Envejecimiento dental prematuro en deportistas / Premature dental aging in athletes

El desgaste natural de los dientes ocurre dependiendo de factores como: calidad de la estructura dental, calidad de la saliva, biotipo facial que determina la fuerza de mordida; de acuerdo a estos factores locales bucales se va envejeciendo la dentadura. Pero los deportistas presentan un patrón de desgaste mayor y continuo debido al tipo de deporte que practican, las horas de entrenamiento, el consumo de bebidas con pH ácido, el cepillado dental vigoroso; todos estos factores pueden conducirlos a que desarrollen lesiones no cariosas (AU)

The natural wear of the teeth occurs depending on factors such as: quality of the dental structure, quality of the saliva, facial biotype that determines the bite force, according to these local oral factors, the teeth age. But in athletes they present a pattern of greater and continuous wear due to the type of sport they practice, the hours of training, the consumption of drinks with an acidic pH, vigorous tooth brushing; all these factors can lead them to develop non-carious lesions (AU)

Comportamiento Mecánico de un Premolar Humano Sano Sometido a Fuerzas Funcionales y Disfuncionales en un MEF / Mechanical Behavior of a Healthy Human Premolar Subjected to Functional and Dysfunctional Forces in a FEM

El propósito de este estudio fue analizar el comportamiento mecánico de la estructura dental sana de un primer premolar inferior humano sometido a fuerzas funcionales y disfuncionales en diferentes direcciones. Se buscó comprender, bajo las variables contempladas, las zonas de concentración de esfuerzos que conllevan al daño estructural de sus constituyentes y tejidos adyacentes. Se realizó el modelo 3D de la reconstrucción de un archivo TAC de un primer premolar inferior, que incluyó esmalte, dentina, ligamento periodontal y hueso alveolar considerando tres variables: dirección, magnitud y área de la fuerza aplicada. La dirección fue dirigida en tres vectores (vertical, tangencial y horizontal) bajo cuatro magnitudes, una funcional de 35 N y tres disfuncionales de 170, 310 y 445 N, aplicadas sobre un área de la cara oclusal y/o vestibular del premolar que involucró tres contactos estabilizadores (A, B y C) y dos paradores de cierre. Los resultados obtenidos explican el fenómeno de combinar tres vectores, cuatro magnitudes y un área de aplicación de la fuerza, donde los valores de esfuerzo efectivo equivalente Von Mises muestran valores máximos a partir de los 60 MPa. Los valores de tensión máximos se localizan, bajo la carga horizontal a 170 N y en el proceso masticatorio en la zona cervical, cuando la fuerza pasa del 60 %. Sobre la base de los hallazgos de este estudio, se puede concluir que la reacción de los tejidos a fuerzas funcionales y disfuncionales varía de acuerdo con la magnitud, dirección y área de aplicación de la fuerza. Los valores de tensión resultan ser más altos bajo la aplicación de fuerzas disfuncionales tanto en magnitud como en dirección, produciendo esfuerzos tensiles significativos para la estructura dental y periodontal cervical, mientras que, bajo las cargas funcionales aplicadas en cualquier dirección, no se generan esfuerzos lesivos. Esto supone el reconocimiento del poder de detrimento estructural del diente y periodonto frente al bruxismo céntrico y excéntrico.

SUMMARY: The purpose of this study was to analyze the mechanical behavior of the healthy dental structure of a human mandibular first premolar subjected to functional and dysfunctional forces in different directions. It was sought to understand, under the contemplated variables, the areas of stress concentration that lead to structural damage of its constituents and adjacent tissues. The 3D model of the reconstruction of a CT file of a lower first premolar was made, which included enamel, dentin, periodontal ligament and alveolar bone considering three variables: direction, magnitude and area of the applied force. The direction was directed in three vectors (vertical, tangential and horizontal) under four magnitudes, one functional of 35 N and three dysfunctional of 170, 310 and 445 N, applied to an area of the occlusal and/or buccal face of the premolar that involved three stabilizing contacts (A, B and C) and two closing stops. The results obtained explain the phenomenon of combining three vectors, four magnitudes and an area of force application, where the values of effective equivalent Von Mises stress show maximum values from 60 MPa. The maximum tension values are located under the horizontal load at 170 N and in the masticatory process in the cervical area, when the force exceeds 60%. Based on the findings of this study, it can be concluded that the reaction of tissues to functional and dysfunctional forces varies according to the magnitude, direction, and area of application of the force. The stress values turn out to be higher under the application of dysfunctional forces both in magnitude and in direction, producing significant tensile stresses for the dental and cervical periodontal structure, while under functional loads applied in any direction, no damaging stresses are generated. This supposes the recognition of the power of structural detriment of the tooth and periodontium against centric and eccentric bruxism.

Lesiones cervicales no cariosas: una revisión sistemática / Non carious cervical lesions: a systematic review

Introducción: las lesiones cervicales no cariosas (NCCL, por sus siglas en inglés) son un grupo de lesiones que afectan el área cervical del órgano dental causando hipersensibilidad dentinaria y defectos estéticos. Objetivo: analizar la literatura sobre las lesiones cervicales no cariosas, su etiología, consideraciones anatómicas, características morfológicas de la lesión y tratamientos no restaurativos. Material y métodos: se realizó una búsqueda en la base de datos PubMed, utilizando las palabras clave: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, recopilando un total de 78 artículos. Resultados: es necesario determinar la etiología antes de seleccionar las estrategias de tratamiento para las lesiones cervicales no cariosas. Conocer los distintos tipos de tejidos que componen al órgano dentario facilita la comprensión de los factores que participan en el desarrollo de las lesiones cervicales no cariosas. Esto permite que el tratamiento se enfoque más en la causa del problema que en los síntomas. Con esto podemos modificar diversos factores de manera interceptiva, los tratamientos de terapia con láser y compuestos tópicos son una estrategia mínimamente invasiva. Conclusiones: la mejor manera de describir a las lesiones cervicales no cariosas sería como una enfermedad multifactorial. Se debe prestar especial atención en los métodos de diagnóstico, identificando cofactores que propicien el avance de la lesión, como son la fricción y la biocorrosión. Esta revisión brinda datos que asocian a los factores oclusales como una de las principales causas de una enfermedad que afecta a más de la mitad de la población adulta (AU)

Introduction: non-carious cervical lesions (NCCL) are a group of lesions that affect the cervical area of the dental organ causing dentin hypersensitivity and cosmetic defects. Objective: to know, through a systematic review, the current state of non-carious cervical lesions. Material and methods: a search was conducted in the PubMed database, using the keywords: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, compiling a total of 78 articles. Results: determining etiology is necessary before selecting treatment strategies for non-carious cervical lesions (NCCL). Know the different types of tissues that make up the dentary organ, facilitate the understanding of the factors involved in the development of noncarious al cervical lesions. This allows treatment to focus more on the cause of the problem than on symptoms. With this we can modify various factors in an interceptive way, laser therapy treatments and topical compounds, are a minimally invasive strategy. Conclusions: the best way to describe non-carious al cervical lesions would be as a multifactorial disease to which special attention should be paid to both diagnostic methods, identifying cofactors that promote the progression of injury, such as friction and biocorrosion. This review provides data that associates occlusal factors as one of the main causes of a disease that affects more than half of the adult population (AU)

Relationship between presence of abfractions and premature contacts

ABSTRACT: Abfractions (AFs) are non-carious cervical lesions considered of multifactorial etiology by several authors. Objective: Relate the presence of premature contacts and AFs. Materials & Methods: The original number of students to be analyzed were 117, 36 of whom (equal amount of women and men) were finally chosen for presenting premature contacts. 19 of them presented abfractions. A survey was conducted with questions on issues like toothbrushing habits, diet and some gastric disorders; besides the participants had to take the Hamilton Anxiety Rating Scale. Then, stone models were obtained and mounted for further occlusal analysis with WCM ® semi-adjustable articulator searching the abfractions and their coincidence with premature contacts. Fisher's exact test (p<0,05) was used to associate AF with toothbrushing habits, diet, burning symptoms and gastroesophageal reflux. Chi-square test (p<0,05) was used to associate AFs and premature contacts. Student's t-distribution was used to associate AFs with anxiety. Results: There was a significant relationship between AFs presence and premature contacts (p=0,00). There was not a significant relationship between presence of AFs and toothbrushing habits and diet. There was not a significant relationship between presence of AFs and anxiety. Conclusions: AF presence do associate with premature contacts in the same affected tooth.

Lesões cervicais não cariosas: considerações etiológicas, clínicas e terapêuticas / Lesiones cervicales no cariosas: consideraciones etiológicas, clínicas y terapéuticas / Non-carious cervical injuries: etiological, clinical and therapeutic considerations

RESUMO Introdução: As lesões cervicais não cariosas são lesões dentárias, que apresentam etiologia multifatorial, sem o envolvimento de bactérias. Objetivo: Descrever as características clínicas, etiologia e tratamento das lesões cervicais não-cariosas. Métodos: Realizou-se uma revisão bibliográfica de estudos publicados nos últimos 5 anos (2014-2018) por meio da busca nas bases de dados: PubMED/Medline, Lilacs, Science Direct, SciELO (Scientific Eletronic Library) e Google Acadêmico. Para a pesquisa foram utilizados os seguintes descritores: "lesões cervicais não cariosas (non-carious cervical lesions)", "abrasão dentária (dental abrasion)", "erosão dentária (dental erosion)", "abfração dentária (dental abfraction)" e "atrição dentária (dental atrittion). Após criteriosa filtragem, foram selecionados 26 artigos e 2 livros para inclusão no estudo. Análise e integração das informações: As lesões cervicais não cariosas comumente classificadas em: abrasão, abfração, erosão e atrição. Essas lesões podem apresentar diversas formas, apesar de serem incluídas em uma classe genérica de denominação. São lesões que causam a perda gradativa dos tecidos mineralizados dentários, podendo trazer inúmeras consequências ao dente acometido. Conclusão: Para um correto diagnóstico e decisão de tratamento, essas lesões devem ser vistas sob seu aspecto etiológico multifatorial. Diversas possibilidades terapêuticas podem ser utilizadas no tratamento dessas lesões sendo necessário que o clínico conheça os principais fatores etiológicos e características clínicas que as diferenciem(AU)

RESUMEN Introducción: Las lesiones cervicales no cariosas son lesiones dentales, que presentan etiología multifactorial, sin la participación de bacterias. Objetivo: Describir las características clínicas, etiología y tratamiento de las lesiones cervicales no cariosas. Métodos: Se realizó una revisión bibliográfica de estudios publicados en los últimos 5 años (2014-2018) a través de la búsqueda en las bases de datos: PubMED / Medline, Lilacs, Science Direct, SciELO (Scientific Eletronic Library) y Google Académico. Para la investigación se utilizaron los siguientes descriptores: "lesiones cervicales no cariosas", "abrasión dental", "erosión dental", "abfracción dental" y " " atrición dental. Después de un cuidadoso filtrado, se seleccionaron 26 artículos y 2 libros para su inclusión en el estudio. Análisis e integración de las informaciones: Las lesiones cervicales no cariosas comúnmente clasificadas en: abrasión, abfración, erosión y atrición. Estas lesiones pueden presentar diversas formas, aunque se incluyen en una clase genérica de denominación. Son lesiones que causan la pérdida gradual de los tejidos mineralizados dentales, pudiendo traer innumerables consecuencias al diente acometido. Conclusiones: Para un correcto diagnóstico y decisión de tratamiento, estas lesiones deben ser vistas bajo su aspecto etiológico multifactorial. Diversas posibilidades terapéuticas pueden ser utilizadas en el tratamiento de esas lesiones, por lo que resulta necesario que el clínico conozca los principales factores etiológicos y características clínicas que las diferencien(AU)

ABSTRACT Introduction: Non-carious cervical lesions are dental lesions of a multifactorial etiology, without the involvement of bacteria. Objective: Describe the clinical characteristics, etiology and treatment of non-carious cervical lesions Methods: A bibliographic review was conducted of studies published in the last five years (2014-2018) by searching the databases PubMED / Medline, Lilacs, Science Direct, SciELO (Scientific Electronic Library) and Google Scholar. The following descriptors were used: "non-carious cervical lesions", "dental abrasion", "dental erosion", "dental abfraction" and "dental attrition. After careful filtering, 26 articles and two books were selected for inclusion in the study. Data analysis and integration: Non-carious cervical lesions are commonly classified as abrasion, abfraction, erosion and attrition. These lesions may present various forms, but they are all grouped in a single generic class. They are lesions that cause the gradual loss of mineralized dental tissue, which may bring countless consequences to the affected tooth. Conclusions: For a correct diagnosis and treatment decision, these lesions must be seen under their multifactorial etiological aspect. Various therapeutic possibilities may be used in the treatment of these lesions, and it is necessary for the clinician to know the main etiological factors and clinical characteristics that differentiate them(AU)

Restorative Rehabilitation of a Patient with Generalized Non-Carious Cervical Lesions: Case Report / Rehabilitación restaurativa de un paciente con lesiones cervicales no-cariosas generalizadas: Reporte de un caso

ABSTRACT Non-Carious Cervical Lesions (NCCL) are a current problem of multifactorial origin that is associated with the loss of vertical occlusal dimension, hypersensitivity, loss of teeth, fractures, and many other pathologies that affect the masticatory function of the oral cavity. Identification of the etiological factors of NCCL comprises a key piece for the solution of the problem. Based on clinical scientific evidence related with the diagnosis, a restorative treatment must be planned according to the loss of dental structure in order to return function and aesthetics. The purpose of this case report was to describe a 54-year-old male patient who was diagnosed with generalized NCCL combined with occlusal vertical dimension loss. The protocol of the treatment process is described.

RESUMEN Las lesiones cervicales no cariosas (LCNC) son una problemática actual de origen multifactorial, la cual se ve asociada a la pérdida de dimensión vertical oclusal, hipersensibilidad, pérdida de dientes, fracturas y muchas otras patologías que afectan la función masticatoria de la cavidad bucal. La identificación de los factores etiológicos de las LCNC son piezas claves para la solución del problema. Basados en la evidencia científica clínica relacionado con el diagnóstico, se debe planificar un plan de tratamiento restaurativo que depende de la pérdida de la estructura dentaria para devolver la función y estética. El objetivo de este reporte de caso es describir a un paciente masculino de 54 años a quien se le diagnosticó LCNC generalizadas combinado con una pérdida de dimensión vertical oclusal. El protocolo de plan de tratamiento es descrito paso a paso.

Lesiones dentales no cariosas en pacientes atendidos en la Clínica Estomatológica Siboney / Non-carious dental lesions in patients treated at the Siboney Stomatology Clinic

Introducción: El desgaste dental es un proceso insidioso y acumulativo que lleva a la destrucción del esmalte y la dentina; conocido como lesiones dentales no cariosas y son: Atrición, Abrasión, Abfracción y Erosión. En Cuba estas lesiones han sido poco estudiadas. Objetivo: Identificar las lesiones dentales no cariosas y sus formas clínicas en pacientes atendidos en la Clínica Estomatológica Siboney. Métodos: Se estudiaron 876 pacientes escogidos al azar de la población que fue atendida durante un período de 10 meses en dicha clínica estomatológica. A los mismos se les realizó un examen estomatológico para determinar si eran portadores o no de tales lesiones y cuál o cuáles variedades de las mismas presentaban. Resultados: Se comprobó que 102 de los 876 pacientes examinados eran portadores de lesiones dentales no cariosas para un 11,43 por ciento; de los cuales el 42,15 por ciento presentaron un solo tipo de lesión; 50 pacientes mostraron dos tipos de lesiones, para un 49,01 por ciento, en todas las combinaciones posibles, siendo la combinación más frecuente Atrición y Abfracción seguida por la Atrición y la Abrasión. Por último, nueve pacientes presentaron tres tipos de lesiones, para un 8,82 por ciento; en este caso la combinación más frecuente fue Atrición, Abfracción y Erosión. Conclusiones: El porcentaje de pacientes con lesiones dentales no cariosas fue relativamente elevado; pudiendo presentarse una lesión aislada o combinaciones de dos o tres; siendo las formas clínicas más frecuentes: Abfracción, en el caso de una lesión; Atrición y Abfracción en el de dos y Atrición, Abrasión y Erosión, en el de tres(AU)

Introduction: Dental wear is an insidious and cumulative process that leads to the destruction of enamel and dentin; Known as non-carious dental injuries and are: Attrition, Abrasion, Abrasion and Erosion. In Cuba these injuries have been little studied. Objective: To identify non-carious dental lesions and their clinical forms in patients treated at the Siboney Stomatology Clinic. Methods: We studied 876 patients chosen at random from the population that was attended during a period of 10 months in said stomatological clinic. They underwent a stomatological examination to determine if they were carriers or not of such injuries and which one or which varieties of them they presented. Results: It was verified that 102 of the 876 patients examined were carriers of non-carious dental lesions for 11.43 percent; of which 42.15 percent presented a single type of injury; 50 patients showed two types of injuries, for 49.01 percent, in all possible combinations, with the most frequent combination being Attrition and Abfraction followed by Attrition and Abrasion. Finally, nine patients presented three types of injuries, for 8.82 percent; in this case the most frequent combination was Attrition, Abrasion and Erosion. Conclusions: The percentage of patients with non-carious dental lesions was relatively high; being able to present an isolated lesion or combinations of two or three; the most frequent clinical forms being: Abfraction, in the case of an injury; Attrition and Abrasion in the two and Attrition, Abrasion and Erosion, in the three(AU)

Lesiones cervicales no cariosas / Non-carious cervical lesions

El objetivo de este trabajo consiste en describir las distintas lesiones cervicales no cariosas, la abrasión, la erosión y la abfracción. Se desarrollarán en detalle su etiología, localización y características clínicas. Se mencionarán los diferentes procedimientos a realizar para su prevención y los materiales a utilizar para su restauración.

This article describes the different types of non-cariouscervical lesions, for example abrasion, erosionand abfraction. We will discuss their etiology, location and clinical features in detail. We will describe the procedures to prevent them, aswell as the materials used for their restoration.

Are non-carious cervical lesions more frequent in sleep bruxism patients? / Lesões cervicais não cariosas são mais frequentes em pacientes com bruxismo do sono?

Objective: to verify the frequency in non-carious lesions in patients with and without sleep bruxism and to try to list the occurrence of such lesions in patients with this parafunctional habit. Material and Methods: 67 patients ranging from 18 to 70 years of age, which all signed a free and consent form were evaluated. Patients with neurological diseases and/or partially or totally edentulous were excluded from the study. Bruxism diagnosis was performed using a validated questionnaire based on the combination of at least two positive confirmations of bruxism. Diagnosis of non-carious cervical lesions (NCCL) was performed by a single calibrated examiner, using #5 clinical probe, intraoral mirror and air flow, analyzing all surfaces of the teeth present in the mouth. The lesions were classified as abfraction, abrasion or erosion. Statistical analysis was performed by U MannWhitney test, at 5% level of significance. Results: sixty patients were diagnosed with bruxism (91.3%) and only seven patients (8.7%) did not present this parafuctional habit. Regardless the gender, five patients (10.1%) presented absence of lesions and 62 patients (89.9%) presented some NCCL. 70% presented abfraction, 41% abrasion and no patient presented erosion. Statistical analysis showed a p-value of 0.03, which demonstrated significant statistical difference of NCCL between the groups. Conclusion: a higher frequency of NCCL in patients with bruxism was observed when compared to patients without this parafuction. (AU)

Objetivo: verificar a frequência de lesões não cariosas nos pacientes com e sem bruxismo do sono e tentar relacionar a ocorrência dessas lesões a esse hábito parafuncional. Material e Métodos: foram avaliados 67 pacientes com idade entre 18 e 70 anos, os quais assinaram um termo de consentimento livre e esclarecido. Foram excluídos da pesquisa pacientes com doenças neurológicas e/ou endêntulos parciais ou totais. O diagnóstico de bruxismo foi realizado através de um questionário validado que se baseiam na combinação de pelo menos duas constatações positivas de bruxismo. O diagnóstico das lesões cervicais não cariosas (LCNC) foi realizado por um único examinador calibrado, e observadas mediante utilização de sonda clínica n° 5, espelho clínico intraoral e jato de ar, analisando todas as faces de todos dos dentes presentes em boca. Essas foram classificadas em abfração, abrasão ou erosão. A análise estatística foi realizada pelo teste U de Mann-Whitney para tratamento estatístico com nível de significância de 5%. Resultados: sessenta pacientes foram diagnosticados com bruxismo (91,3%) e apenas sete pacientes (8,7%) não possuíam esse hábito parafuncional. Independente do gênero, cinco pacientes (10,1%) possuíam ausência e sessenta e dois pacientes (89,9%) possuíam presença de alguma LCNC. 70% possuíam abfração, 41% abrasão e nenhum paciente apresentou erosão. O teste estatístico obteve um p-valor igual a 0,03; demostrando uma diferença estatisticamente significativa da presença de LCNC entre os grupos. Conclusão: nota-se que houve uma maior frequência de LCNC em pacientes com bruxismo em comparação ao grupo que não apresentou essa parafunção. (AU)

Influence of the occlusal contacts in formation of Abfraction Lesions in the upper premolar / Influência dos contatos oclusais na formação de lesões de Abfração no pré-molar superior

Objective: The aim of this study was to observe the influence of different occlusal contacts in a superior pre-molar structure using Finite Element Analysis. Material and Methods: A three-dimensional model of a superior pre-molar was designed to simulate three occlusion situations, namely central occlusion and two types of lateral occlusion contacts. The model presents enamel, dentin, a periodontal ligament and a fixation cylinder separately. All materials were considered isotropic, linear and homogeneous, and the contacts of each structure were perfectly bonded. On analysis software, a load was applied to an occlusal surface at 40° to the long axis on lateral contacts, and directed to the long axis on central occlusion contact. Results: The results were obtained in stress maps and the maximum values were then plotted in table for quantitative comparison, with the enamel concentrating more stress than dentin and the occlusal contact presenting the worst biomechanical behavior. Conclusion: Within the limitations of this study, it is possible conclude that: eccentric contacts have higher potential to develop abfraction lesions on the cervical region of teeth, thus increasing the magnitude of tensile and shear stresses. (AU)

Objetivo: observar a influência de diferentes contatos oclusais em uma estrutura pré-molar superior usando a análise por elementos finitos. Material e Métodos: um modelo tridimensional de pré-molar superior foi projetado para simular três situações de oclusão: oclusão central e dois tipos de contatos de oclusão lateral. O modelo apresentou esmalte, dentina, ligamento periodontal e um cilindro de fixação separadamente. Todos os materiais foram considerados isotrópicos, lineares e homogêneos, e os contatos de cada estrutura foram considerados perfeitamente ligados. No software de análise, aplicou-se uma carga na superfície oclusal a 40°, ao longo eixo do dente, nos contatos laterais e direcionada para apical no contato de oclusão central. Resultados: os resultados foram obtidos nos mapas de tensão e os valores máximos foram escritos em tabela para comparação quantitativa, com o esmalte concentrando mais tensão do que a dentina e o contato em cúspide de balanceio apresentando o pior comportamento biomecânico. Conclusão: dentro das limitações deste estudo, é possível concluir que: os contatos excêntricos facilitam o surgimento de lesões de abfração na região cervical dos dentes, pois aumentam a magnitude das tensões de tração e de cisalhamento. (AU)

Non-carious Cervical Lesion: A Review Article.

Non-carious cervical lesions are usually described as “tooth substance loss.” Such process includes attrition, abrasion, erosion, abfraction, localized non-hereditary dentinal hypocalcification, localized non-hereditary dentinal hypoplasia, amelogenesis imperfecta, dentinogenesis imperfecta, and tooth trauma. The non-carious cervical lesion is complex lesions in which there is a loss of enamel, dentin, cementum, bone and keratinized attached gingiva. Furthermore, there is gingival crest disharmony, poor emergence profile, loss of identifiable cemento-enamel junction, Miller’s recession class, and dentin/root sensitivity. The treatment of this non-carious lesion includes restorations such as glass-ionomer cement (GIC), composites, and Resin-modified GIC. We can even restore them with porcelain fused metal crowns or full ceramic crowns.

Absence of Non-Carious Cervical Lesions (NCCLs) in a Chilean Pre-Columbian Sample with Severe Occlusal Tooth Wear / Ausencia de Lesiones Cervicales no Cariosas (NCCLs) en una Muestra Chilena Precolombina con Severo Desgaste Oclusal

This study evaluates the non-carious cervical lesions (NCCLs) and the occlusal tooth wear in a pre-Columbian sample (n= 67, adults) from San Pedro de Atacama (North of Chile, 400-1300 BCE). The cervical regions of tooth were observed for loss of enamel and/or dentine in order to identify them as NCCLs and the tooth wear was characterized by the Basic Erosive Wear Examination (BEWE) index. None of the individuals analyzed presented NCCLs, whereas the 98.5% (66/67) of them showed occlusal wear. The mean BEWE index was 2.5, indicating severe dental wear (3 being the highest possible score of BEWE). This lack of relation among severe tooth wear and NCCLs gives support to the idea of loss of crown height reduces cervical stress and develop of NCCLs in archaeological populations.

Este estudio evalúa las lesiones cervicales no cariosas (NCCLs) y el desgaste dental oclusal en una muestra precolombina (n= 67, adultos) de San Pedro de Atacama (Norte de Chile, 400-1300 AEC). Se analizó la perdida de esmalte y/o dentina en las áreas cervicales de los dientes con el propósito de identificarlas como NCCLs y el desgaste dental fue evaluado según el índice Basic Erosive Wear Examination (BEWE). Ninguno de los individuos analizados presentó NCCLs, mientras el 98,5% (66/67) de ellos mostró desgaste oclusal. El promedio del índice BEWE fue de 2,5, indicando severo desgaste dental (siendo 3 el puntaje más alto posible). La falta de relación entre severo desgaste dental y NCCLs apoya la idea que la pérdida de altura de las coronas reduce el estrés cervical y el desarrollo de NCCLs en poblaciones arqueológicas.

Prevalence of Tooth Wear Due to Dietary Factors in South Canara Population.

Aims: The aim of the study was to determine the prevalence of tooth wear due to dietary factors in South Canara population. Place and Duration of Study: Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte Mangalore and the rural satellite centers. Duration of the Study: June 2014 - July 2014 (1 Month). Methodology: 2000 patients were evaluated using diagnostic instruments for presence of attrition, erosion, abrasion and abfraction, followed by the questionnaire which evaluated the prevalence of tooth wear due dietary factors in South Canara Population. Collected data were statistically analyzed using the “Statistical Package for the Social Sciences” (SPSSv16.0) software. Statistical Analysis: Data obtained was statistical analyzed using Statistical Package for the Social Sciences (SPSSv16.0). Differences between variables were analyzed using Pearsons Chisquare test. Results: Total prevalence of tooth wear in the study population is 58.7% out of which attrition (18.9%), abrasion (25.1%) erosion (3.8%) and abfraction (10.9%) was observed. A significant increase of tooth wear in males (85.45%) was observed. In the present study prevalence of tooth wear was significant in age group of 56-65 years (68.9%) whereas attrition (57.40%) in age group >=66 and abrasion (47.42%) was significantly more in age group of 56-65 years respectively. Erosion is significantly high in age group of 26-35 years (7.2%), abfraction in age group of 36-45 years (10.3%). Nonvegetarians (32%) showed increased tooth wear with urban population having the highest prevalence (74.9%) and alcohol consumption being a major cause for erosion (57.33%). Tooth wear is an irreversible, non carious, destructive process, which results in a functional loss of dental hard tissue. Dietary factor is one of the etiologies of tooth wear, the role of acidic foods and drinks are probably important for the progression of tooth wear. Conclusion: The response to this current study conducted to evaluate the prevalence of tooth wear due to dietary factors in south canara population stated that tooth wear was more prevalent in males and most affected age group was 56-65 years. Non-vegetarians showed increased tooth wear and alcohol consumption being one of the major cause for erosion.

Analysis of stress distribution of tooth restored with metal-ceramic crown covering abfraction lesion according to its finish line location under occlusal load / 대한치과보철학회지

PURPOSE: When the full veneer crown was treated in the tooth with abfraction lesion due to various causes, the prognosis of it may be compromised according to the location of the finish line, but there is few study about the location of its buccal finish line. The purpose of this study was to investigate the effect of location of the finish line of the full veneer crown on stress distribution of the tooth with abfraction lesion. MATERIALS AND METHODS: The two dimensional finite element model was developed to express tooth, surrounding tissue and full veneer crown. The stress distribution under eccentric 144 N occlusal load was analyzed using finite element analysis. The location of finish line was set just at the lower border of the lesion (Group 0), 1 mm (Group 1) and 2 mm (Group 2) below the lower border of the lesion. RESULTS: In the Group 0, von Mises stress was concentrated at the finish line and the apex of the lesion. Also, the stress at the bucal finish line propagated to the lingual side. In the Group 1 and Group 2, stress distribution was similar each other. Stress was concentrated at the apex of lesion, but the stress at the buccal finish line did not propagate to the lingual side. That implied decrease of the possibility of horizontal crown fracture. CONCLUSION: Full veneer crown alleviated the stress concentrated at the apex of the abfraction lesion, when the finish line of full veneer crown was set below the lower border of abfraction lesion.

Diagnóstico do trauma oclusal: extrapolações para a região óssea peri-implantar podem ser feitas / Diagnosis of occlusal trauma:extrapolations for peri-implant bone region can be done

As imagens oferecem uma linguagem que revela o dinamismo tecidual ósseo. A densidade óssea e a configuração espacial variam em suas estruturas e indicam uma menor ou maior reação e capacidade de adaptação às demandas funcionais, como cargas mastigatórias nos dentes naturais ou nos implantes osseointegrados. No planejamento de um tratamento reabilitador, é fundamental planejar a distribuição de carga e avaliar as condições dos dentes remanescentes e sua relação com o osso vizinho. Detectar a resposta óssea ao trauma oclusal preexistente pode favorecer uma avaliação mais precisa das condições mastigatórias e dos vícios parafuncionais: uma verdadeira história prévia funcional dos dentes remanescentes. Ressalta-se que as interferências e sobrecargas oclusais demoram meses, ou anos, para induzir os sinais e sintomas clássicos do trauma oclusal enquanto entidade clínica. Quando o dente apresenta-se com necrose pulpar e com sinais de trauma oclusal, o ideal será direcionar a anamnese e exames para um diagnóstico de traumatismo dentário superposto, mesmo em dentes posteriores. Não há fundamentação científica segura para afirmar-se que interferências ou sobrecargas oclusais provocam necrose pulpar. Um questionamento muito comum: até que ponto as forças ortodônticas de ancoragem podem ser aplicadas nos implantes osseointegrados? As forças ortodônticas não superam, em qualquer situação, a intensidade, amplitude e variabilidade das forças oclusais. Se um implante pode receber cargas mastigatórias, o mesmo pode se aplicar às forças ortodônticas de ancoragem.

Images provide a language to describe the dynamics of bone and tissue. Bone density and space distributionvary and indicate greater or lower reaction and adaptation to functional demands, such as masticatory loads,on natural teeth or osseointegrated implants. In rehabilitation, load distributions have to be planned, and theremaining teeth and their relation with neighboring bone should be evaluated. The detection of bone responsesto pre-existing occlusal trauma may provide a more accurate evaluation of masticatory conditions and parafunctionalhabits, that is, a true functional history of remaining teeth. Occlusal interference and overloads takemonths or years to induce classical signs and symptoms of occlusal trauma as a clinical entity. When a toothhas pulp necrosis and signs of occlusal trauma, the evaluation of history, as well as all tests, should be directedto the diagnosis of superposed dental trauma even when posterior teeth are affected. There is no scientific basisto confirm that occlusal interferences and overloads lead to pulp necrosis. A frequent question: Up to whatpoint should orthodontic forces be applied to osseointegrated implants? Orthodontic forces are not greater, inany situation, than occlusal forces in terms of intensity, amplitude and variability. If an implant can bear masticatory loads, it may also receive orthodontic forces resulting from anchorage.

Occlusal trauma can not be compared to orthodontic movement or Occlusal trauma in orthodontic practice and V-shaped recession

The mechanisms of tissue changes induced by occlusal trauma are in no way comparable to orthodontic movement. In both events the primary cause is of a physical nature, but the forces delivered to dental tissues exhibit completely different characteristics in terms of intensity, duration, direction, distribution, frequency and form of uptake by periodontal tissues. Consequently, the tissue effects induced by occlusal trauma are different from orthodontic movement. It can be argued that occlusal trauma generates a pathological tissue injury in an attempt to adapt to new excessive functional demands. Orthodontic movement, in turn,performs physiological periodontal bone remodeling to change the position of the teeth in a well-planned manner, eventually restoring normalcy.

Os mecanismos das alterações teciduais induzidas pelo trauma oclusal não são minimamente comparáveis aos do movimento ortodôntico. Embora ambos os eventos tenham uma causa primária de natureza física, essas forças aplicadas sobre os tecidos dentários têm características completamente distintas na intensidade, tempo, direção, distribuição, frequência e forma de absorção pelos tecidos periodontais. Por consequência, os efeitos teciduais induzidos no trauma oclusal são diferentes do movimento ortodôntico. Pode-se afirmar que o trauma oclusal gera uma lesão tecidual de natureza patológica, na tentativa de se adaptar a novas demandas funcionais excessivas. Por sua vez, o movimento ortodôntico utiliza-se da remodelação óssea periodontal fisiológica para mudar o dente de posição, de forma planejada e com posterior restabelecimento da normalidade.

Prevalence of dental abfraction among a sample of Sudanese patients

The aims of the present study were to determine the prevalence of dental abfraction among a sample of adult Sudanese patients and to investigate the possible association between abfraction and different etiological factors. The diagnosis of abfraction included both clinical examination and laboratory work. All attended patients were examined for presence of cervical lesion. Complete clinical history was obtained from the examined cases by using self report questionnaire. Impression was taken for cases with suspected abfraction by using additional silicon impression material; a study cast was evaluated for every case. Analysis of the study was conducted by applying an inlay wax over the lesion to produce wax pattern. The wax pattern was evaluated; any pattern that had a wedge shape was considered as an abfraction lesion. Prevalence of dental abfraction was found to be about 9.4%. Males and females were equally affected, mandibular and maxillary premolars are the most frequently affected teeth. There was a direct correlation between abfraction and parafunctional habits.

Abfracciones: lesiones cervicales no cariosas en cuña, su relación con el estrés / Abfractions: non-carious cervical in wedge, its relationship with stress

La abfracción es una lesión por pérdida del tejido duro en la unión amelo cementaría del diente en vestibular o lingual, acompañada generalmente de sensibilidad. El estrés emocional, la acción de fuerzas excéntricas generadas por interferencias oclusales, el bruxismo, pueden ser considerados factores predisponentes; por ello se planteó un estudio observacional descriptivo con componente analítico, el objetivo fue determinar la prevalencia de abfracciones, para luego asociarlas con el estrés emocional en 110 pacientes de 15 a 59 años en edad en la Facultad de Odontología de la Universidad Nacional de Asunción y una clínica privada en el año 2008. Para determinar el nivel de estrés emocional se utilizó un cuestionario, Maslach Burnout Inventory, valorado en una escala de alto/moderado, leve y bajo, se utilizó la inspección clínica y el sondeo para diagnosticar la abfracción. Se encontró una prevalencia de abfracción de 44%, de los cuales el 49% correspondió al sexo masculino. El diente más afectado fue el primer premolar inferior izquierdo (9,9%). El 100% de los pacientes presentaban estrés y hubo asociación estadísticamente significativa entre la abfracción y el bruxismo 0,004 p<0,005(F), también con el estado civil de los pacientes 0,001 p<0,005(F) entre los que prevalecían los casados 59%. Un alto porcentaje de pacientes presentaban abfracciones y estrés, pero no hubo asociación estadísticamente significativa p=0,3(F).

Abfraction is a lesion due to hard tissue loss at the cementoenamel junction either on buccal or lingual surface of a tooth, generally accompanied by sensitivity. Emotional estrés, eccentric forces generated by occlusal interferences, bruxism can be considered as predisposing factors, therefore an observational descriptive study with an analytic component was set out in order to determine the prevalence of abfractions and to relate them to emotional estrés in 110 patients ages 15 - 59 at the Facultad de Odontología de la Universidad Nacional de Asunción as well as at a private clinic in 2008. In order to determine emotional estrés, a questionnaire by Maslach Burnout Inventory was used, ranging from high, moderate, mild and low. Clinical checkup and probing were the means to diagnose abfraction. A prevalence of 44% was found, 49% of which were males. The most affected tooth was lower left first premolar (9.9%). 100% presented estrés and there was statistically significant relationship between abfraction and bruxism 0,004 p<0,005(F), also regarding marital status, there was more prevalence among married patients (59%). A high percentage of patients presented both abfraction and estrés, but there was no statistically significant association p=0,3(F).

Lesiones cervicales no cariosas asociadas a bruxismo nocturno grave: informe de un caso clínico / Non-carious cervical lesions associated with severe bruxism: report of a case report

Entre las lesiones cervicales no cariosas, la abfracción se define como la pérdida patológica de la estructura del diente en la región de unión cemento-esmalte, debido a la flexión producida por las fuerzas oclusales excéntricas, generalmente vinculadas a algunas interferencias oclusales, contactos prematuros, bruxismo y apretamiento. El presente artículo es un informe de un caso de una paciente, RFG, de 47 años, sexo femenino, que asistió a la clínica del "Servicio ATM" con la queja principal del bruxismo y la recesión gingival. En la historia clínica se informó de las actividades parafuncionales desde hace 2 años, además de episodios de depresión y ansiedad. En el examen clínico se observaron lesiones de abfracción en todos los elementos posteriores, hipertonicidad del masetero y puntos dolorosos de baja intensidad en el pterigoideo y en el esternocleidomastoideo. Para controlar los síntomas, el tratamiento inicial fue el uso de una férula neuromiorelajante. Teniendo en cuenta las manifestaciones sintomáticas relacionadas con las estructuras del sistema estomatognático, los hábitos parafuncionales y el perjuicio de los aspectos psicosociales, este trabajo tiene como objetivo establecer una relación entre las lesiones de abfracción, los factores etiológicos y las manifestaciones clínicas del trastorno temporomandibular que se incluyen en este informe de caso.

Among the noncarious cervical lesions, the abfraction is defined as the pathological loss of tooth structure at the cementoenamel junction due to the bending generated by occlusal eccentric forces, usually linked to some occlusal interference, premature contacts, bruxism and tight. This article show the case of patient RFG, 47 years old, female, who attended the "SERVICIO ATM" clinic with main complaint of bruxism and gingival retraction. In anamnesis, parafuncional activity was recorded 2 years ago, and episodes of depression and anxiety.In the clinical examination were observed abfraction lesions in all posterior teeth, hypertonicity of the masseter and painful light sites in medial pterygoid and sternocleidomastoid. For control of symptoms, initial treatment was established with occlusal plate. In view of the symptomatic manifestations involving structures of the stomatognathic system, parafunctional habits and commitment to the psychosocial aspects, this work aims to make a brief association, so little reported in the literature, among the lesions of abfraction, the etiological factors and clinical manifestations of the temporomandibular disorder found in this case.

Desgaste dental y factores de riesgo asociados / Dental erosion and risk factors associated

Se presenta paciente masculino de 35 años que acude a consulta de la clínica de posgrado dela Facultad de Odontología de la Universidad Javeriana por inconformidad estética-masticatoria y sensibilidad al frío generalizada. Dentro de sus hábitos alimenticios refiere ingerir 2 litros diarios de Coca Cola y fumar 20 cigarrillos al día. El paciente con desgaste dental severo presenta cambios únicos que deben ser manejados por medio de un acertado diagnostico, planificación del tratamiento y metodología restaurativa para obtener resultados con pronóstico favorable y predecible. La etiología de la pérdida de tejido dental de este caso es multifactorial, en la que encontramos una combinación de erosión química por dieta con el hábito del bruxismo, la cual está asociada con varios problemas como lo son la hipersensibilidad, reducción excesiva de la corona clínica, cambios en el esquema oclusal y estética, que afectan directamente el estilo de vida del paciente. La literatura soporta diversos métodos para el manejo de pacientes con desgaste severo, dependiendo de los hallazgos en cada caso y el comportamiento de diversos materiales que podemos utilizar en la rehabilitación. En este reporte clínico se describe el paciente en referencia, con historia de bruxismo, erosión y desarmonía oclusal, el cual es rehabilitado integralmente con coronas individuales, con material estético (Procera Alúmina, Metal-Cerámica), restituyendo el esquema oclusal y cambio en sus hábitos. El objetivo de este tratamiento fue prevenir mayor pérdida de tejido dental y el mejoramiento de la función y apariencia del paciente.

A 35 year old male patient with no systemic compromise assists for a consultation at the graduate studies clinic of the school of dentistry of Javeriana University due to inconformity regarding aesthetics, mastication, and general sensitivity to cold. In his eating habits, he refers to drink up to 2lts of Coca Cola and daily smoke 20 cigarettes. The patient with severe dental wear out presents unique changes which must be handled making a thorough diagnosis, treatment planning and a methodical restoration to obtain results with a favorable and predictable prognosis. In this case, the loss of dental tissue's etiology is a multifactorial one, where we find a combination of chemical erosion due to a diet and bruxism, which are associated with several problems such as hypersensitivity, excessive reduction of the clinical crown, and changes in the occlusal scheme and aesthetics, which all affect directly onthe patient's lifestyle. Literature supports diverse methods for the handling of patients with severe wear out, depending on the clinical findings of each case and the behavior of the different materials we can use in oral rehabilitation. In this clinical report, the patient above mentioned is described with a history of bruxism, dental erosion and occlusal disharmony, whom is integrally rehabilitated with individual crowns, made of aesthetic material (Procera Alumina, Metal-Ceramic), giving him back an occlusal scheme and change in his habits. The objective of this treatment was to prevent a mayor loss of dental tissue and the improvement in function and appearance of the patient.