ABSTRACT
Introduction: Erosive tooth wear (ETW) is defined as a chemical-mechanical process leading to the cumulative loss of hard dental tissue without the involvement of bacteria. Objective: to give to clinicians an overview about most important ETW topics. Data source: main scientific data base (PubMed, Lilacs) in the last 10 years, with the keywords: dental erosion, diagnosis and prevention. Classical articles were selected for the realization of an integrative literature review. Data synthesis : the prevalence of ETW has been reported to range from 10% to 80% in children and 4% to 82% in adults. The management of ETW should include early diagnosis, the evaluation of different etiological factors, risk identification and the proposal of preventive measures to avoid the progression of the condition. These measures include fluoride exposure, use of low abrasive toothpastes, clinical monitoring, and in more severe cases sealant application and restorations. Patients suffering from eating disorders with purging behaviour and gastroesophageal reflux disease are considered the most important risk groups. Conclusion : Clinicians should be aware of this condition with growing prevalence, once substance loss is an irreversible condition, providing prompt preventive measures during the early stages that are essential to reduce ETW.
Introdução: O Desgaste Dentário Erosivo é definido como um processo químico- mecânico que leva a uma perda cumulativa de tecido dentário duro, sem que ocorra o envolvimento de bactérias. Objetivo : atualizar os cirurgiões-dentistas sobre os principais tópicos a respeito do Desgaste Dentário Erosivo. Fonte de dados: principais bases científicas (PubMed, Lilacs) nos últimos 10 anos, com as palavras-chave: erosão dentária, diagnóstico e prevenção. Foram selecionados os artigos clássicos sobre o tema para a realização da revisão integrativa de literatura. Síntese de dados : A prevalência de Desgaste Dentário Erosivo tem sido reportada na literatura em porcentagens que variam de 10% a 80% em crianças e de 4% a 82% em adultos. A abordagem clínica do Desgaste Dentário Erosivo deve incluir um diagnóstico precoce, a avaliação dos diferentes fatores etiológicos, a identificação do risco e a proposta de medidas preventivas para retardar a progressão dessa condição. Essas medidas incluem a aplicação de fluoretos, o uso de dentifrícios com baixa abrasividade, monitoramento clínico e, em casos mais graves, a aplicação de selantes e procedimentos restauradores. Pacientes diagnosticados com transtornos alimentares ou com refluxo gastroesofágico são considerados um dos grupos de risco mais importantes para o desenvolvimento dessa condição. Conclusão: Os clínicos devem estar atentos a essa condição de prevalência crescente, uma vez que a perda de estrutura dentária é irreversível, promovendo medidas preventivas eficazes, desde os estágios iniciais, contribuindo assim para o controle e redução do Desgaste Dentário Erosivo entre seus pacientes.
Subject(s)
Tooth Erosion , Tooth Wear/diagnosis , Tooth Wear/etiology , Tooth Wear/prevention & controlABSTRACT
Abstract High viscous glass ionomer cement (GIC) has gained popularity as a restorative material; however, high wear is pointed as one of the major drawbacks of this material. Protective surface coatings were developed to protect GIC from water contamination with the additional advantage of occluding any surface cracks or porosities commonly found in this material, possibly resulting in an increased wear resistance of the restorations. Objective: The objective of this study was to investigate the clinical wear of GIC approximal restorations in primary molars protected either with a nanofilled self-adhesive light-cured protective coating (NPC) or with petroleum jelly. Material and Methods: Approximal caries lesions in primary molars from 32 schoolchildren previously enrolled in another clinical trial were included in this investigation. GIC restorations were performed according to the Atraumatic Restorative Treatment approach and protected with either petroleum jelly or a NPC. Impressions of the restored hemiarch were done after 1 day and 6, 12, 24 and 36 months. The impressions were scanned in a 3-D appliance and the obtained images were superimposed using an appropriate computer software. Two-way ANOVA for repeated measures and Tukey's post-hoc test were used to analyze the wear of restorations (α=5%). Results: A significant difference was found between the two groups, with a wear protection offered by the application of a NPC. Conclusion: These results suggest that the application of a NPC has a protective effect on the clinical wear of approximal GIC restorations in primary teeth.
Subject(s)
Humans , Male , Female , Child , Petrolatum/chemistry , Resin Cements/chemistry , Tooth Wear/prevention & control , Glass Ionomer Cements/chemistry , Surface Properties , Time Factors , Tooth, Deciduous , Materials Testing , Reproducibility of Results , Analysis of Variance , Treatment Outcome , Dental Restoration Failure , Dental Atraumatic Restorative Treatment/methodsABSTRACT
El bruxismo es una actividad muscular mandibular repetitiva, caracterizada por apriete y rechinamiento dentario. Se considera un fenómeno regulado por el sistema nervioso central, principalmente, e influido por factores periféricos. Tiene 2 manifestaciones circadianas distintas: puede ocurrir durante el sueño -indicado como bruxismo de sueño- o durante la vigilia -indicado como bruxismo despierto-. El bruxismo es mucho más que solo el desgaste que podemos observar en los dientes: de hecho, se asocia con dolor orofacial, cefaleas, trastornos del sueño, trastornos respiratorios durante el sueño como el síndrome de apnea e hipoapnea del sueño, trastornos del comportamiento o asociados al uso de fármacos. Además, se ve influido por factores psicosociales y posturales, lo que indica que parafunciones oromandibulares, los trastornos temporomandibulares, la maloclusión, los altos niveles de ansiedad y de estrés, entre otros, podrían influir en la ocurrencia de bruxismo. Su etiología es considerada hoy como multifactorial. Su detección temprana, diagnóstico, tratamiento y la prevención de sus posibles consecuencias en los pacientes es responsabilidad del pediatra y del odontólogo. El objetivo de esta revisión es actualizar los conceptos sobre esta patología y alertar a los profesionales de la salud sobre su detección precoz y su manejo oportuno.
Bruxism is a rhythmic masticatory muscle activity, characterized by teeth grinding and clenching. This is a phenomenon mainly regulated by the central nervous system and peripherally influenced. It has two circadian manifestations, during sleep (sleep bruxism) and awake states (awake bruxism). Bruxism is much more than just tooth wearing. It is currently linked to orofacial pain; headaches; sleep disorders; sleep breathing disorders, such as apnea and hypopnea sleep syndrome; behavior disorders, or those associated with the use of medications. It is also influenced by psycho-social and behavior factors, which means that oromandibular parafunctional activities, temporomandibular disorders, malocclusion, high levels of anxiety and stress, among others, may precipitate the occurrence of bruxism. Nowadays, its etiology is multifactorial. The dentist and the pediatrician are responsible for its early detection, diagnosis, management, and prevention of its possible consequences on the patients. The aim of this review is to update the concepts of this disease and to make health professionals aware of its early detection and its timely management.
Subject(s)
Humans , Child , Adolescent , Facial Pain/etiology , Sleep Bruxism/therapy , Tooth Wear/etiology , Anxiety/etiology , Sleep Wake Disorders/etiology , Temporomandibular Joint Disorders/etiology , Sleep Bruxism/complications , Sleep Bruxism/diagnosis , Early Diagnosis , Tooth Wear/prevention & control , Headache/etiologyABSTRACT
A atrição pode explicar certas alterações que ocorrem depois de meses ou de anos de tratamento reabilitador, ocasionando mudanças na forma e nos tamanhos mesiodistal e oclusoapical das coroas dentárias, mudando a posição e a relação dos implantes dentários. A atrição dentária pode: 1) representar um sinal de desajustes oclusais; 2) indicar hábitos parafuncionais, como o apertamento e o bruxismo; 3) reduzir o perímetro da arcada dentária, pois os pontos de contato proximal transformam-se em facetas de contato ao longo dos anos; 4) envelhecer a boca, isso por causa de alguns detalhes morfológicos que variam conforme a faixa etária do paciente, como a eliminação dos serrilhados por meio de alisamento da margem incisal, até o aparecimento de dentina, como uma linha ou faixa amarelada escura entre o esmalte vestibular e o lingual, na incisal dos incisivos e caninos; 5) agravar ainda mais o envelhecimento promovido pelo apinhamento dentário; 6) exacerbar o envelhecimento, pela perda de dimensão vertical da face; 7) estar associada ao aparecimento de diastemas entre os implantes osseointegrados e os dentes naturais, depois de alguns anos de concluído o tratamento reabilitador.
Attrition may explain certain alterations identified after months and years of rehabilitation treatment. Such alterations may be explained by changes in mesiodistal as well as occlusal - apical shape and size of dental crowns, which change in relation to the position and relationship established with dental implants. Dental attrition can: 1 . represent a sign of occlusal maladjustment ; 2 . indicate parafunctional habits such as clenching and bruxism; 3 . reduce arch perimeter, since the contact points are transformed into proximal contact facets over the years; 4. age the mouth due to some morphological details that vary according to the age of the patient, including the elimination of jaggies with smoothing of the incisal edge until the dentin appears as a line or dark yellowish band between the buccal and lingual enamel incisal incisors and canine 5. further aggravate aging promoted by crowding ; 6 . age due to loss of vertical dimension of the face 7. be associated with diastema occurring between dental implants and natural teeth a few years after the rehabilitation treatment is finished.
Subject(s)
Humans , Male , Female , Aging , Tooth Wear/complications , Tooth Wear/prevention & control , Diastema/etiology , Brazil , Dental Implants , Esthetics, Dental , Mouth RehabilitationABSTRACT
OBJECTIVE: This in vitro study evaluated the effect of calcium glycerophosphate (CaGP) supplemented to soft drinks on bovine enamel erosion. MATERIAL AND METHODS: Four pH-cycles were performed, alternating demineralization by the beverage and remineralization in artificial saliva. RESULTS: Mean wear (±SD, µm) was 7.91±1.13, 7.39±1.01, 7.50±0.91 and 5.21±1.08 for Coca-Cola® without CaGP or containing CaGP at 0.1, 1.0 or 2.0 mM, respectively, while no wear was detected for CaGP at 5.0 and 10.0 mM. Corresponding figures for Sprite Zero® without CaGP or containing CaGP at 0.1, 1.0, 2.0, 5.0 or 10.0 mM were 8.04±1.30, 7.84±0.71, 7.47±0.80, 4.96±0.81, 3.99±0.10 and 1.87±0.12, respectively. CONCLUSION: Supplementation of both beverages with CaGP seems to be an alternative to reduce their erosive potential.
Subject(s)
Animals , Cattle , Carbonated Beverages/adverse effects , Dental Enamel/drug effects , Glycerophosphates/pharmacology , Tooth Erosion/prevention & control , Dental Enamel/chemistry , Hardness , Materials Testing , Random Allocation , Saliva, Artificial , Surface Properties , Tooth Erosion/chemically induced , Tooth Wear/prevention & controlABSTRACT
O desgaste dentário é um processo fisiológico e natural. Entretanto, lesões como abrasão, atrição, abfração e erosão podem ser patológicas dependendo da severidade e relacionada com a idade. Enquanto o declínio da incidência de cárie tem sido observado, o desgaste dentário por aqueles mecanismos tem se tornado um achado clínico importante. Em muitas situações é impossível distinguir qual o principal fator envolvido com as lesões por Perda da Estrutura Dentária (PED) devido a sua etiologia multifatorial e diagnóstico complexo. Adicionalmente, fatores específicos podem atuar sinergicamente com a etiologia da PED, incluindo as atividades funcionais e parafuncionais, dieta, doenças, fatores salivares, hábitos de higiene e atividade ocupacional.Entretanto, a erosão é o principal assunto dos estudos de PED, pois pesquisas clínicas indicam o aumento da sua prevalência e apontam o seu efeito dominante sobre os outros mecanismos.A erosão origina-se por meio do contato crônico dos dentes com substâncias ácidas que podem ser de origem extrínseca e intrínseca, sem o envolvimento bacteriano. A avaliação minuciosa dos hábitos do paciente associado ao exame clínico auxiliam na determinação da etiologia e dos fatores de risco, sendo esses o foco do manejo da erosão. A mensagem deste trabalho é apresentar uma abordagem de base sólida para a PED onde o seu restabelecimento deve ser acompanhado por aconselhamentos e mudanças de hábitos alimentares e quando presente doenças sistêmicas ou aos distúrbios alimentares o tratamento médico deve estar associado.
Tooth wear is a physiological and natural process. However, lesions like abrasion, attrition and erosion may be pathological depending on their age-related severity. While the rate of caries has decreased, pathological tooth wear has become an increasingly common clinical finding. In most cases it is a challenge to determine the main factor involved with the tooth wear lesion, given its multifactorial etiology and complex diagnostic. Additionally, specific factors can act synergistically with tooth wear etiology including functional and parafunctional activities, diet, diseases, salivary factors, hygiene habits and occupational activity. Erosion seems to be a major source and main topic on tooth wear studies since recent clinical research has pointed its increased prevalence and also its dominant effect over other mechanisms. Erosion is caused by chronic contact of teeth with acid substances that can be of extrinsic or intrinsic origin, without bacterial involvement.A thorough assessment of patient habits, and clinical exam aiming at determination of etiological and risk factors are the goals of erosion management. The message of this paper is to provide a sound basis approach to tooth wear, where restoration of lost dental structure should be coupled with counseling and changes of dietary habits and/or medical treatment if associated with eating disorders or systemic diseases.