Dental diseases and dental wear as a proxy for dietary patterns in Hellenistic-early Roman Menainon, Sicily

OBJECTIVE

This paper explores dental diseases and wear as a proxy for dietary patterns in Hellenistic-early Roman Menainon.

MATERIALS

This study includes 166 individuals (4th-1st c. BCE).

METHODS

Carious lesions, dental calculus, antemortem tooth loss, and dental wear were recorded to explore male-female and adult-juvenile differences, and to position Menainon in the broader Hellenistic/early Roman world through comparisons with published data from other sites.

RESULTS

Males and females showed similar rates of dental diseases. Dental wear, in contrast, was systematically greater in males. Caries rates were high in both adults and juveniles, but adults showed more calculus. The population from Menainon had higher frequencies for calculus and carious lesions compared to contemporary Italian and Greek assemblages, and a similar frequency for antemortem tooth loss.

CONCLUSION

Some sex-related differences in the dietary patterns of the Menainon population were visible but small. The diet of adults and juveniles must have been similar in terms of carbohydrate consumption but different with regard to protein consumption. The high frequency of carious lesions and calculus compared to other Greco-Roman sites suggests that this population must have had good access to dietary resources (protein and carbohydrates).

SIGNIFICANCE

This paper provides insights on gender (sex-related) and age divisions in the Hellenistic/early Roman society through the exploration of food consumption in a Sicilian assemblage.

LIMITATIONS

Dividing the assemblage by sex and age group reduced considerably the sample size.

SUGGESTIONS FOR FURTHER RESEARCH

Stable isotopes and dental microwear analyses should be used to investigate dietary patterns further.

Reliability of qualitative occlusal tooth wear evaluation using an intraoral scanner: A pilot study

Dental wear analysis through the use of an intraoral scanner is a reality of modern dentistry. This study aimed to investigate the reliability of qualitative tooth wear evaluation through three-dimensional images captured with an intraoral scanner and compared to clinical and photographic examinations. Eighteen adult volunteers of both genders (18 to 55 years old) were submitted to clinical exams, intraoral photographs and intraoral scanning protocol using an optical scanner (TRIOS® Pod, 3Shape, Copenhagen, Denmark). Occlusal tooth wear, from second to second premolars, was measured by two evaluators and reevaluated after 30 days, according to a slight modification of the method described by Mockers et al. Weighted Kappa was used to measure intra and inter-examiner agreement. The Friedman test was used to verify the differences among methods. Random and systematic errors were assessed using Bland-Altman plots. All statistical analysis was performed with p<0.05. There was a substantive agreement for clinical (K = 0.75) and photographic exams (K = 0.79) and a moderate agreement for intraoral scanner analysis (K = 0.60) for inter-examiner evaluation. A substantial intra-examiner agreement was obtained for both evaluators. No significant difference between the methods was observed (p = 0.7343 for examiner 1 and 0.8007 for examiner 2). The Bland-Altman plot confirmed no systematic errors between the methods and a random error of 0.25 with the scanner method when compared to clinical assessment. All three methods showed reliability in qualitative occlusal tooth wear evaluation. Intraoral scanning seems to be a sound and reliable tool to evaluate tooth wear when compared to traditional methods, considering the lower inter-examiner agreement and the inherent limitations of this pilot study. Further research will be necessary in order to achieve more robust evidence.

Dietary diversity and evolution of the earliest flying vertebrates revealed by dental microwear texture analysis

Pterosaurs, the first vertebrates to evolve active flight, lived between 210 and 66 million years ago. They were important components of Mesozoic ecosystems, and reconstructing pterosaur diets is vital for understanding their origins, their roles within Mesozoic food webs and the impact of other flying vertebrates (i.e. birds) on their evolution. However, pterosaur dietary hypotheses are poorly constrained as most rely on morphological-functional analogies. Here we constrain the diets of 17 pterosaur genera by applying dental microwear texture analysis to the three-dimensional sub-micrometre scale tooth textures that formed during food consumption. We reveal broad patterns of dietary diversity (e.g. Dimorphodon as a vertebrate consumer; Austriadactylus as a consumer of 'hard' invertebrates) and direct evidence of sympatric niche partitioning (Rhamphorhynchus as a piscivore; Pterodactylus as a generalist invertebrate consumer). We propose that the ancestral pterosaur diet was dominated by invertebrates and later pterosaurs evolved into piscivores and carnivores, shifts that might reflect ecological displacements due to pterosaur-bird competition.

[Cup-shaped tooth wear defects: more than erosive challenges?]

The underlying mechanism of the development of cups and grooves on occlusal tooth surfaces is still unclear. The aim of this study was to evaluate factors contributing to in-vitro cup formation, and to elucidate the clinical process. Extracted human molar teeth were exposed to acidic aqueous solutions at pH of 4.8 and 5.5 in combination with different loading conditions: no load (0N, control), 30N or 50N. Before and after 3 months exposure, the samples were scanned using a non-contact profilometer. A statistically significant difference between a loading of 0N and 50N was found at pH 4.8 (p < 0.002). Cup shaped lesions had formed only at pH of 4.8, in the 30N and 50N groups. The study showed that a cup can arise fully in enamel and that this requires simultaneous acidic and mechanical loading.

Three-dimensional tooth surface texture analysis on stall-fed and wild boars (Sus scrofa)

Categorizing the archaeological remains of Sus scrofa as domesticated “pigs” or wild “boars” is often difficult because of their morphological and genetic similarities. For this purpose, we tested whether feeding ecological change of S. scrofa that accompanied their domestication can be detected based on the three-dimensional texture created on the tooth enamel surface by mastication. We scanned the lower tooth surface of one wild and one stall-fed populations of modern S. s. leucomystax and one wild population of S. s. riukiuanus by using a confocal laser microscope. The average body weight of S. s. leucomystax is twice as heavier as that of S. s. riukiuanus. The textures were quantified using the industrial “roughness” standard, ISO 25178, to prevent inter-observer errors and to distinguish small differences that were difficult to detect by two dimensional image observation. The values of parameters related to height and volume were significantly larger in the stall-fed population. Twenty parameters differed significantly between the stall-fed and wild population of S. s. leucomystax, which indicated that the feeding ecological difference affected the ISO parameters of the two boar populations. Six parameters also differed between the wild populations of S. s. leucomystax and S. s. riukiuanus. Surprisingly, no parameter differed between the populations of stall-fed S. s. leucomystax and wild S. s. riukiuanus. Consumption of hard nuts and/or agricultural fruits and crops by the wild population of S. s. riukiuanus may have produced a tooth surface texture similar to that of the stall-fed population of S. s. leucomystax. Further analysis of S. s. riukiuanus with a known diet is necessary to conclude whether ISO parameters reflect the dietary transition accompanying the domestication of Sus (e.g., wild, semi-domestic, and domestic). Until then, caution is needed in discriminating domesticated populations from wild populations that mainly feed on hard objects.

The physiological linkage between molar inclination and dental macrowear pattern

OBJECTIVES

Exact symmetry and perfect balance between opposite jaw halves, as well as between antagonistic teeth, is not frequently observed in natural masticatory systems. Research results show that asymmetry in our body, skull, and jaws is often related to genetic, epigenetic, environmental and individual ontogenetic factors. Our study aims to provide evidence for a significant link between masticatory asymmetry and occlusal contact between antagonist teeth by testing the hypothesis that tooth inclination is one of the mechanisms driving distribution of wear in masticatory phases in addition to dietary and cultural habits.

MATERIALS AND METHODS

The present work investigates the relationship between dental macrowear patterns and tooth inclinations on a sample of complete maxillary and mandibular 3D models of dental arches from 19 young and adult Yuendumu Aboriginal individuals. The analysis was carried out on first molars (M1) from all quadrants. Occlusal Fingerprint Analysis was used for the quantification of macrowear patterns, and 2D cross-sectional geometric analysis was carried out to investigate asymmetry in dental arches.

RESULTS

The asymmetry is highly variable on both arches, and it is associated with differences in the inclination of upper M1 crowns. Each molar has variable inclination (buccal/lingual) which influence tooth to tooth contact, producing greater or lesser variation in wear pattern. Interindividual variability of morphological variation of the occlusal relationship has to be considered in macrowear analysis.

DISCUSSION

Our results suggest that overall asymmetry in the masticatory apparatus in modern humans affects occlusal contact areas between antagonist teeth influencing macrowear and chewing efficiency during ontogeny.

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

Aim

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

Materials and Methods

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

Results

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

Conclusions

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

Quantitative comparison of incisal tooth wear in patients receiving one-phase or two-phase treatment for skeletal Class III malocclusion with anterior crossbite

OBJECTIVES

The present study aimed to compare the amount of incisal tooth wear in the maxillary central incisors of patients with skeletal Class III malocclusion and anterior crossbite receiving one-phase or two-phase treatment. The hypothesis was that tooth wear would differ according to treatment modalities.

MATERIALS AND METHODS

Maxillary dental casts obtained before (T1) and after (T2) orthodontic treatment were divided into three groups. Group I consisted of casts from 21 patients (7 males, 14 females; mean age 9.8 years) who received two-phase treatment (maxillary protraction followed by fixed appliance therapy). Group II comprised casts from 37 patients who underwent orthodontic camouflage treatment for crossbite, subdivided according to age. Group IIa consisted of casts from 15 adolescents (8 males, 7 females; mean age 13.5 years), and group IIb consisted of casts from 22 adults (13 males, 9 females; mean age 24.5 years). Maxillary dental casts obtained at T1 and T2 were scanned. For each pair of digital images, T2 was superimposed on T1 using the best-fit method. Tooth wear was quantified and compared among groups.

RESULTS

Significantly less tooth wear was observed in group I compared to groups IIa and IIb, but no difference was found between groups IIa and IIb. Spearman correlation analysis revealed no significant correlation between tooth wear and age, treatment duration, or craniofacial morphology.

CONCLUSIONS

Despite the long duration of early treatment, it caused less wear of the maxillary central incisors than did orthodontic camouflage treatment.

A Proposed Methodology to Assess the Accuracy of 3D Scanners and Casts and Monitor Tooth Wear Progression in Patients

PURPOSE

The aim of this study was to detail and assess the capability of a novel methodology to 3D-quantify tooth wear progression in a patient over a period of 12 months.

MATERIALS AND METHODS

A calibrated stainless steel model was used to identify the accuracy of the scanning system by assessing the accuracy and precision of the contact scanner and the dimensional accuracy and stability of casts fabricated from three different types of impression materials. Thereafter, the overall accuracy of the 3D scanning system (scanner and casts) was ascertained. Clinically, polyether impressions were made of the patient's dentition at the initial examination and at the 12-month review, then poured in type IV dental stone to assess the tooth wear. The anterior teeth on the resultant casts were scanned, and images were analyzed using 3D matching software to detect dimensional variations between the patient's impressions.

RESULTS

The accuracy of the 3D scanning system was established to be 33 μm. 3D clinical analysis demonstrated localized wear on the incisal and palatal surfaces of the patient's maxillary central incisors. The identified wear extended to a depth of 500 μm with a distribution of 4% to 7% of affected tooth surfaces.

CONCLUSION

The newly developed 3D scanning methodology was found to be capable of assessing and accounting for the various factors affecting tooth wear scanning. Initial clinical evaluation of the methodology demonstrates successful monitoring of tooth wear progression. However, further clinical assessment is needed.

Testing Dietary Hypotheses of East African Hominines Using Buccal Dental Microwear Data

There is much debate on the dietary adaptations of the robust hominin lineages during the Pliocene-Pleistocene transition. It has been argued that the shift from C3 to C4 ecosystems in Africa was the main factor responsible for the robust dental and facial anatomical adaptations of Paranthropus taxa, which might be indicative of the consumption of fibrous, abrasive plant foods in open environments. However, occlusal dental microwear data fail to provide evidence of such dietary adaptations and are not consistent with isotopic evidence that supports greater C4 food intake for the robust clades than for the gracile australopithecines. We provide evidence from buccal dental microwear data that supports softer dietary habits than expected for P. aethiopicus and P. boisei based both on masticatory apomorphies and isotopic analyses. On one hand, striation densities on the buccal enamel surfaces of paranthropines teeth are low, resembling those of H. habilis and clearly differing from those observed on H. ergaster, which display higher scratch densities indicative of the consumption of a wide assortment of highly abrasive foodstuffs. Buccal dental microwear patterns are consistent with those previously described for occlusal enamel surfaces, suggesting that Paranthropus consumed much softer diets than previously presumed and thus calling into question a strict interpretation of isotopic evidence. On the other hand, the significantly high buccal scratch densities observed in the H. ergaster specimens are not consistent with a highly specialized, mostly carnivorous diet; instead, they support the consumption of a wide range of highly abrasive food items.

[A PhD completed 6. Tooth Wear Evaluation System: development and applications]

Numerous ranking systems exist for the quantification of tooth wear, each unfortunately with its own particular shortcomings. In this dissertation a new and very comprehensive tooth wear evaluation system is described. In it, the existing terminology is adapted to distinguish among mechanical-intrinsic (formerly attrition), mechanical-extrinsic (formerly abrasion), chemical-intrinsic (formerly erosion) and chemical-extrinsic (formerly erosion). In order to indicate the degree of wear, the terms mild, moderate, serious and severe are used. On the basis of previous systems, the terms, 3 degree-of-wear systems were developed and tested for reliability for use in the dentist's clinic, on dental models and oral imaging. The ranking scales were shown to be reliably applicable intra-orally, on the dental models and on the oral images, particularly on occlusal/incisal surfaces. The findings of this research have resulted in the formation of a modular Tooth Wear Evaluation System in order to quantify, qualify, monitor and establish the sources of tooth wear. The evaluation system can also be used to determine treatment options.

Dental-macrowear and diet of Tigara foragers from Point Hope, northern Alaska

SUMMARY

Ethnographic studies indicate that Eskimo foragers are characterized by well-defined sexual division of labor and extensive use of anterior teeth as a tool, resulting in higher degrees of wear. However, little is known about the intra-population variation in molar-macrowear rates and dietary implications. Here, percentages of dentin exposure (PDE) were recorded on first mandibular molars among Tigara foragers from Point Hope (Alaska) and attempt to correlate age and sex variation in wear patterns. We found that no overall sex-related differences in PDE exist and suggest that molars did not take a part in para-masticatory or cultural practices. Strong correlation with increasing age was found as expected but males wore their teeth at higher rates than females related to masticatory demands during growth. Our findings suggest that individual variation in molar-macrowear must be attributed to biomechanics of chewing and cultural behavior rather than sexual variation in food acquisition.

Functional crown lengthening surgery in the aesthetic zone; periodontic and prosthodontic considerations

Crown lengthening surgery aims to increase the amount of supragingival tooth tissue by resection of the soft and/or hard tissues to enable otherwise unrestorable teeth to be restored by increasing the retention and resistance forms of the teeth. Restoration of the worn dentition may require significant prosthodontic knowledge and skill. A prosthodontist should be involved from the beginning of the management of the patient. A number of key stages should be considered for correct management. Although the periodontist may guide the prosthodontist with regards to what may or may not be possible surgically, the overall treatment plan should be prosthodontically driven. Clinical Relevance: Toothwear of the anterior dentition provides a unique challenge to restore not only function but also to manage the aesthetic demands of the patient. To ensure that the correct outcome is reached, clinicians should be familiar with the normal anatomical proportions and relationships to enable planning and treatment to take place.

First molar size and wear within and among modern hunter-gatherers and agricultural populations

Apart from reflecting modern human dental variation, differences in dental size among populations provide a means for studying continuous evolutionary processes and their mechanisms. Dental wear, on the other hand, has been widely used to infer dietary adaptations and variability among or within diverse ancient human populations. Few such studies have focused on modern foragers and farmers, however, and diverse methods have been used. This research aimed to apply a single, standardized, and systematic quantitative procedure to measure dental size and dentin exposure in order to analyze differences among several hunter-gatherer and agricultural populations from various environments and geographic origins. In particular, we focused on sexual dimorphism and intergroup differences in the upper and lower first molars. Results indicated no sexual dimorphism in molar size and wear within the studied populations. Despite the great ethnographic variation in subsistence strategies among these populations, our findings suggest that differences in sexual division of labor do not affect dietary wear patterns.

Dental wear patterns in early modern humans from Skhul and Qafzeh: A response to Sarig and Tillier

The use of teeth as tools for manipulating objects and simple food-processing methods was common among prehistoric and modern hunter-gatherer human populations. Paramasticatory uses of teeth frequently produce enamel chipping and distinctive types of dental wear that can readily be related to specific tool functions. In particular, the presence of unusual occlusal wear areas (named para-facets) on maxillary teeth of prehistoric, historic and modern hunter-gatherers has been associated with cultural habits involving extensive use of teeth (Fiorenza et al., 2011; Fiorenza and Kullmer, 2013). However, Sarig and Tillier (2014) believe that this wear had been caused by pathological occlusal relationships rather than by the use of teeth as tools. In this contribution, we show how occlusal contacts are created and how it is possible to distinguish between masticatory and non-masticatory wear facets by using an innovative digital approach called Occlusal Fingerprint Analysis. Statistical results from the analysis of comparative modern samples clearly demonstrate that described para-facets in Skhul and Qafzeh could not have been produced by dental occlusal anomalies such as malocclusions and crossbites. Moreover, dental pathologies in prehistoric humans were extremely rare. Only with the adoption of the modern lifestyle between 18th and 19th centuries, did the emergence of malocclusions become significantly more common. Because more than 50% of the Skhul and Qafzeh individuals analysed in our study are characterised by this distinctive type of wear, it is highly unlikely that their para-facets occurred as a result of dental pathologies.

The Overbite Complexity: How The Vertical Position, Tooth-Size Ratios And Other Factors Affect Occlusion and Overbites

This article explains the complexity of overbites and how to diagnose pre-treatment occlusions to finish orthodontic cases with stable, long lasting occlusion and proper overbites. It explains the changes that occur when overbites deepen and how to correct to proper overbite positions.

The wear and tear of teeth

A review is presented of the mechanical damage suffered by tooth crowns. This has been the subject of much recent research, resulting in a need to revise some of the thinking about the mechanisms involved. Damage is classified here by scale into macro-, meso- and microfracture. The focus is on the outer enamel coat because this is the contact tissue and where most fractures start. Enamel properties appear to be tailored to maximize hardness, but also to prevent fracture. The latter is achieved by the deployment of developmental flaws called enamel tufts. Macrofractures usually appear to initiate as extensions of tufts on the undersurface of the enamel adjacent to the enamel-dentine junction and extend from there into the enamel. Cracks that pass from the tooth surface tend to be deflected by an enamel region of high toughness; if they find the surface again, a chip (mesofracture) is produced. The real protection of the enamel-dentine junction here is the layer of decussating inner enamel. Finally, a novel analysis of mechanical wear (microfracture) suggests that the local toughness of the enamel is very important to its ability to resist tissue loss. Enamel and dentine have contrasting behaviours. Seen on a large scale, dentine is isotropic (behaving similarly in all directions) while enamel is anisotropic, but vice versa on a very small scale. These patterns have implications for anyone studying the fracture behaviour of teeth.

Bizarre tooth surface loss and the Miswak stick

Tooth surface loss can present in a variety of ways, some of which can appear rather strange on first examination. This case report demonstrates an unusual presentation of tooth surface loss (TSL) and its subsequent treatment. This loss of hard dental tissue appeared to be affecting the whole of the patient's remaining dentition, both lingually and buccally. Detailed questioning revealed the origins of this problem which turned out to be due to excessive use of an intra-oral Miswak chewing stick. Cinical Relevance: This article will enable clinicians to understand the importance of specific, targeted history-taking, involving a rare case of tooth surface loss as well as the use of minimally destructive restoration composites and a fibre-reinforced composite bridge.

Age-related tooth wear differs between forest and savanna primates

Tooth wear in primates is caused by aging and ecological factors. However, comparative data that would allow us to delineate the contribution of each of these factors are lacking. Here, we contrast age-dependent molar tooth wear by scoring percent of dentine exposure (PDE) in two wild African primate populations from Gabonese forest and Kenyan savanna habitats. We found that forest-dwelling mandrills exhibited significantly higher PDE with age than savanna yellow baboons. Mandrills mainly feed on large tough food items, such as hard-shell fruits, and inhabit an ecosystem with a high presence of mineral quartz. By contrast, baboons consume large amounts of exogenous grit that adheres to underground storage organs but the proportion of quartz in the soils where baboons live is low. Our results support the hypothesis that not only age but also physical food properties and soil composition, particularly quartz richness, are factors that significantly impact tooth wear. We further propose that the accelerated dental wear in mandrills resulting in flatter molars with old age may represent an adaptation to process hard food items present in their environment.

Copper deficit as a potential pathogenic factor of reduced bone mineral density and severe tooth wear

The study evaluated if men and women with severe tooth wear were at increased risk of general bone loss. Enamel biopsies obtained from 50 subjects aged 47.5 ± 5 years showed decreased copper content, which was associated with reduced spine bone mineral density, suggesting deficits of this trace element contributing to bone demineralization, enamel attrition, and deteriorated quality of mineralized tissues.

INTRODUCTION

The objective of this cross-sectional study was to assess associations between enamel trace minerals and bone mineral density (BMD) in severe tooth wear. We hypothesized that similar factors contributed to both the excessive abrasion of dental enamel and reduced BMD in subjects with tooth wear.

METHODS

Fifty patients aged 47.5 ± 5 years with severe tooth wear and 20 age-, sex-, and body mass index (BMI)-matched healthy volunteers with normal dental status were studied regarding dietary intakes of trace elements, serum and salivary copper (Cu), zinc (Zn), and calcium (Ca) concentrations, and serum PTH, osteocalcin, and hydroxyvitamin D levels. Tooth wear was determined using clinical examination based on standard protocol according to Smith and Knight. In all subjects, acid biopsies of the maxillary central incisors were carried out to assess mineral composition of the enamel. Atomic absorption spectroscopy with an air/acetylene flame was used to measure Ca and Zn, and graphite furnace atomic absorption spectroscopy was used to analyze Cu content. BMD was examined using dual energy X-ray absorptiometry.

RESULTS

Tooth wear patients had reduced lumbar spine, but not femoral, BMD relative to controls (p < 0.001). No differences were found in enamel Ca concentration and Zn content was slightly higher in tooth wear patients than in controls whereas Cu content was significantly decreased in the patients: 19.59 ± 16.4 vs 36.86 ± 26.1 μg/l (p = 0.01) despite similar levels of Cu in serum and saliva. The differences were independent of serum 25-OH-D, osteocalcin concentrations or PTH either.

CONCLUSION

Severe tooth wear is associated with reduced spinal BMD. Enamel in adult individuals with severe tooth wear is low in copper content. Therefore, further work is needed to determine whether copper plays a role in bone pathophysiology in these patients.

Enamel mineral content in patients with severe tooth wear

PURPOSE

The amounts of calcium (Ca), magnesium (Mg), zinc (Zn), and copper (Cu) in enamel may be crucial for maintaining its integrity and to attenuate potential environmental effects on teeth. The aim of this study was to examine whether the mineral composition of enamel could influence tooth wear.

MATERIALS AND METHODS

A total of 50 patients with severe tooth wear were compared with 20 healthy volunteers. Tooth wear was assessed using clinical examination according to the protocol of Smith and Knight. Subsequently, the maxillary central incisors of each subject were subjected to acid biopsies to assess the mineral composition in the enamel. Atomic absorption spectroscopy with an air/acetylene flame was used to analyze for Ca, Zn, and Mg. Graphite furnace atomic absorption spectroscopy was used to analyze for Cu.

RESULTS

The concentrations of Ca and Mg in tooth enamel were comparable in the study and control groups. Zn enamel content was higher in patients with tooth wear, and Cu enamel content was lower in these patients compared with the control group.

CONCLUSION

The differing Zn and Cu contents in tooth enamel might offer a reason for excessive tooth wear in these patients. However, the results require further, more detailed study.

Diet-related buccal dental microwear patterns in Central African Pygmy foragers and Bantu-speaking farmer and pastoralist populations

Pygmy hunter-gatherers from Central Africa have shared a network of socioeconomic interactions with non-Pygmy Bantu speakers since agropastoral lifestyle spread across sub-Saharan Africa. Ethnographic studies have reported that their diets differ in consumption of both animal proteins and starch grains. Hunted meat and gathered plant foods, especially underground storage organs (USOs), are dietary staples for pygmies. However, scarce information exists about forager–farmer interaction and the agricultural products used by pygmies. Since the effects of dietary preferences on teeth in modern and past pygmies remain unknown, we explored dietary history through quantitative analysis of buccal microwear on cheek teeth in well-documented Baka pygmies. We then determined if microwear patterns differ among other Pygmy groups (Aka, Mbuti, and Babongo) and between Bantu-speaking farmer and pastoralist populations from past centuries. The buccal dental microwear patterns of Pygmy hunter-gatherers and non-Pygmy Bantu pastoralists show lower scratch densities, indicative of diets more intensively based on nonabrasive foodstuffs, compared with Bantu farmers, who consume larger amounts of grit from stoneground foods. The Baka pygmies showed microwear patterns similar to those of ancient Aka and Mbuti, suggesting that the mechanical properties of their preferred diets have not significantly changed through time. In contrast, Babongo pygmies showed scratch densities and lengths similar to those of the farmers, consistent with sociocultural contacts and genetic factors. Our findings support that buccal microwear patterns predict dietary habits independent of ecological conditions and reflect the abrasive properties of preferred or fallback foods such as USOs, which may have contributed to the dietary specializations of ancient human populations.

Detecting inter-cusp and inter-tooth wear patterns in rhinocerotids

Extant rhinos are the largest extant herbivores exhibiting dietary specialisations for both browse and grass. However, the adaptive value of the wear-induced tooth morphology in rhinos has not been widely studied, and data on individual cusp and tooth positions have rarely been published. We evaluated upper cheek dentition of browsing Diceros bicornis and Rhinoceros sondaicus, mixed-feeding R. unicornis and grazing Ceratotherium simum using an extended mesowear method adapted for rhinos. We included single cusp scoring (EM(R)-S) to investigate inter-cusp and inter-tooth wear patterns. In accordance with previous reports, general mesowear patterns in D. bicornis and R. sondaicus were attrition-dominated and C. simum abrasion-dominated, reflecting their respective diets. Mesowear patterns for R. unicornis were more attrition-dominated than anticipated by the grass-dominated diet, which may indicate a low intake of environmental abrasives. EM(R)-S increased differentiation power compared to classical mesowear, with significant inter-cusp and inter-tooth differences detected. In D. bicornis, the anterior cusp was consistently more abrasion-dominated than the posterior. Wear differences in cusp position may relate to morphological adaptations to dietary regimes. Heterogeneous occlusal surfaces may facilitate the comminution of heterogeneous browse, whereas uniform, broad grinding surfaces may enhance the comminution of physically more homogeneous grass. A negative tooth wear gradient was found in D. bicornis, R. sondaicus and R. unicornis, with wear patterns becoming less abrasion-dominated from premolars to molars. No such gradients were evident in C. simum which displayed a uniform wear pattern. In browsers, premolars may be exposed to higher relative grit loads, which may result in the development of wear gradients. The second premolar may also have a role in food cropping. In grazers, high absolute amounts of ingested abrasives may override other signals, leading to a uniform wear pattern and dental function along the tooth row, which could relate to the observed evolution towards homodonty.

Effects of industrial noise on circumpulpar dentin--a field emission scanning electron microscopy and energy dispersive spectroscopy analysis

Chronic exposure to Industrial Noise (IN), rich in Low Frequency Noise (LFN), causes systemic fibrotic transformation and sustained stress. Dental wear, significantly increased with exposure to LFN, affects the teeth particularly through the circumpulpar dentin. Our goal is to understand the consequences of IN exposure on the circumpulpar dentin of Wistar rats. 10 Wistar rats were exposed to IN for 4 months, according to an occupationally simulated time schedule and 10 animals were used as age-matched controls. The first and the second upper and lower molars of each animal were processed for observation by Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive Spectroscopy (EDS) analysis was performed. In exposed animals FESEM showed a 2.0 to 6.0 μm-dense mineral band between dentin and the pulp with no regular continuity with the tubules. This structure had a few tubules where the odontoblasts processes could be observed embedded within the band and collagen fibers were trapped inside. EDS analysis revealed that it was hydroxyapatite similar to dentin, with a higher carbon content. FESEM results show that the band may be tertiary reparative dentin formed by odontoblast-like cells, but the increased amount of carbon (EDS) could mean that it is sclerotic dentin. IN should be acknowledge as a strong stimulus, able to cause an injury to odontoblasts and to the formation of reparative tertiary dentin, in a process that may accelerate the aging of the teeth, either by direct impact of acoustic pressure pulsations or by increased stress and dental wear.

The evolutionary paradox of tooth wear: simply destruction or inevitable adaptation?

Over the last century, humans from industrialized societies have witnessed a radical increase in some dental diseases. A severe problem concerns the loss of dental materials (enamel and dentine) at the buccal cervical region of the tooth. This “modern-day” pathology, called non-carious cervical lesions (NCCLs), is ubiquitous and worldwide spread, but is very sporadic in modern humans from pre-industrialized societies. Scholars believe that several factors are involved, but the real dynamics behind this pathology are far from being understood. Here we use an engineering approach, finite element analysis (FEA), to suggest that the lack of dental wear, characteristic of industrialized societies, might be a major factor leading to NCCLs. Occlusal loads were applied to high resolution finite element models of lower second premolars (P₂) to demonstrate that slightly worn P₂s envisage high tensile stresses in the buccal cervical region, but when worn down artificially in the laboratory the pattern of stress distribution changes and the tensile stresses decrease, matching the results obtained in naturally worn P₂s. In the modern industrialized world, individuals at advanced ages show very moderate dental wear when compared to past societies, and teeth are exposed to high tensile stresses at the buccal cervical region for decades longer. This is the most likely mechanism explaining enamel loss in the cervical region, and may favor the activity of other disruptive processes such as biocorrosion. Because of the lack of dental abrasion, our masticatory apparatus faces new challenges that can only be understood in an evolutionary perspective.

Relationship between the preferred chewing side and the angulation of anterior tooth guidance

OBJECTIVES

The aim of this study was to evaluate a possible relationship between preferred chewing side (PCS) and the anterior guidance angle.

SUBJECTS AND METHODS

Forty dental nurses and technicians, aged 24-46 years, were each given a piece of chewing gum, which they chewed for about 3 min. At 7 regular intervals (every 15 s), they were interrupted by the principal investigator (P.L.) in order to observe on which side of their mouths they had the bolus of chewing gum. Moulds of their jaws were made and the position of the maxillary arch relative to temporomandibular joints was recorded with a facebow and transferred to a semi-adjustable articulator. After mounting the stone casts of each subject, a measure of the anterior guidance angle was taken with an adjustable incisal table.

RESULTS

Of the 40 subjects, 14 (35%) presented a PCS. Among the 14 subjects who preferred a chewing side, there was a correlation between the PCS and a low angulation of teeth constituting the anterior guidance on that side, but this correlation was statistically nonsignificant.

CONCLUSION

In this study, we found that unilateral chewing creates uneven wear on the anterior teeth and changed the anterior guidance angulation.

Comparison of load-fatigue performance of posterior ceramic onlay restorations under different preparation designs

OBJECTIVE

The objective of this study was to evaluate the load-fatigue performance of posterior ceramic onlay restorations relative to two variables: preparation design (with or without buccal veneers); and the existing amount of tooth structure (non-worn tooth, worn tooth).

METHODS

Sixty extracted third molars were divided into five groups. One group received a mesial-occlusal-distal (MOD) gold onlay restoration (control). The other four experimental groups were prepared for ceramic onlay restorations. Two of the groups additionally received 2-mm occlusal reduction to simulate occlusal wear. All restored teeth were subjected to thermocycling prior to fatigue testing. A fatigue load of 150 N was applied on the occlusal surface at a frequency of 1.2 hz, at an angle of 135 degrees to the long axis of the tooth. Specimen failure was defined as the occurrence of crack propagation in the luting cement layer. This was monitored by the strain gauge on the specimen.

RESULTS

All specimens restored on worn tooth had significantly lower fatigue failure cycle counts than those of non-worn tooth. The fracture mode analysis revealed that ceramic fracture tended to be demonstrated only in the group of worn tooth groups.

CONCLUSIONS

The addition of a buccal veneer component had no significant effect on the load-fatigue performance of posterior ceramic onlay restorations, but the existing amount of tooth structure did have a significant effect on the load-fatigue performance of posterior ceramic onlay restorations. Catastrophic failures (ceramic fracture) occurred only in the group of worn tooth.

Anatomical crown width/length ratios of worn and unworn maxillary teeth in Asian subjects

Crown width/length ratios have been considered an important aspect in the esthetic zone. Because previous investigations focused on Caucasian populations, limited information is available on other ethnic groups to propose a comprehensive approach to anterior maxillary teeth. The purpose of this study was to analyze the dimensions of anatomical crowns of maxillary anterior tooth groups with respect to width, length, and width/length ratios among an Asian population. The tooth dimensions presented in this investigation may serve as guidelines for treatment planning in restorative dentistry and periodontal surgery for this particular ethnic group.

Tooth size variation related to age in Amboseli baboons

We measured the molar size from a single population of wild baboons from Amboseli (Kenya), both females (n=57) and males (n=50). All the females were of known age; the males represented a mix of known-age individuals (n=31) and individuals with ages estimated to within 2 years (n=19). The results showed a significant reduction in the mesiodistal length of teeth in both sexes as a function of age. Overall patterns of age-related change in tooth size did not change whether we included or excluded the individuals of estimated age, but patterns of statistical significance changed as a result of changed sample sizes. Our results demonstrate that tooth length is directly related to age due to interproximal wearing caused by M2 and M3 compression loads. Dental studies in primates, including both fossil and extant species, are mostly based on specimens obtained from osteological collections of varying origins, for which the age at death of each individual in the sample is not known. Researchers should take into account the phenomenon of interproximal attrition leading to reduced tooth size when measuring tooth length for ondontometric purposes.

Age and individual foraging behavior predict tooth wear in Amboseli baboons

Teeth represent an essential component of the foraging apparatus for any mammal, and tooth wear can have significant implications for survival and reproduction. This study focuses on tooth wear in wild baboons in Amboseli, southern Kenya. We obtained mandibular and maxillary tooth impressions from 95 baboons and analyzed digital images of replicas made from these impressions. We measured tooth wear as the percent dentine exposure (PDE, the percent of the occlusal surface on which dentine was exposed), and we examined the relationship of PDE to age, behavior, and life history variables. We found that PDE increased significantly with age for both sexes in all three molar types. In females, we also tested the hypotheses that long-term patterns of feeding behavior, social dominance rank, and one measure of maternal investment (the cumulative number of months that a female had dependent infants during her lifetime) would predict tooth wear when we controlled for age. The hypothesis that feeding behavior predicted tooth wear was supported. The percent of feeding time spent consuming grass corms predicted PDE when controlling for age. However, PDE was not associated with social dominance rank or maternal investment.

Hunter-Schreger Band patterns in human tooth enamel

Using light microscopy, we examined Hunter-Schreger Band (HSB) patterns on the axial and occlusal/incisal surfaces of 160 human teeth, sectioned in both the buccolingual and mesiodistal planes. We found regional variations in HSB packing densities (number of HSBs per mm of amelodentinal junction length) and patterns throughout the crown of each class of tooth (maxillary and mandibular: incisor, canine, premolar, and molar) examined. HSB packing densities were greatest in areas where functional and occlusal loads are greatest, such as the occlusal surfaces of posterior teeth and the incisal regions of incisors and canines. From this it is possible to infer that the behaviour of ameloblasts forming enamel prisms during amelogenesis is guided by genetic/evolutionary controls that act to increase the fracture and wear resistance of human tooth enamel. It is suggested that HSB packing densities and patterns are important in modern clinical dental treatments, such as the bonding of adhesive restorations to enamel, and in the development of conditions, such as abfraction and cracked tooth syndrome.

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion

INTRODUCTION

The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion.

METHODS

The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%.

RESULTS

The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group.

CONCLUSIONS

Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement.

Nothing in nature is as consistent as change

Dentition, as a mechanically stressed part of the orofacial system, is subject to physiological wear processes that affect the occlusal surface, the cutting-edge and the approximate contact points of teeth. The reasons are abrasive food particles, tooth contacts during chewing as well as erosion. Up until the Middle ages and even further on, both the deciduous and the permanent dentition were, depending on age, subject to distinct hard tissue defects. These regularly led from normal over-bite, which develops during dentition, to a pronounced edge-to-edge bite. In dentistry this known phenomenon is widely interpreted as a pathological adaptation. Due to specific subsistence conditions and dietary habits in food intake and preparation abrasive changes can be found in the dentition of our ancestors, beginning with the history of humanity up until historic times. However, hardly in today's population. Abrasive food particles and erosion are the main factors that cause wear in dental enamel. We analyzed occlusal hard tissue changes that led to edge-to-edge-bite in chronologically scattered skeletal series from different regions in Germany. The sample consists of both males and females from varying age groups. The skulls were photographed in standardized positions and radiographically examined. The results show that dental wear is a natural, age-dependent process which does not lead to pathological changes. Crowding and contact surface caries can even widely be impeded through abrasion. Therefore dental wear is a natural process that has only been prevented by 'civilization' in the past two centuries. Edge-to-edge-bite is still the preferable occlusion in man.

Wear and surface roughness of bovine enamel submitted to bleaching

The present study evaluated surface roughness and wear of bovine enamel following three different bleaching techniques and simulated brushing. Initial surface roughness (Ra) was evaluated and teeth were randomly divided into 4 groups (n = 10): Group 1, control; Group 2, 35% hydrogen peroxide (HP) activated by a hybrid light; Group 3, 35% HP activated by a halogen light; and Group 4, 16% carbamide peroxide. After bleaching, surface roughness was measured and teeth were subjected to 100,000 cycles of simulated brushing. After brushing, the final roughness and wear was determined. Data were statistically analyzed by ANOVA and Tukey test (P < 0.05). There were no significant differences among groups comparing initial and postbleaching roughness. After brushing, significant differences were found between the control and experimental groups. Group 4 showed a significant increase in roughness values compared with Group 2. The control group showed significantly less wear than other groups. Bleaching techniques promoted increased roughness and wear of bovine enamel, when submitted to simulated brushing. Tooth enamel after bleaching can present a larger alteration in the amount of roughness due to brushing.