Restablecimiento de guía anterior con restauraciones adhesivas / Reestablishing of anterior guidance with adhesive restorations

La estética ha llegado a formar una parte muy importante en la odontología actual. Sin embargo, no debemos sobreponer las necesidades estéticas sobre las necesidades funcionales. La pérdida de estructura dental asociada a bruxismo puede ser considerada patológica cuando compromete la guía anterior, la cual es la influencia en los movimientos mandibulares que proveen las superficies contactantes de los dientes maxilares anteriores con los mandibulares anteriores y evita contactos excéntricos dañinos en los dientes posteriores. El objetivo de este reporte de caso es presentar una alternativa conservadora para restablecer tanto la estética como la funcionalidad de una paciente de 34 años de edad que acudió a la Clínica de Prostodoncia de la Universidad Autónoma de Guadalajara en busca de rehabilitación estética de dientes anteriores. Una vez realizada su evaluación inicial se llegó al diagnóstico de pérdida de guía anterior por desgaste patológico asociado a bruxismo. El tratamiento incluyó tratamientos de conductos, remoción de caries y restauraciones mal ajustadas, coronas y carillas para restablecer la guía anterior. Se cumplieron con las expectativas estéticas que tenía la paciente al igual que con las necesidades funcionales que fueron objetivo desde el inicio, logrando un restablecimiento de la guía anterior de manera conservadora (AU)

Esthetics has become a very important part of dentistry today. However, we should not superimpose esthetic needs over functional needs. The loss of tooth structure associated with bruxism can be considered pathologic when it compromises the anterior guidance, which is the influence on mandibular movements that provides the contacting surfaces of the maxillary anterior teeth with the mandibular anterior teeth and avoids damaging eccentric contacts in the posterior teeth. The aim of this case report is to present a conservative way to restore both esthetics and function in a 34-year-old patient who came to the Prosthodontics Clinic of the Universidad Autónoma de Guadalajara in search of an esthetic appearance of her anterior teeth. After her initial evaluation, a diagnosis of anterior guide loss due to pathological wear associated with bruxism was made. Treatment included root canal treatment, removal of caries, and ill-fitting restorations, crowns, and veneers to reestablish the anterior guidance. The aesthetic expectations of the patient have met as well as the functional needs that were aimed from the beginning, achieving a conservative reestablishment of the anterior guidance system (AU)

Prevalence of erosive tooth wear and associated risk factors in Colombian adolescents

Abstract Accurate determination of the prevalence of erosive tooth wear (ETW) and associated risk factors in adolescents can inform clinical management guidelines. The aim of this analytical cross-sectional study was to estimate the prevalence, severity, and risk factors of ETW in adolescents aged 12-15 years in the municipality of Usaquén in Bogotá, Colombia. Two calibrated examiners clinically assessed ETW using Basic Erosive Wear Examination (BEWE) Index (range: 0-3). All tooth surfaces (excluding proximal) were scored to allow estimation of the Highest (0-3) and Total BEWE (sum of Highest BEWE score per sextant: 0-18) scores per patient. Sociodemographic characteristics, ETW risk factors, and caries severity (ICDAS-epi-merged) were evaluated, and their association with the presence of ETW (indicated by a Highest BEWE score of 2-3) was examined using preliminary analyses and logistic regression models. The study sample included 454 adolescents (mean age: 13.5±1.1 years; female: 61.7%), and the prevalence of ETW was 71.6%. The majority of participants exhibited a Highest BEWE score of 3 (58.0%) and a Total BEWE score ≤8 (84.3%). The preliminary analysis showed an association between the presence of ETW and age, caries, and brushing teeth before eating (p-value < 0.05). Risk factors for ETW included always brushing teeth before eating [adjusted Prevalence Ratio (PRa) 1.31, p-value=0.014], presence of extensive carious lesions (PRa 1.23, p-value = 0.024), male gender (PRa 1.14, p-value = 0.028), and age > 14 years (PRa 1.17, p-value = 0.009). Although ETW was highly prevalent, most Colombian adolescents exhibited low Total BEWE scores. ETW was associated with frequent fruit intake, age, toothbrushing habits, caries lesions, and sex.

Can the combination of proanthocyanidin and vitamin E or palm oil effectively protect enamel against in vitro erosive and abrasive challenges?

Abstract Objectives This study aimed to assess the effect of proanthocyanidin, palm oil and vitamin E against erosive and erosive+abrasive challenges in vitro after enamel pellicle formation in situ. Methodology Bovine enamel blocks (n=84) were obtained and divided into the following treatment groups: negative control (NC) - deionized water; positive control (PC) - SnCl2/NaF/AmF-containing solution; palm oil (PO); 2% proanthocyanidin (P2); vitamin E (VitE); 2% proanthocyanidin+palm oil (P2PO); and 2% proanthocyanidin+vitamin E (P2VitE). For 5 days, one half of the sample from each group was subjected to erosion and the other half was subjected to erosion+abrasion. The acquired enamel pellicle (AEP) was pre-formed in situ for 30 minutes. The specimens were then treated in vitro with solutions (500 µl, 30s for each group). Subsequently, the blocks were left in the oral cavity for another hour to obtain the modified AEP. The blocks were immersed in 0.5% citric acid (pH=2.5) for 90s, 4×/day. AEP formation and treatment were carried out before the first and third erosive challenges, and after these challenges, abrasive cycles (15s) were performed on half of the samples. Enamel wear was quantified by profilometry and data were analyzed by two-way ANOVA and Tukey's test (p<0.05). Results All groups showed higher wear when exposed to erosion+abrasion than when exposed to erosion alone (p=0.0001). PO, P2VitE, P2, and P2PO showed enamel wear similar to the PC group, but only PC, PO and P2VitE differed from the NC group. The other groups behaved similarly to NC. Conclusion It was concluded that the combination of proanthocyanidin and vitamin E was effective in reducing wear in the face of in vitro erosive and erosive+abrasive challenges.

Efeito da adição de partículas bioativas ao gel clareador dental / Efeito da adição de partículas bioativas ao gel clareador dental

O estudo avaliou o efeito da adição de partículas bioativas ao gel clareador (peróxido de hidrogênio 35%, técnica de consultório), quanto ao clareamento e sobre a estrutura dental, além da resistência à desmineralização. O objetivo da primeira parte do estudo foi avaliar géis, com diferentes partículas bioativas e concentrações, para o potencial clareador e às alterações da estrutura dental. O objetivo da segunda parte foi avaliar géis, com diferentes partículas bioativas e concentrações, perante a suscetibilidade do esmalte ao protocolo cariogênico e ao desgaste dental erosivo. Espécimes de incisivos bovinos foram avaliados na primeira parte por análise da cor, microdureza Knoop e rugosidade. Os grupos foram controle negativo (CN), controle comercial (CCWhiteness HP), controle experimental (CE-gel sem partícula), controle positivo (CPsolução de peróxido), e os grupos experimentais onde as partículas bioativas S-PRG e 45S5 foram utilizadas nas concentrações de 5, 10, 15 e 20 %. Na segunda parte foram avaliados por microradiografia para a alteração da densidade mineral e profundidade da lesão perante o protocolo cariogênico e pela perfilometria para o desgaste dental erosivo. Os grupos foram CN, CC, CE, controle fluoreto (CF), e os grupos experimentais onde as partículas bioativas S-PRG e 45S5 foram utilizados nas concentrações de 15 e 20 % apenas. Os dados foram analisados estatisticamente para verificar a diferença entre os grupos (α=5%). Para a mudança de cor (∆E*00) foi observada diferença apenas para o fator partícula, S-PRG-3,37(0,48)a e 45S5-3,67(0,76)b. Todos os grupos experimentais foram estatisticamente iguais o CP e diferentes do CN. Para a microdureza (KNH%) foi observada diferença para a interação dos fatores, sendo o S-PRG 20% o grupo com maior aumento da microdureza. Todos os grupos experimentais foram diferentes e maiores que CP, CC e CE. Não foram observadas diferenças de rugosidade entre os grupos. Para a alteração da densidade mineral foi observada diferença para a interação dos fatores e tempo. Os grupos S-PRG 15% e 20% foram os grupos que apresentaram a menor alteração da densidade mineral em todos os tempos testados. Aos 14 e 21 dias o SPRG 20% foi diferente do CN e semelhante ao CF. Para a profundidade da lesão foram observadas diferenças estatísticas para o fator partícula e tempo, S-PRG206,8(59,2)a e 45S5 230,0(63,7)b, 7 dias-148,9(19,7)a, 14 dias-217,7(22,5)b e 21 dias288,7(30,7)c. Aos 14 e 21 dias o S-PRG 20% foi diferente do CN e semelhante ao CF. Para o desgaste foi observada diferença apenas para o tempo, 5 dias-1,2(0,2)a e 10 dias-2,3(0,3)b. Conclui-se que: a adição de partículas bioativas não reduziu a efetividade clareadora, contribuiu para o aumento da microdureza e não alterou a rugosidade. Além disso, o grupo S-PRG com 20% teve suscetibilidade à desmineralização por cárie semelhante ao grupo controle fluoreto e nenhum grupo alterou a suscetibilidade ao desgaste dental erosivo (AU)

The study evaluated the consequences of bioparticle addition on tooth bleaching gel (hydrogen peroxide 35%, in-office technique), for its bleaching effect and changes on tooth structure, also for resistance against demineralization. The aim of the first part of the study was to evaluate bleaching gels containing different bioactive particles and concentrations over the bleaching potential and possible dental structural changes. The objective of the second part was to evaluate bleaching gels containing different bioactive particles and concentrations to assess enamel susceptibility to cariogenic and erosive tooth wear protocols after bleaching treatments. Bovine incisors specimens were used in the first part for analysis of color, Knoop microhardness and roughness. The groups were negative control (NC), commercial control (CCWhiteness HP), experimental control (EC-gel without particles), positive control (PCperoxide solution), and experimental groups were the bioactive particles S-PRG and 45S5 used in concentrations of 5, 10, 15, and 20 %. In the second part, specimens were evaluated using advanced transverse microradiography to assess the change in mineral density and lesion depth in response to the cariogenic protocol, and profilometry to measure wear in response to the erosive tooth wear protocol. The groups were NC, CC, EC, fluoride control (FC), and experimental groups were the bioactive particles S-PRG and 45S5 used only in concentrations of 15 and 20 %. The data were statistically analyzed to verify the differences between the groups (α=5%). For the color change (∆E*00), a difference was observed only for particle, S-PRG3,37(0,48)a and 45S5-3,67(0,76)b. All experimental groups were statistically similar to PC and different from NC. For the microhardness (KNH%), difference was observed for factors interaction, S-PRG 20% was the group with higher hardness increase. All experimental groups were different and higher than PC, CC, and EC. No roughness differences were observed between groups. For the mineral density alteration differences were observed for factors interaction and time. S-PRG 15% and 20% presented the lower mineral density change for all measurements times. On 14 and 21 days S-PRG 20% was different from NC and similar to FC. For lesion depth differences were observed for factor particle and time, S-PRG-206,8(59,2)a and 45S5- 230,0(63,7)b, 7 days-148,9(19,7)a, 14 days-217,7(22,5)b and 21 days-288,7(30,7)c. On 14 and 21 days S-PRG 20% was different from NC and similar to FC. For wear the only difference was for time, 5 days-1,2(0,2)a and 10 days-2,3(0,3)b. It was concluded that the addition of bioactive particles did not reduce the bleaching effectiveness, it contributed to microhardness increase and did not change roughness. Furthermore, the S-PRG group with 20% susceptibility to cariogenic demineralization was similar to the fluoride control group, and no group showed a change in susceptibility to erosive tooth wear (AU)

Rendimiento Clínico de las Restauraciones Adhesivas con Resina Compuesta en Casos de Pacientes con Desgaste Severo e Incremento de Dimensión Vertical: Revisión de Literatura Sistematizada / Clínical Performance of Adhesive Restorations with Composite Resin in Cases of Patients with Severe Wear and Increased Vertical Dimension: Systematized Literature Review

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.

Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.

Effects of different toothpaste formulations on erosive tooth wear prevention: systematic review / Efeitos de diferentes dentifrícios na prevenção do desgaste dentário erosivo: revisão sistemática de literatura

Objective: erosive tooth wear is a multifactorial condition that results in loss of dental hard tissue, caused by a chemical and mechanical process. This paper aims to carry out a systematic review presenting the effects of different toothpaste formulations on the loss of dental enamel surface in vitro. Material and Methods: the searches were performed in the databases PubMed, Web of Science, LILACS and Scielo. Articles published from 2010 to 2020 were filtered, without language restriction. Articles that included abrasion and erosion protocols were searched, as they were more similar to clinical reality, since toothpaste is applied through tooth brushing. The searches with descriptors and free terms on the topic resulted in 992 articles, however only 12 were within the search criteria. Results: the selected studies appointed that association of conventional fluorides (NaF) with metallic fluorides can be a promising strategy for the reduction of surface loss by erosive tooth wear. Toothpastes containing sodium fluoride, as well as tin without chitosan, showed a reduction in surface loss, considered sufficient for individuals with medium exposure to acids. In children's toothpastes, the one containing sodium fluoride showed a reduction in surface loss when compared to non-fluoride dentifrices. Conclusion: different protocols may result in less or greater loss of enamel surface, and methodological differences should be considered. To clarify the effects of dentifrices on erosive tooth wear, other properties of dentifrices should be investigated. (AU)

Objetivo: o desgaste erosivo é uma condição multifatorial que resulta em perda de tecido duro dentário, causado por um processo químico e mecânico. Este trabalho tem como objetivo realizar uma revisão sistemática de literatura apresentando os efeitos de diferentes formulações de dentifrícios na perda de superfície de esmalte dentário in vitro. Material e Métodos: a busca foi realizada nas bases de dados PubMed, Web of Science, LILACS e Scielo. Foram filtrados artigos publicados no intervalo de 2010 a 2020, sem restrição de idioma. Buscou-se artigos que incluíssem protocolos de abrasão e erosão, por mais se assemelhar a realidade clínica, uma vez que o dentifrício é aplicado através da escovação dentária. A busca com descritores e termos livres sobre o tema encontrou 992 artigos, entretanto somente 12 estavam dentro dos critérios da pesquisa. Resultados: os estudos selecionados apontaram que associação dos fluoretos convencionais (NaF) com os metálicos pode ser uma estratégia promissora para a redução de perda de superfície pelo desgaste dentário erosivo. Dentifrícios contendo fluoreto de sódio, assim como estanho sem quitosana, apresentaram redução na perda de superfície, sendo considerada suficiente para indivíduos com exposição média aos ácidos. Em dentifrícios infantis, aquele que continha fluoreto de sódio apresentou uma redução de perda de superfície quando comparado com dentifrícios sem fluoreto. Conclusão:diferentes protocolos podem resultar em menor ou maior perda de superfície de esmalte e as diferenças (AU)

Longitudinal assessment of dental erosion-abrasion by cross-polarization optical coherence tomography in vitro

Abstract: This study tested a novel in vitro dental erosion-abrasion model and the performance of cross-polarization optical coherence tomography (CP-OCT) in longitudinally monitoring the simulated lesions. Thirty human enamel specimens were prepared and randomized to receive three dental erosion-abrasion (EA) protocols: severe (s-EA, lemon juice/pH:2.5/4.25%w/v citric acid), moderate (m-EA, grapefruit juice/pH:3.5/1.03%w/v citric acid) and no-EA (water, control). EA challenge was performed by exposing the specimens to acidic solutions 4x/day and to brushing 2x/day with 1:3 fluoridated toothpaste slurry, for 14 days. Enamel thickness measurements were obtained using CP-OCT at baseline (D0), 7 (D7) and 14 days (D14) and micro-computed tomography (micro-CT) at D14. Enamel surface loss was measured with both CP-OCT and optical profilometry at D0, D7 and D14. Data was analyzed with repeated-measures ANOVA and Pearson's correlation (r) (α = 0.05). CP-OCT enamel thickness decreased over time in the s-EA group (D0 >D7 > D14, p < 0.001) and m-EA group (D0 > D14, p = 0.019) but did not change in the no-EA group (p = 0.30). Overall, CP-OCT and micro-CT results at D14 correlated moderately (r = 0.73). CP-OCT surface loss was highest for s-EA (p <0.001) but did not differ between moderate and no-EA (p = 0.25). Enamel surface loss with profilometry increased with severity (no-EA>m-EA>s-EA, p < 0.001). D14 surface loss was higher than D7 for both methods except for the no-EA group with profilometry. CP-OCT and profilometry had moderate overall correlation (r = 0.70). Our results revealed that the currently proposed in vitro dental erosion-abrasion model is valid and could simulate lesions of different severities over time. CP-OCT was a suitable method for monitoring the EA lesions.

Fluorotic Enamel Susceptibility to Dental Erosion and Fluoride Treatment

Abstract The purpose of this in vitro study was to test the hypothesis that fluoride treatment can prevent dental erosion on fluorotic enamel of different severities. It followed a 3×2 factorial design, considering a) fluorosis severity: sound (TF0, Thylstrup-Fejerskov Index), mild (TF1-2), moderate (TF3-4); and b) fluoride treatment: 0 (negative control) and 1150ppmF. Human molars with the three fluorosis severities (n=16, each) were selected and randomly assigned to the two fluoride treatments (n=8). Enamel blocks (4×4mm) were prepared from each tooth and subjected to a dental erosion cycling model, for 10 days. The daily cycling protocol consisted of erosive challenges (1% citric acid, pH 2.4), interspersed by periods of immersion in artificial saliva, and three 2-minute treatments with either 0 or 1150ppm F. The enamel volume loss (mm3) was calculated by subtracting values obtained by microtomography before and after cycling. Two-Way ANOVA showed no significant interaction between fluorosis severity and fluoride treatment (p=0.691), and no significant effect for either fluorosis severity (TF0 mean±standard-deviation: 13.5(10-2±0.42(10-2, TF1-2: 1.50(10-2±0.52(10-2, TF3-4: 1.24(10-2±0.52(10-2, p=0.416) or treatment (0ppmF: 1.49(10-2±0.53(10-2; 1150ppmF: 1.21(10-2±0.42(10-2; p=0.093), when evaluated independently. Considering the limitations of this in vitro study, the presence and severity of fluorosis in enamel do not appear to affect its susceptibility to dental erosion. Fluoride treatment was not effective in preventing the development of dental erosion in both sound and fluorotic enamel substrates under our experimental conditions.

Resumo Este estudo in vitro foi testou a hipótese de que o tratamento com flúor pode prevenir a erosão dentária no esmalte fluorótico de diferentes severidades. O objetivo deste estudo foi: investigar o efeito protetor dos fluoretos contra a erosão e abrasão simuladas no esmalte fluorótico. Seguiu um desenho fatorial 3×2, considerando a) severidade da fluorose em 3 níveis: hígido (TF0, Índice Thylstrup-Fejerskov), suave (TF1-2), moderada (TF3-4); b) tratamento com flúor: 0 (controle negativo) e 1150ppmF. Molares humanos com as três severidades de fluorose (n=16, cada) foram selecionados e distribuídos aleatoriamente para os dois tratamentos com flúor (n=8). Blocos de esmalte (4×4mm) foram preparados a partir de cada dente e submetidos a um modelo de ciclo de erosão dentária, por 10 dias. O protocolo de ciclagem diária consistiu em seis desafios erosivos de 5 minutos (1% de ácido cítrico, pH 2,4), intercalados por seis períodos de imersão em saliva artificial e três tratamentos de 2 minutos com 0 ou 1150ppmF. O volume do esmalte perdido foi calculado subtraindo o perfil superficial 3D obtido por microtomografia antes e depois da ciclagem. A ANOVA de dois fatores não mostrou interação significativa entre a severidade da fluorose e o tratamento com flúor (p = 0,691) e nenhum efeito significativo para a severidade da fluorose (TF0 média+/desvio padrão: 13,5(10-2±0,42(10-2, TF1-2: 1,50(10-2±0,52(10-2, TF3-4: 1,24(10-2±0,52(10-2, p=0,416) ou tratamento (0: 1,49(10-2±0,53(10-2; 1150ppmF: 1,21(10-2±0,42(10-2, p=0,093), quando avaliados independentemente. Considerando as limitações deste estudo in vitro, a presença e severidade da fluorose no esmalte não parece afetar sua suscetibilidade à erosão dentária. O tratamento com flúor não foi eficaz na prevenção do desenvolvimento da erosão dentária em esmalte hígido e fluorótico, sob as condições experimentais utilizadas.

Prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous populations in Brazil: a systematic review and meta-analysis

Abstract The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.

Tooth wear due to dental attrition among 12-year-old adolescents / Desgaste dentário por atrição entre adolescentes de 12 anos de idade

Aim: To evaluate the prevalence and distribution of tooth wear due to dental attrition among 12-year-old adolescents according to their gender, reports of tooth grinding during sleep/while awake (bruxism), and sleep features related to sleep-disordered breathing. Methods: A cross-sectional study was conducted with 172 adolescents from southeast Brazil. Parents/caregivers answered questions about sociodemographic characteristics; reports of adolescents' tooth grinding during sleep, and sleep features (e.g. sleep duration and position, snoring, drooling on the pillow) in the previous two weeks. Adolescents self-reported the occurrence of tooth clenching/grinding while awake in the previous two weeks. Tooth wear due to dental attrition was assessed by a previously calibrated researcher, using a validated 5-point analogical ordinal occlusal/incisal tooth wear grading scale, with scores ranging from 0 (no wear) to 4 (loss of crown height ≥ 2/3), depending on tooth wear severity. Descriptive statistics and the Mann-Whitney test (p < 0.05) were performed to identify differences in tooth wear due to the distribution of dental attrition, according to adolescents' characteristics. Results: Most adolescents were female (58.0%) and 81.6% of the participants presented tooth wear due to dental attrition within the enamel. Adolescents who snored had a higher number of incisors with tooth wear due to dental attrition (p = 0.035). Females showed a higher number of canines with tooth wear due to dental attrition (p = 0.020). Adolescents whose parents reported tooth grinding during sleep presented a higher number of bicuspids with tooth wear due to dental attrition (p = 0.001). Conclusion:Tooth wear due to dental attrition within the enamel was observed in most adolescents. The distribution, depending on specific groups of teeth, was higher among female adolescents, adolescents' whose parents reported tooth grinding, and adolescents who snored during sleep.

Objetivos: Avaliar a prevalência e distribuição de DDA entre adolescentes de 12 anos de acordo com o sexo, relato de ranger de dentes durante o sono e vigília (bruxismo) e características relacionadas a desordens respiratórias do sono.Método: Desenvolveu-se um estudo transversal com 172 adolescentes do sudeste do Brasil. Seus pais/responsáveis responderam um questionário contendo informações sociodemográficas, relato sobre os filhos rangerem os dentes durante o sono e hábitos do sono dos filhos (duração do sono, posição que dorme, roncar, babar no travesseiro) nas duas últimas semanas. Adolescentes relataram ocorrência de ranger/apertar de dentes durante a vigília nas duas últimas semanas. DDA foi avaliado por um pesquisador previamente calibrado através de uma escala analógica ordinal de cinco pontos de desgaste dentário para faces oclusal/incisal previamente validada, com escores variando de 0 (sem desgaste) a 4 (perda da coroa em altura ≥ 2/3), dependendo da gravidade do desgaste. Análises descritivas e teste de Mann-Whitney (p < 0,05) foram realizados para identificar as diferenças na distribuição de DDA de acordo com as características dos adolescentes.Resultados: A maioria dos adolescentes eram meninas (58,0%) e 81,6% dos participantes apresentaram DDA em esmalte em algum elemento dentário. Adolescentes que rocavam apresentavam mais incisivos com DDA (p = 0.035). Meninas apresentaram maior número de caninos com DDA (p = 0.020). Adolescentes que rangiam os dentes durante a noite apresentaram maior número de pré-molares com DDA (p = 0.001).Conclusão: Desgaste dentário por atrição em esmalte foi observado na maioria dos adolescentes. A distribuição, dependendo de grupos de dentes específicos, foi maior entre meninas, adolescentes que roncavam durante o sono e que rangiam os dentes durante o sono.

Prevalence and Development Factors of Increased Tooth Abrasion in Residents of Kaspiysk

Background: Loss of hard tissues is diverse in its localization and can manifest itself in the area of one, several or all of the patient's teeth, one of the most serious consequences of this pathology is a decrease in the height of the lower third of the face. Materials and Methods: The paper presents the results of a comprehensive dental examination and survey data of 98 patients. During the study, patients were divided by age groups, gender characteristics, pathological disorders and depending on the plane of erasure (horizontal, vertical, mixed) teeth. The prevalence and factors of the development of increased abrasion of hard tissues of teeth were determined. Conclusion: Local exogenous and general endogenous factors turned out to be a more frequent cause of increased tooth abrasion for residents of the city of Kaspiysk.

Possibilidades reabilitadores para pacientes com erosão dental: uma revisão de casos clínicos / Rehabilitation possibilities for patients with dental erosion: a clinical case review / Posibilidades rehabilitadoras para pacientes con erosión dental: revisión de casos clínicos

Objetivo: revisar na literatura as possibilidades reabilitadoras para pacientes com erosão dental. Método: screeningda literatura que seguiu os princípios do check listSANRA. A pesquisa foi realizada nas bases de dados da BVS (LILACS e BBO), Scielo, Cochrane Library e via buscador de pesquisa PubMed. Foram incluídos estudos na língua inglesa, relatos de casos clínicos disponíveis na íntegra. Foram realizadas buscas por artigos publicados até fevereiro de 2022 e sem restrição cronológica. Resultados:entre44 artigos identificados, 10 foram selecionados. A maioria dos estudos (40%) foram publicados no Brasil, seguido dos Estados Unidos (20%) e Itália (20%). As possibilidades de reabilitação identificadas foram o uso de coroas de cerâmica, laminados cerâmicos e restauração direta com resina composta. Conclusão:foi possível verificar que a reabilitação dos elementos dentários com materiais diretos (resinas compostas) ou indiretos (cerâmica ou cerômeros) tem demonstrado resultados satisfatórios,conforme os casos clínicos investigados.

Objective: to review the literature on rehabilitative possibilities for patients with dental erosion.Method: literature screening thatfollowed the principles of the SANRA check list. The search was performed in the BVS (LILACS and BBO), Scielo, Cochrane Library and PubMed databases. English language studies and clinical case reports available in full were included. Articles published until February 2022 and without chronological restriction were searched.Results: among 44 articles identified, 10 were selected. Most studies (40%) were published in Brazil, followed by the United States (20%) and Italy (20%). The rehabilitation possibilities identified were the use of ceramic crowns, ceramic laminates and direct restoration with composite resin.Conclusion: it was possible to verify that the rehabilitation of dental elements with direct materials (composite resins) or indirect (ceramics or ceromers) has shown satisfactory results, according to the clinical cases investigated.

Objetivo: revisar la literatura sobre las posibilidades rehabilitadoras para pacientes con erosión dental.Método: screeningbibliográfico que siguió los principios de la check listSANRA. La búsqueda se realizó en las bases de datos BVS (LILACS y BBO), Scielo, Cochrane Library y PubMed. Se incluyeron estudios en inglés, informes de casos clínicos disponibles en su totalidad. Se realizaron búsquedas de artículos publicados hasta em Febrero de 2022 y sin restricción cronológica.Resultados: de los 44 artículos identificados, se seleccionaron 10. La mayoría de los estudios (40%) se publicaron en Brasil, seguido de Estados Unidos (20%) e Italia (20%). Las posibilidades de rehabilitación identificadas fueron el uso de coronas cerámicas, laminados cerámicos y restauración directa con resina compuesta.Conclusión:se pudo comprobar que la rehabilitación de elementos dentales con materiales directos (resinas compuestas) o indirectos (cerámicas o cerómeros) ha mostrado resultados satisfactorios, según los casos clínicos investigados.

Self-Report of the perception of stress and signs of bruxism generated during the pandemic in student of the health area / Autoinforme de la percepción de estrés y signos de bruxismo derivados de la pandemia en estudiantes del área de la salud

Abstract Bruxism is the repetitive muscle-mandibular behavior characterized by clenching and/or grinding of the teeth, which reflects the presence of one or more underlying conditions or factors. The objective of this descriptive study was to determine the association between bruxism and stress self-perceived during the pandemic, as well as their frequency by gender and academic area. An interrogation and self-perceived stress scale PSS-14 were applied to students from the different areas of the Institute of Health Sciences (ICSa) to determine the presence or absence of stress and bruxism symptom, a Chi-square was used for the comparison between variables, considering a value of p0.005. ICSa students between 18 and 24 age perceive symptoms of bruxism and high levels of stress caused during the pandemic.

Resumen El bruxismo es el comportamiento músculo-mandibular repetitivo caracterizado por apretamiento y/o rechinamiento de los dientes, que refleja la presencia de una o varias condiciones o factores subyacentes. Se realizó un estudio descriptivo con el objetivo de determinar la asociación del nivel de estrés y síntomas de bruxismo autopercibidos durante la pandemia, así como su frecuencia por género y área académica. Se aplicó un interrogatorio y escala de estrés percibido PSS-14 a los estudiantes de las distintas áreas del Instituto de Ciencias de la Salud (ICSa) para determinar la presencia o ausencia de estrés y síntomas de bruxismo, se utilizó una Chi-cuadrada para la comparación entre variables, considerando significativo un valor de p0.0001. Los estudiantes de 18 a 24 años de edad del ICSa perciben síntomas de bruxismo y altos niveles de estrés originados durante la pandemia.

Development of a sodium fluoride and stannous chloride-containing gel for treatment of dental erosion

Resumo Este estudo desenvolveu e testou géis experimentais contendo íons fluoreto (F-) e estanho (Sn2+) para o controle da erosão dentária. Os espécimes polidos, de esmalte e dentina, foram previamente erodidos (solução de ácido cítrico a 1%, 10 min) e alocados aleatoriamente em 5 grupos (n = 10): Placebo - gel de hidroxipropilmetilcelulose (HMC); F + Sn + HMC - 7.500 ppm F- / 15.000 ppm Sn2+; F + HMC - 7.500 ppm F-; Gel de flúor fosfato acidulado comercial (12.300 ppm F-); e Controle - sem tratamento. Após o tratamento (aplicado por 60 s), os espécimes foram submetidos a uma ciclagem de erosão-remineralização (5 min em solução de ácido cítrico a 0,3%, 60 min em saliva artificial, 4 × / dia, 20 dias). A perda de superfície (SL, em µm) foi determinada após o 5º, 10º e 20º dias de ciclagem (α = 0,05). Para o esmalte, após 5 e 10 dias, o F + Sn + HMC apresentou a menor PS, não diferindo do gel comercial. Após 20 dias, não foram encontradas diferenças entre os grupos comercial, F + HMC e F + Sn + HMC. O placebo não diferiu do controle em nenhum momento, e ambos os grupos apresentaram a maior PS, comparado aos demais grupos. Para dentina, no 5º dia , F + Sn + HMC, F + HMC e comercial não diferiram significativamente, apresentando menor PS que o grupo controle e placebo. No 10º dia, F+Sn+HMC e comercial apresentaram a menor PS comparado ao grupo controle e placebo. No 20º dia, apenas o gel comercial apresentou PS menor que o controle e o placebo. Assim, o gel experimental F + Sn + HMC foi capaz de controlar a progressão da erosão dentária.

Abstract: This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.

Dental erosion and oral health-related quality of life in children aged 3 to 5 years living in Lima: Peru / Erosión dental y calidad de vida relacionada con la salud bucal en niños de 3 a 5 años de Lima: Perú

Objetive: To determine the impact of dental erosion on the oral health related quality of life in preschool children aged 3 to 5 years. Material and Methods: An observational, cross-sectional study was carried out. The sample consisted of 150 preschoolers from a preschool in the suburban areas of Lima, Peru. The Basic Erosive Wear Examination (BEWE) index was used for the evaluation of dental erosion; and the Early Childhood Oral Health Impact Scale (ECOHIS) was used to measure quality of life. The data were analyzed in the statistical program SPSS v.25. Results: A prevalence of erosion of 40.7% was observed; with an initial loss of tooth surface in 28% and a loss of hard tissue of <50% of the surface area in 12% of the examined children. No statistically significant association was found between the impact of erosion and the oral health related quality of life (p> 0.05). However, the dimension with the highest score was functional limitations. Conclusion: The prevalence of dental erosion in preschool children was high, and dental erosion did not show an impact on the oral health related quality of life.

Objetivo: Determinar el impacto de la erosión dental en la calidad de vida relacionada con la salud bucal en preescolares de 3 a 5 años. Material y Métodos: Se realizó un estudio observacional de corte transversal. La muestra estuvo conformada por 150 preescolares de un jardín infantil de la zona suburbana de Lima, Perú. Se utilizó el índice Basic Erosive Wear Examination (BEWE) para la evaluación de la erosión dental; y se utilizó la Escala de Impacto en la Salud Bucal de la Primera Infancia (ECOHIS) para medir la calidad de vida. Los datos fueron analizados en el programa estadístico SPSS v.25. Resultado: Se observó una prevalencia de erosión del 40,7%; con una pérdida inicial de superficie dental en el 28% y una pérdida de tejido duro <50% del área superficial en el 12% de los niños examinados. No se encontró asociación estadísticamente significativa entre el impacto de la erosión y la calidad de vida relacionada con la salud bucal (p> 0,05). Sin embargo, la dimensión con mayor puntaje fue limitaciones funcionales. Conclusión: La prevalencia de erosión dental en pre- escolares fue alta, y la erosión dental no mostró impacto en la calidad de vida relacionada con la salud bucal.

Influence of non-carious cervical lesions, bone attachment level, and occlusal load on the stress distribution pattern in maxillary premolars: finite element analysis

This study aimed to evaluate the influence of different bone attachment levels and occlusal loads on the stress distribution pattern of maxillary premolars with or without non-carious cervical lesion (NCCL), before and after restoration with composite resin by three-dimensional (3D) finite element analysis. From the healthy model, NCCL models were produced and the cavity was restored with composite resin. Models with vertical and horizontal bone loss were also made. For each model, three types of occlusal loads were simulated (100 N): vertical load (VL), buccal load (BL), and palatal load (PL). After processing the models, the data were obtained in MPa for the criteria of Maximum Principal Stress (for all structures) and Minimum Principal Stress (for cortical and medullary bones). Stress values were collected for a node on the cervical buccal surface (Maximum Principal Stress) and the buccal crestal bone (Minimum Principal Stress). As a result, the different bone attachment levels did not affect stress distribution at the amelodentinal junction. The buccal load promoted a higher concentration of compressive stress on the buccal bone surface and the palatal load resulted in greater tensile stress in the buccal cervical third of the tooth. The concentration of tensile stress in the buccal cervical third was exacerbated by the presence of NCCL and it was similar to the healthy and restored models. It can be concluded that stress concentration at the bone level does not depend on the presence or absence of NCCL and the restoration procedure but it is related to the type of occlusal load. However, the presence of NCCL promoted a higher stress concentration in the cervical region, especially when combined with oblique occlusal loads.

Use of electronic devices, practice of sports, and awake bruxism in schoolchildren aged eight to ten years

Abstract The aim of the present study was to investigate whether possible awake bruxism (AB) is associated with the use of electronic devices and the practice of sports in schoolchildren aged eight to ten years. A cross-sectional study was conducted with 739 students in public and private schools in the city of Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing sociodemographic data. The children answered questions about use of electronic devices, practice of sports, and AB. Statistical analysis involved robust logistic regression for complex samples (α = 5%). The prevalence of possible AB was 14.9%. Being female (OR = 1.71, 95%CI: 1.11-2.63), being the middle child (OR = 2.19, 95%CI: 1.14-3.88), having unmarried parents (OR = 1.73, 95%CI: 1.13-2.65), daily use of a cell phone/tablet/computer (OR = 1.82, 95%CI: 1.19-2.80), use of electronic devices for two or more hours per day (OR = 1.97, 95%CI: 1.35-2.86), and playing sports in and/or out of school (OR = 1.60, 95%CI: 1.18-2.52) remained associated with possible AB in the final model. The presence of possible AB was influenced by the use of electronic devices and the practice of sports among schoolchildren aged eight to ten years.

Relationship between intrinsic and extrinsic factors with Erosive Tooth Wear in adults: a cross-sectional study

Abstract The objective of this study was to explore the relationship between intrinsic and extrinsic factors and a high cumulative score of the Basic Erosive Wear Examination (BEWE) in a Chilean adult group. A cross-sectional study was performed with the Ethics Committee's approval from the Universidad de los Andes. A consecutive adult (18 to 46 years old) sampling (n = 553) from the Health Center in San Bernardo-Chile, was selected from September 2016 to January 2017. Dental exams were performed by two trained and calibrated examiners, according to the BEWE index. In order to search for potentially related factors, a hetero-applied questionnaire previously developed and evaluated was applied. Our interest was individuals with severe erosion tooth wear (BEWE ≥ 14). Logistic regression models reporting crude odds ratio (OR) and adjusted OR by age, 95% confidence interval (95%CI), and p-values were estimated. Variables, odds ratios and 95% CI related with BEWE ≥ 14 were: age (OR 1.1 [1.07-1.14]); currently drinking alcohol (OR 1.59 [1.06-2.39]); esophagitis (OR 8.22 [1.60-42.22]); difficulty to swallow (OR 2.45 [1.10-5.44]); chest pain (OR 2.07 [1.18-3.64]); anorexia (OR 3.82 [1.07-13.68]); vitamin C intake (OR 1.92 [1.08-3.43]). Age, alcohol consumption, self-reported esophagitis, history of gastric symptoms, anorexia, and vitamin C intake were related as risk factors to high BEWE scores in this sample of Chilean adults in San Bernardo, Chile.

Effect of CO2 laser combined with AmF/NaF/SnCl2 solution on the prevention of human and bovine enamel erosion

Abstract: This in vitro study evaluated the potential of CO2 laser (10.6 μm) combined with a stannous/fluoride-containing solution for preventing erosion in human/bovine enamel. Forty-eight samples of each substrate were randomly allocated to four groups (n = 12): W - distilled water; E - AmF/NaF/SnCl2 solution; L - CO2 laser; and LE - CO2 laser+AmF/NaF/SnCl2 solution. After surface treatments, samples were submitted to a 5-day erosive challenge, alternating immersions in 0.5% citric acid (2 minutes, 6x/day) and in artificial saliva. Optical profilometry (μm) and scanning electron microscopy (SEM) were used to determine surface loss and surface morphology, respectively. Data were statistically analyzed by two-way ANOVA and Tukey's tests (p < 0.05). For human enamel, tissue loss was lower in group L (12.37 ± 4.46) than in group W (16.45 ± 2.76), and higher than in the groups treated with AmF/NaF/SnCl2 solution (E-5.44 ± 2.37; LE-5.55 ± 2.31). In group L, SEM images reveled a disorganized surface but fewer projections than in group W and LE showed fewer irregularities than W, E, and L. For bovine enamel, tissue loss in group L (13.90 ± 3.50) did not differ from that in group W (14.10 ± 2.98), and was higher than losses in groups E (5.70 ± 2.12) and LE (8.12 ± 2.56), which were statistically similar to each other. Groups W and L had similar aspects of demineralization, whereas groups E and LE showed homogenous surfaces. Surface-treated samples had no changes in their surfaces. CO2 laser was able to slightly prevent surface loss only on human enamel surface, but did not enhance the AmF/NaF/SnCl2 effect on the prevention of enamel erosion.

Relationship between extrinsic factors and non-carious cervical lesions in patients of the National Hospital "Hipólito Unánue"

Non-carious cervical lesions cause destructive dental disorders that actively contribute to the progressive loss of dental structure and the immediate need for dental treatment, due to their multiple symptoms and factors that produce them. Aim: The purpose of the study was to determine the relationship between extrinsic factors and non-carious cervical lesions in patients of the National Hospital Hipólito Unánue. Methods: The research was of a descriptive correlative type. The sample consisted of male and female patients between 18 and 65 years old, who attended the carielogy service of this hospital. For data collection, 2 questionnaires were used to estimate the values of the extrinsic factors that allowed us to obtain the necessary information on the variables to be studied. Spearman's Rho was applied to determine the relationship between the variable's study. Results: According to Spearman's Rho of 0.622, compared to p-0.000 <0.01. Between the variables studied; extrinsic factors and noncarious cervical lesions there is a moderate and significant positive correlation. Conclusion: Through this section it was possible to demonstrate the existing relationship between extrinsic variable factors and non-carious cervical lesions, therefore it was concluded that there is a moderate and significant positive correlation in the sample comprised by the patients of the Hospital in mention