - N J M Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - C M Kreulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - E M Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - B A M M Sterenborg
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - M C D N J M Huysmans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - B A C Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
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Longitudinal 3D Study of Anterior Tooth Wear from Adolescence to Adulthood in Modern Humans. BIOLOGY 2021; 10:biology10070660. [PMID: 34356515 PMCID: PMC8301389 DOI: 10.3390/biology10070660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/23/2022]
Abstract
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.
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Mehta SB, Lima VP, Bronkhorst EM, Crins L, Bronkhorst H, Opdam NJM, Huysmans MCDNJM, Loomans BAC. Clinical performance of direct composite resin restorations in a full mouth rehabilitation for patients with severe tooth wear: 5.5-year results. J Dent 2021; 112:103743. [PMID: 34229000 DOI: 10.1016/j.jdent.2021.103743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate the 5.5-year performance of direct resin composite restorations, prescribed for patients with severe tooth wear, requiring full-mouth rehabilitation. METHODS A convenience sample of 34 patients were recruited to a prospective trial between December 2010 and June 2013. The participants were provided 1269 full-mouth direct resin composite restorations (Clearfil AP-X) by 5 experienced operators, using the DSO-technique. Treatment resulted in an increase in the vertical dimension of occlusion (VDO). Failure was assessed at three levels. Frequencies of failure were analysed using Kaplan Meier survival curves and the effects of the relevant variables calculated with a multifactorial Cox regression (p < 0.05). RESULTS Annual failure rates (for all levels of failure, 'Level 3- ') of ≤ 2.2% and ≤ 2.9% were respectively reported for the anterior and posterior restorations with a mean observation time of 62.4 months. The completion of an anterior restoration with the need for further appointments resulted in significantly more Level 2- & 3- failures. An evaluation of the performance of the premolar and posterior maxillary restorations showed significantly lowered risks of certain types of failures, compared to the molar and posterior mandibular restorations. CONCLUSIONS At 5.5 years, 2.3% of the overall restorations displayed catastrophic, (Level 1) failures. Molar restorations, posterior mandibular restorations and the anterior restorations requiring two further sessions for completion, were associated with significantly higher risks for failure. CLINICAL SIGNIFICANCE Direct resin composite can offer an acceptable medium-term option for the treatment of severe, generalized tooth wear; molar restorations may require higher maintenance.
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Affiliation(s)
- Shamir B Mehta
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Conservative & MI Dentistry, Unit of Distance Learning, King's College London Faculty of Dentistry, Oral & Craniofacial Sciences, Guy's Campus, London.
| | - Verônica P Lima
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Luuk Crins
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Hilde Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Niek J M Opdam
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Bas A C Loomans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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The effect of pre-treatment levels of tooth wear and the applied increase in the vertical dimension of occlusion (VDO) on the survival of direct resin composite restorations. J Dent 2021; 111:103712. [PMID: 34102230 DOI: 10.1016/j.jdent.2021.103712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate the effects of the level of pre-treatment tooth wear and increasing the VDO on the performance of direct resin composite restorations for the rehabilitation of pathological tooth wear. METHODS Full-mouth (pre-treatment) grading was performed on digital greyscale scan records for 34 participants (35.3 ± 8.4 years) with signs of moderate-to-severe generalised tooth wear, using the Tooth Wear Evaluation System and the Basic Erosive Wear Examination. Each participant received full-mouth direct resin composite restorations, with increased VDO. The post-treatment increase in the VDO was determined. Recalls were planned after 1 month, and after 1, 3, and 5 years. Three 'levels' of restoration failure were described. The effects of the variables on the frequencies of restoration failure were calculated with a multivariable Cox regression, (p < 0.05). RESULTS 1269 restorations were placed with a mean observation period of 62.4 months. Increasing the VDO by 1 mm significantly reduced the risks of all levels of anterior restoration failure (HR ≤ 0.62, p ≤ 0.025). A higher anterior BEWE surface score was associated with increased risks of Level 2- & 3- failures, (HR ≥ 1.29, p ≤ 0.019). Premolar restorations showed lower risks of Level 2- & 3- failure, compared to the molar restorations, (HR ≤ 0.5, p ≤ 0.005). CONCLUSION Levels of pre-treatment wear and the applied change in the VDO significantly affected failure risk. CLINICAL RELEVANCE Direct resin composite restorations for the rehabilitation of wear should be made as voluminous as possible, respecting the presenting biological, functional, and esthetic constraints.
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Mehta SB, Bronkhorst EM, Crins L, Huysmans MCDNJ, Wetselaar P, Loomans BAC. A comparative evaluation between the reliability of gypsum casts and digital greyscale intra-oral scans for the scoring of tooth wear using the Tooth Wear Evaluation System (TWES). J Oral Rehabil 2021; 48:678-686. [PMID: 33370476 PMCID: PMC8248338 DOI: 10.1111/joor.13141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/28/2022]
Abstract
Background The Tooth Wear Evaluation System (TWES) is a type of tooth wear index. To date, there is the lack of data comparing the reliability of the application of this index on gypsum cast records and digital greyscale intra‐oral scan records. Objectives A comparative evaluation between the use of gypsum cast records and digital greyscale intra‐oral scan records with the reliability of tooth wear scoring using the TWES amongst a group of patients with tooth wear. Methods Records for 10 patients with moderate to severe tooth wear (TWES ≥ 2) were randomly selected from a larger clinical trial. TWES grading of the occlusal/incisal, buccal and palatal/lingual surfaces was performed to determine the levels of intra‐ and interobserver agreement. Intra‐observer reproducibility was based on the findings of one examiner only. For the interobserver reproducibility, the findings of two examiners were considered. One set of models/ records were used per patient. Cohen's weighted kappa (κW) was used to ascertain agreement between and within the observers. Comparison of agreement was performed using t tests (P < .05). Results For the scoring of the of the total occlusal/incisal surfaces, the overall levels of intra‐ and interobserver agreement were significantly higher using the gypsum cast records than with the digital greyscale intra‐oral scan records, (P < .001) and (P < .001), respectively. For the overall buccal surfaces, only a significant difference was found in the intra‐observer agreement using gypsum casts, (P = .013). For the palatal/lingual surfaces, a significant difference was only reported in the interobserver agreement using gypsum casts, (P = .043). At the occlusal/incisal surfaces, grading performed using gypsum casts, culminated in significantly higher TWES scores than with the use of the digital greyscale intra‐oral scans (P < .001). At the buccal and palatal/lingual surfaces, significantly higher wear scores were obtained using digital greyscale intra‐oral scan records (P < .009). Conclusions The TWES can offer a reliable means for the scoring of wearing occlusal/incisal surfaces using gypsum casts. The reliability offered by digital greyscale intra‐oral scans for consecutive scoring was in general, inferior.
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Affiliation(s)
- Shamir B Mehta
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Conservative & MI Dentistry, Unit of Distance Learning, King's College London Faculty of Dentistry, Oral & Craniofacial Sciences, Guy's Campus, London, UK
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Luuk Crins
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Marie-Charlotte D N J Huysmans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Bas A C Loomans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Long-term results of a randomized clinical trial of 2 types of ceramic crowns in participants with extensive tooth wear. J Prosthet Dent 2020; 127:248-257. [PMID: 33303191 DOI: 10.1016/j.prosdent.2020.08.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Evidence is sparse regarding the long-term outcomes of restorative treatment of patients with extensive tooth wear. PURPOSE The purpose of this long-term prospective randomized clinical trial was to evaluate the performance and success rate of pressed lithium disilicate (LD) and translucent zirconia (TZ) crowns in participants with extensive tooth wear. MATERIAL AND METHODS A total of 62 participants with extensive tooth wear (17 women, 45 men; mean age 44.8 years; range 25-63 years) received a total of 713 crowns, LD=362 and TZ=351. Both types of crowns had chamfer preparations and were adhesively luted with dual-polymerizing composite resin cement (PANAVIA F 2.0; Kuraray Noritake Dental Inc). The restorations were clinically reevaluated on average 14, 31, 39, 54, and 65 months after insertion of the crowns according to the modified United States Public Health Service (USPHS) criteria. RESULTS After an observation period of up to 6 years, the survival rate for both types of crowns was 99.7%, with 1 lost LD crown after 1 year as a result of loss of retention and 1 lost TZ crown after 3 years because of tooth fracture at the cemento-enamel junction. The success rates were similar for both types of crowns: 98.6% for LD and 99.1% for TZ. Reasons for failures were that 3 participants in each group developed apical lesions, minimal ceramic fractures, or their crowns were rebonded after loss of adhesion. Assessment of color at baseline was significantly different with a better match for LD (84.8% Alfa, 15.2% Bravo) than for TZ crowns (36.5% Alfa, 63.5% Bravo), including TZ crowns with veneered porcelain (P<.001). Secondary caries and cracks did not occur. A post hoc analysis of clinical performance did not indicate any significant differences between extensive tooth wear with primarily mechanical or chemical factors. CONCLUSIONS No differences were found between the 2 types of ceramic materials concerning the long-term success and clinical performance, except that TZ crowns were rated by a blinded clinician as less esthetic than LD crowns. The use of high-strength ceramic materials, as well as reliable adhesive bonding, are probably the key factors in the long-term success of ceramic crowns in participants with extensive tooth wear independent of the specific etiology.
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O'Toole S, Bartlett D, Keeling A, McBride J, Bernabe E, Crins L, Loomans B. Influence of Scanner Precision and Analysis Software in Quantifying Three-Dimensional Intraoral Changes: Two-Factor Factorial Experimental Design. J Med Internet Res 2020; 22:e17150. [PMID: 33245280 PMCID: PMC7732705 DOI: 10.2196/17150] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/22/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Three-dimensional scans are increasingly used to quantify biological topographical changes and clinical health outcomes. Traditionally, the use of 3D scans has been limited to specialized centers owing to the high cost of the scanning equipment and the necessity for complex analysis software. Technological advances have made cheaper, more accessible methods of data capture and analysis available in the field of dentistry, potentially facilitating a primary care system to quantify disease progression. However, this system has yet to be compared with previous high-precision methods in university hospital settings. OBJECTIVE The aim of this study was to compare a dental primary care method of data capture (intraoral scanner) with a precision hospital-based method (laser profilometer) in addition to comparing open source and commercial software available for data analysis. METHODS Longitudinal dental wear data from 30 patients were analyzed using a two-factor factorial experimental design. Bimaxillary intraoral digital scans (TrueDefinition, 3M, UK) and conventional silicone impressions, poured in type-4 dental stone, were made at both baseline and follow-up appointments (mean 36 months, SD 10.9). Stone models were scanned using precision laser profilometry (Taicaan, Southampton, UK). Three-dimensional changes in both forms of digital scans of the first molars (n=76) were quantitatively analyzed using the engineering software Geomagic Control (3D Systems, Germany) and freeware WearCompare (Leeds Digital Dentistry, UK). Volume change (mm3) was the primary measurement outcome. The maximum point loss (μm) and the average profile loss (μm) were also recorded. Data were paired and skewed, and were therefore compared using Wilcoxon signed-rank tests with Bonferroni correction. RESULTS The median (IQR) volume change for Geomagic using profilometry and using the intraoral scan was -0.37 mm3 (-3.75-2.30) and +0.51 mm3 (-2.17-4.26), respectively (P<.001). Using WearCompare, the median (IQR) volume change for profilometry and intraoral scanning was -1.21 mm3 (-3.48-0.56) and -0.39 mm3 (-3.96-2.76), respectively (P=.04). WearCompare detected significantly greater volume loss than Geomagic regardless of scanner type. No differences were observed between groups with respect to the maximum point loss or average profile loss. CONCLUSIONS As expected, the method of data capture, software used, and measurement metric all significantly influenced the measurement outcome. However, when appropriate analysis was used, the primary care system was able to quantify the degree of change and can be recommended depending on the accuracy needed to diagnose a condition. Lower-resolution scanners may underestimate complex changes when measuring at the micron level.
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Affiliation(s)
- Saoirse O'Toole
- Centre for Clinical, Oral and Translational Sciences, King's College London, London, United Kingdom
| | - David Bartlett
- Centre for Clinical, Oral and Translational Sciences, King's College London, London, United Kingdom
| | | | - John McBride
- University of Southampton, Southampton, United Kingdom
| | - Eduardo Bernabe
- Centre for Clinical, Oral and Translational Sciences, King's College London, London, United Kingdom
| | - Luuk Crins
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Bas Loomans
- Radboud University Medical Centre, Nijmegen, Netherlands
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Awareness and Treatment Decisions on Tooth Wear among Jordanian Dentists and Prosthodontists: A Cross-Sectional Survey Study. Int J Dent 2020; 2020:8861266. [PMID: 33299419 PMCID: PMC7701210 DOI: 10.1155/2020/8861266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/25/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
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.
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Viana Í, Alania Y, Feitosa S, Borges AB, Braga RR, Scaramucci T. Bioactive Materials Subjected to Erosion/Abrasion and Their Influence on Dental Tissues. Oper Dent 2020; 45:E114-E123. [PMID: 32053454 DOI: 10.2341/19-102-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effect of erosion or erosion-abrasion on bioactive materials and adjacent enamel/dentin areas. METHODS AND MATERIALS Enamel and dentin blocks (4×4×2 mm) were embedded side by side in acrylic resin, and a standardized cavity (1.2×4×1.5 mm) was prepared between them. Preparations were restored with the following materials: composite resin (Filtek Z350, control); experimental composite containing di-calcium phosphate dihydrate particles (DCPD); Giomer (Beautifil II), high viscosity glass ionomer cement (GIC, Fuji IX); and a resin-modified GIC (Fuji II LC). The specimens were submitted to two cycling models (n=10): erosion or erosion-abrasion. The challenges consisted of five-minute immersion in 0.3% citric acid solution, followed by 60-minute exposure to artificial saliva. Toothbrushing was carried out twice daily, 30 minutes after the first and last exposures to acid. Dental and material surface loss (SL, in μm) were determined by optical profilometry. Data were analyzed with Kruskal-Wallis and Dunn tests (α=0.05). RESULTS Under erosion, for enamel, only the GIC groups presented lower SL values than Z350 (p<0.001 for Fuji IX and p=0.018 for Fuji II LC). For dentin, none of the materials showed significantly lower SL values than Z350 (p>0.05). For material, the GICs had significantly higher SL values than those of Z350 (p<0.001 for Fuji IX and p=0.002 for Fuji II LC). Under erosion-abrasion, the enamel SL value was significantly lower around Fuji II LC compared with the other materials (p<0.05). No significant differences were observed among groups for dentin SL (p=0.063). The GICs and Giomer showed higher SL values than Z350 (p<0.001 for the GICs and p=0.041 for Giomer). CONCLUSION Both GIC-based materials were susceptible to erosive wear; however, they promoted the lowest erosive loss of adjacent enamel. Against erosion-abrasion, only Fuji II LC was able to reduce enamel loss. For dentin, none of the materials exhibited a significant protective effect.
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Speech changes in patients with a full rehabilitation for severe tooth wear, a first evaluation study. Clin Oral Investig 2019; 24:3061-3067. [DOI: 10.1007/s00784-019-03174-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
Abstract
Objective
The aim of this study was to evaluate changes in speech characteristics and self-perceived quality of speech in tooth wear patients, after occlusal rehabilitation.
Materials and methods
Patients with tooth wear were included in this study after informed consent. The amount of tooth wear was scored with Tooth Wear Evaluation System (TWES). To assess the perspective of the patient, the Dutch Speech Handicap Index was used (SHI). Acoustic analysis was performed to evaluate changes with the use of voice recordings. These were made before treatment, T0; directly after treatment, T1; 1 month after treatment, T2. With the use of PRAAT software, the spectral characteristic centre of gravity (COG) was evaluated for the sounds /s/, /f/, /v/, /d/, /t/, /m/.
Results
Recordings of 17 patients (14 men, 3 women, mean age 41.2 ± 10.4 years) were included. SHI scores did not change significantly between T0 and T2 (p = 0.054). A multiple regression model showed that for all sounds the intercept was negative, but statistically significant only for /s/ and /f/ between T0 and T1. The effect of the initial change (between T0 and T1) on the change between T1 and T2 was clearly negative for all sounds (p < 0.001), showing a rebound effect ranging between 29 and 68% of the initial change.
Conclusion
Tooth wear patients perceive improvement in speech function after treatment.
Clinical significance
Clinicians may explain to patients that speech is likely to alter for a short period due to treatment but that there will be a good adaption to the new situation.
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Impact of restorative treatment of tooth wear upon masticatory performance. J Dent 2019; 88:103159. [DOI: 10.1016/j.jdent.2019.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/22/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022] Open
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Osiewicz MA, Werner A, Roeters FJM, Kleverlaan CJ. Wear of direct resin composites and teeth: considerations for oral rehabilitation. Eur J Oral Sci 2019; 127:156-161. [DOI: 10.1111/eos.12600] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Magdalena A. Osiewicz
- Department of Integrated Dentistry; Jagiellonian University; Krakow Poland
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Arie Werner
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Franciscus J. M. Roeters
- Department of Comprehensive Dentistry; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam the Netherlands
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Sterenborg BA, Kalaykova SI, Loomans BA, Huysmans MCD. Impact of tooth wear on masticatory performance. J Dent 2018; 76:98-101. [DOI: 10.1016/j.jdent.2018.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022] Open
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Restorative Management of Severe Localized Tooth Wear Using a Supraoccluding Appliance: A 5-Year Follow-Up. Case Rep Dent 2018; 2018:9864782. [PMID: 29977627 PMCID: PMC5994272 DOI: 10.1155/2018/9864782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/17/2018] [Accepted: 03/07/2018] [Indexed: 11/17/2022] Open
Abstract
This case report illustrates a novel conservative restorative management of a patient with bulimia nervosa who presented with severe localized upper palatal tooth wear and an anterior reverse overjet. This was achieved by using a localized bite raising or supraoccluding appliance, cemented on the lingual side of the lower anterior teeth to create interocclusal space, obviating the need for tooth reduction of the eroded upper palatal and incisal tooth surfaces. Surgical crown lengthening was performed to create a better aesthetic gingival architecture. All-ceramic restorations were provided on the upper anterior teeth to restore the tooth surface loss and provide a positive overbite and overjet. There was no complication or other observable biological change detected at the 5-year follow-up. The use of an appliance applying the supraoccluding technique, or Dahl concept, is a safe, conservative, and useful treatment option in the management of localized tooth wear.
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