Dietary differences in archosaur and lepidosaur reptiles revealed by dental microwear textural analysis.

Reptiles are key components of modern ecosystems, yet for many species detailed characterisations of their diets are lacking. Data currently used in dietary reconstructions are limited either to the last few meals or to proxy records of average diet over temporal scales of months to years, providing only coarse indications of trophic level(s). Proxies that record information over weeks to months would allow more accurate reconstructions of reptile diets and better predictions of how ecosystems might respond to global change drivers. Here, we apply dental microwear textural analysis (DMTA) to dietary guilds encompassing both archosaurian and lepidosaurian reptiles, demonstrating its value as a tool for characterising diets over temporal scales of weeks to months. DMTA, involving analysis of the three-dimensional, sub-micrometre scale textures created on tooth surfaces by interactions with food, reveals that the teeth of reptiles with diets dominated by invertebrates, particularly invertebrates with hard exoskeletons (e.g. beetles and snails), exhibit rougher microwear textures than reptiles with vertebrate-dominated diets. Teeth of fish-feeding reptiles exhibit the smoothest textures of all guilds. These results demonstrate the efficacy of DMTA as a dietary proxy in taxa from across the phylogenetic range of extant reptiles. This method is applicable to extant taxa (living or museum specimens) and extinct reptiles, providing new insights into past, present and future ecosystems.

Relación entre desgaste dental severo y síndrome de apnea-hipoapnea del sueño (SAHS) / Relationship between dental wear and severe sleep apnea-hypopnea syndrome (SAHS)

Introducción: El síndrome de apneashipopneas del sueño (SAHS) es un problema mayor de salud pública que, en sus formas más graves, afecta al 3-6% de los hombres, al 2-5% de las mujeres y al 1-3% de los niños. Estudios epidemiológicos han encontrado una elevada prevalencia de bruxismo en pacientes con SAHS. Este artículo investiga la presencia de desgaste dentario en pacientes con apnea del sueño y la asociación potencial entre ambos factores. La hipótesis nula es la no asociación entre el desgaste dentario y el SAHS. Material y métodos: Se reclutaron pacientes de forma retrospectiva desde la unidad del sueño del centro que cumpliesen con los siguientes criterios de inclusión: mayores de 18 años y estudio realizado en la unidad del sueño confirmando la presencia de SAHS. Una vez reclutados, los pacientes se sometieron a una exploración dental con el fin de detectar posibles alteraciones dentales. Los parámetros dentales evaluados fueron: desgate dental (leve, moderado y severo) y causa del desgaste (atrición, erosión y abfracción). Resultados: Fueron reclutados 99 pacientes de forma consecutiva que cumplieron los criterios de inclusión anteriormente descritos. EL 46,5% de los pacientes fueron hombres con una edad media de 54±11 años. Al relacionar el grado de desgaste dentario en los diferentes grupos de pacientes con SAHS observamos que los pacientes con mayor grado de desgaste dental (severo) presentaron un IAH correspondiente a un SAHS leve en 2 casos (2,02%), un IAH correspondiente a un SAHS moderado en 6 casos (6,06%) y un IAH correspondiente a un SAHS severo en 8 casos (8,08%), siendo las diferencias entre los grupos estadísticamente significativas (Chi-cuadrado, p=0,000). Conclusiones: El desgaste dentario puede ser un indicativo de que el paciente presente enfermedades asociadas como el SAHS por lo que debe ser tomado como un síntoma y realizar las pruebas necesarias para su confirmación o exclusión

Introduction: The obstructive sleep apnea (OSA) is a major public health problem that, in its most severe forms, affects 3-6% of men, and 2-5% of women and 1-3% of children. Epidemiological studies have found a high prevalence of bruxism in patients with Osa. This article investigates the presence of dental wear in patients with sleep apnea and the association potencies between both factors. The null hypothesis is the non-association between dental wear and OSA. Material and methods: Patients were recruited retrospectively from the sleep unit that fulfilled the following inclusion criteria: Over 18 years and study performed in the sleep unit confirming the presence of OSA. Once recruited, the patients underwent a dental examination in order to detect possible dental alterations. The dental parameters assessed were: Dental wear (mild, moderate and severe) and cause of wear (attrition, erosion and abfraction). Results: 99 patients were recruited consecutively who met the inclusion criteria mentioned above. 46.4% of the patients were males with an average age between 54 +-11 years. In relation to the degree of dental wear of the different groups of patients with OSA observed that patients with higher degree of dental wear (severe) presented an AHI corresponding to a mild osas in 2 cases (2.02%), an AHI corresponding to a moderate OSA in 6 cases (6.06%) and an AHI corresponding to a severe osas in 8 cases (8,08%) the differences between the statistically significant groups (Chi-squared, p = 0,000). Conclusions: The tooth wear can be an indication that the patient presents diseases associated with the Osas so it should be taken as a symptom and perform the necessary tests for their confirmation or exclusion

Erosive Tooth Wear Among Different Tooth Types and Surfaces in Japanese Adults 15 to 89 Years Old.

PURPOSE: To evaluate the prevalence of erosive tooth wear on buccal, incisal/occlusal and palatal/lingual surfaces in a wide age range of Japanese adults. MATERIALS AND METHODS: The study included a total of 1108 adults aged 15 to 89 years in Tokyo, Japan. The subjects were asked to complete a self-administered nutrition-related questionnaire. Two examiners evaluated tooth wear on the buccal, occlusal/incisal and palatal/lingual surfaces in a full-mouth recording, using a modified Smith and Knight tooth-wear index. Subjects who frequently consumed acidic beverages or food, or had gastric reflux and at least one tooth with an initial enamel smooth-surface wear facet were placed in an erosion-positive group, and the rest of subjects were placed in the erosion-negative group. RESULTS: 26.1% of the participants were placed in the erosion-positive group. For buccal surfaces, advanced wear progression was predominantly observed on maxillary and mandibular anterior teeth, especially in the youngest age group (15-39 years). On incisal/occlusal surfaces, early dentin exposure was observed in the middle age group (40-49 years) in the erosion-positive group. For palatal/lingual surfaces, wear progression was mainly observed on maxillary anterior teeth among 30- to 39-year olds and 50- to 59-year-old in the erosion-positive group, but that prevalence was lower than for the other tooth surfaces. CONCLUSIONS: For all age groups of Japanese adults, the prevalence of erosive tooth wear depended on tooth types and surfaces.

Is a Basic Erosive Wear Examination (BEWE) reliable for recording erosive tooth wear on 3D models?

OBJECTIVES: To assess the reliability of the BEWE index on 3D models and to compare 3D-assessed erosive tooth wear scores with clinically detected scores. METHODS: In total, 1964 members of the Northern Finland Birth Cohort 1966 participated in a standardized clinical dental examination including the Basic Erosive Wear Examination (BEWE) and dental 3D modelling at the age of 45-46 years. Of those examined, 586 were randomly selected for this study. 3D models were assessed using the same BEWE criteria as in the clinical examination. Calculated kappa values as well as the prevalence and severity of erosive wear according to the clinical examination and 3D models were compared. Re-examinations were performed to calculate intra- and inter-method and -examiner agreements. RESULTS: The BEWE index on 3D models was reproducible; the mean intra- and inter-examiner agreement were 0.89 and 0.87, respectively, for sextant level, and 0.64 and 1, respectively, for BEWE sum scores. Erosive tooth wear was recorded as more severe in 3D models than in the clinical examination, and inter-method agreement was 0.41 for severe erosive wear (BEWE sum>8). The biggest inter-method differences were found in upper posterior sextants. CONCLUSIONS: The BEWE index is reliable for recording erosive tooth wear on 3D models. 3D models seem to be especially sensitive in detecting initial erosive wear. Additionally, it seems that erosive wear may be underscored in the upper posterior sextants when assessed clinically. Due to the nature of 3D models, the assessment of erosive wear clinically and on 3D models may not be entirely comparable. CLINICAL SIGNIFICANCE: 3D models can serve as an additional tool to detect and document erosive wear, especially during the early stages of the condition and in assessing the progression of wear. When scoring erosive wear clinically, care must be taken especially when assessing upper posterior sextants.

Instrumento clasificador para el examen de la guía anterior de la oclusión / Classifying instrument for occlusion previous guide exam

Fundamento: la guía anterior se convierte en algo difícil para los que incursionan en procederes rehabilitadores, pero no existe un instrumento para examinar la misma con fines docentes y asistenciales.Objetivo: desarrollar un instrumento clasificador para el examen clínico de la guía anterior de la oclusión.Métodos: se realizó un estudio descriptivo, en la clínica Ismael Clark Mascaró de la ciudad de Camagüey, desde septiembre de 2015 hasta febrero de 2016. El universo de estudio lo conformó la totalidad de 196 pacientes desdentados parciales, alta de servicios básicos y necesitados de rehabilitación protésica. La muestra no probabilística quedó constituida por 150 pacientes que reunieron los requisitos de inclusión. La investigación se realizó en tres momentos: ordenamiento, obtención de información y confrontación.Resultados: el 58 porciento de los pacientes no presentaron integridad morfológica de la guía anterior. Las interferencias predominaron en el 70 porciento de los pacientes de forma severa. Los examinados, 62 porciento con una guía anterior no funcional tenían curva de compensación pronunciada. Sobresale la dimensión vertical oclusiva dentro los parámetros establecidos con la guía anterior no adecuada en el 60 porciento de los pacientes.Conclusiones: sobresalió la falta de integridad morfológica de la guía anterior. Las interferencias dentarias severas fueron las más numerosas. La curva de Wilson pronunciada y la dimensión vertical oclusiva dentro de los parámetros establecidos, predominó en la mayoría de los pacientes con la guía anterior no funcional(AU)

Background: the previous guide becomes a difficult tool for those who make incursions into procedures of rehabilitation, but there is no instrument to examine it with teaching and assistance purposes.Objective: to develop a classifying instrument for the clinical exam of occlusion previous guide.Methods: a descriptive study was conducted at Ismael Clark Mascaro dental clinic of Camagüey from September 2015 to February 2016. The universe of study was composed of the 196 partial toothless patients who were discharged from the primary level of attention, and who needed of denture rehabilitation. The non-probabilistic sample was constituted by all the people who had the inclusion requirements, 150 patients. The investigation was carried out in three stages: classification, getting information and confrontation.Results: generally, 58 percent of the patients did not present morphological integrity of the previous guide. The interferences prevailed in 70 percent of the patients in a severe way. On the other hand, 62 percent of the examined patients with a dysfunctional previous guide had a curve of marked compensation. The vertical occlusive dimension stands out within the established parameters with the inadequate previous guide in 60 percent of the patients.Conclusions: the lack of morphological integrity of the previous guide was highlighted. The severe dental interferences were the most numerous. Wilson marked curve and the vertical occlusive dimension within the established parameters prevailed in most of the patients with the dysfunctional previous guide(AU)

[A PhD completed 6. Tooth Wear Evaluation System: development and applications]. / Hora est 6. Het Gebitsslijtage Beoordelingssysteem: ontwikkeling en toepassingen.

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

The Octagon Model: a clinical tool for assessing marginal tissue recession.

The Octagon Model is a clinical assessment tool designed to assess marginal tissue recession (MTR) and estimate the level of difficulty in achieving root coverage. It evaluates eight patient- and siterelated factors: patient's expectations, smoking status, width of keratinized tissue, absence/presence of cervical lesion, interproximal soft tissue/bone level, depth and width of recession defect, and buccal bone thickness. The model is presented in a three-colored diagram to facilitate communication between clinicians and between clinicians and their patients, and to assist clinicians in optimizing treatment plans at both site and patient levels.

Ritual tooth modification among the Baka pygmies in Cameroon.

INTRODUCTION: Ritual tooth mutilation is a relatively understudied human body mutilatory practices. The purpose of the study was to examine the effects of ritual tooth modification, teeth cleaning measures and herbal medications for their oral health problems among the Baka pygmies in Cameroon. MATERIALS AND METHODS: This cross-sectional study was conducted between January and March, 2012 using semi-structured questionnaire as the tool of data collection. Intra-oral examinations were carried out to determine the dental hard tissue loss using Smith and Knight Tooth Wear Index (TWI). RESULTS: Fifty-six pygmies with ritual tooth modification made of 34 males (60.7%) and 22 females (39.3%) with a mean age of 31 years were interviewed and had oral health examination. The reported age at which the tooth modification was done was between 10 and 15 years with mean age as 12 ± 1.66 years. More than half (58.9%) of the participants reported the tooth filing as painful and nearly two-thirds (64.3%) of the participants reported having persistent pain afterwards. The upper right central and lateral incisors were the most commonly modified teeth. A total of 42.9%, 12.5% and 7.1% of the participants had Smith and Knight TWI scores of 2, 3 and 4 respectively. All the participants reported cleaning their teeth at least once-daily with about two-thirds (66.1%) of them doing so with chewing stick. The majority (67.9%) of the participants reported cleaning their teeth for cosmetic reasons [to remove dirt' (60.7%) and 'to remove stains' (7.1%)]. The oral health problems among the participants in form of tooth sensitivity, toothache and dental abscess were treated with plant-based traditional medicines from Irvingia gabonensis, Ricinodendron heudoletti, Pterocarpus soyauxii, Alchornea cordifolia and Piptadeniastrum africanum. CONCLUSION: Ritual tooth modification is a painful mutilatory practice which is culturally significant for the Baka pygmies without health benefit. There is need for intervention to stop this harmful traditional practices among the pygmies. Further studies is recommended to elucidate the medicinal and pharmaceutical benefits of plants used for tooth sensitivity and other oral health problems by the pygmies.

Is erosive tooth wear an oral disease?

Erosive tissue loss is part of the physiological wear of teeth. Clinical features are an initial loss of tooth shine or luster followed by flattening of convex structures; with continuing acid exposure, concavities form on smooth surfaces, or grooving and cupping occur on incisal/occlusal surfaces. Dental erosion must be distinguished from other forms of wear, but can also contribute to general tissue loss by surface softening, thus modifying physical wear processes. The determination of dental erosion as a condition or pathology is relatively easy in the case of pain or endodontic complications, but is ambiguous in initial stages and in terms of function or esthetics. The impact of dental erosion on oral health is discussed. However, it can be concluded that in most cases dental erosion is best described as a condition, with the acid being of nonpathological origin.

Impact of bariatric surgery on oral health conditions: 6-months cohort study.

OBJECTIVES: We evaluate oral health conditions before and after bariatric surgery. METHODS: The sample was composed of 59 patients who had undergone Roux-en-Y gastric bypass (RYGB). Salivary flow, periodontal pocket depth and dental wear were evaluated before and after 6 months of surgery. Body mass index (BMI), C-reactive protein (CRP) and glucose levels were obtained from the patient's medical files. A t-test was used for dependent samples. RESULTS: The mean BMI decreased from 49.31 ± 8.76 to 35.52 ± 8.12 kg/m(2) in 6 months after surgery (P < 0.000). Before surgery, 67% of patients had high levels of CRP and 38% higher blood glucose levels and after surgery there were significant reductions in these levels (P < 0.001). Salivary flow ranged from 0.84 to 0.95 ml/min. There was increased prevalence of periodontal pockets (P = 0.022) and mean pocket depth increased to about 0.5 mm (P < 0.001). The percentage of surfaces with dental wear in dentine was significantly higher after bariatric surgery (P = 0.002), while dental wear in enamel decreased (P = 0.019). CONCLUSIONS: Bariatric surgery may improve systemic conditions. However, it had a negative impact on oral health conditions because of an increase in periodontal disease and dental wear.

Occlusal tooth wear in patients of a dental school's prosthodontic department in Xi'an, China.

PURPOSE: To assess the relationships between occlusal tooth wear and occlusal conditions, chewing side preference, and occlusal guidance scheme. MATERIALS AND METHODS: A total of 257 Chinese adult dental school patients were categorized according to a hierarchical functional classification system. Occlusal tooth wear was assessed using a modified Smith and Knight index. Occlusal tooth wear index (OTWI) scores were analyzed using multivariate regression models, including four specific occlusal conditions (≥10 teeth in each arch, complete anterior regions, sufficient premolar regions, and sufficient molar regions) adjusted for age and sex. RESULTS: Occlusal tooth wear was observed in all participants; older participants and men had significantly higher mean OTWI scores. The occlusal condition of having fewer than 10 teeth in each arch was significantly associated with occlusal tooth wear; participants with fewer than 10 teeth in each arch had higher mean OTWI scores in anterior and premolar teeth. OTWI scores for the different tooth types were highly correlated with chewing side preference. OTWI scores for the molar region (including third molars) were significantly higher at the preferred chewing side. The same effect was seen for OTWI scores of all teeth combined. OTWI scores were not associated with occlusal guidance scheme. CONCLUSIONS: The occlusal condition of having fewer than 10 teeth in each arch appears to be a risk factor for increased occlusal tooth wear. Occlusal wear was more severe at the chewing side. Occlusal tooth wear was significantly associated with the nondental factors of age and sex.

A survey of management strategies for noncarious cervical lesions.

Both causation and management of noncarious cervical lesions (NCCLs) (abfractions, wedge-shaped defects, stress-induced cervical lesions, and cervical erosion) remain debatable. A survey of clinicians' perceptions was therefore conducted at a recent professional meeting to determine optimal approaches to NCCL management. Examples of lesions differing in depth (1, 2, and 3 mm) were presented as being either sensitive or nonsensitive, and participants recorded their responses to the presented individual scenarios. This report provides information regarding correlations between increases in lesion depth, lesion sensitivity, and professionals' willingness to restore them. It was also noted that decisions to ensure mechanical retention positively influenced estimates for restoration longevity.

Validation of the Basic Erosive Wear Examination.

The Basic Erosive Wear Examination (BEWE) is a practical index for screening tooth wear, using a 4-point ordinal scale (0-3). The highest score is recorded in each sextant and a total score (or BEWE sextant cumulative) is calculated per subject. This study aims to investigate if the BEWE sextant cumulative score compares to one comprising a percentage score from all tooth surfaces and as a highest BEWE per subject. The aim is to assess the validity of this score. A total of 350 subjects were recruited from hospital and general practice in south-east England. Buccal, occlusal and lingual/palatal BEWE scores were collected and percentages calculated based on scores 1, 1 and above, 2 and above and 3. BEWE sextant cumulative scores and highest BEWE scores were also recorded per subject. Spearman's correlation coefficients (p values) assessed the relationship between BEWE sextant cumulative scores, BEWE percentages and BEWE highest score per subject. The BEWE sextant cumulative score correlates significantly to a BEWE score taken as a percentage score from all tooth surfaces (Spearman's r > 0.5, p < 0.001) and especially to BEWE surface scores of 1 and above and 2 and above (r > 0.8, p < 0.001) and as a highest surface score per subject (r > 0.8, p < 0.001). BEWE sextant score provides a representation of tooth wear on all tooth surfaces. This study validates a tooth wear index, which provides clinicians with risk indicators of a patient's level of tooth wear and may help to guide clinical management.

Quantification of incisal tooth wear in upper anterior teeth: conventional vs new method using toolmakers microscope and a three-dimensional measuring technique.

OBJECTIVES: This study aimed to quantify tooth wear in upper anterior teeth using a new CAD-CAM Laser scanning machine, tool maker microscope and conventional tooth wear index. METHODS: Fifty participants (25 males and 25 females, mean age = 25 ± 4 years) were assessed for incisal tooth wear of upper anterior teeth using Smith and Knight clinical tooth wear index (TWI) on two occasions, the study baseline and 1 year later. Stone dies for each tooth were prepared and scanned using the CAD-CAM Laser Cercon System. Scanned images were printed and examined under a toolmaker microscope to quantify tooth wear and then the dies were directly assessed under the microscope to measure tooth wear. The Wilcoxon Signed Ranks Test was used to analyze the data. RESULTS: TWI scores for incisal edges were 0-3 and were similar at both occasions. Score 4 was not detected. Wear values measured by directly assessing the dies under the toolmaker microscope (range = 113 - 150 µm, mean = 130 ± 20 µm) were significantly more than those measured from Cercon Digital Machine images (range=52-80 µm, mean = 68 ± 23 µm) and both showed significant differences between the two occasions. CONCLUSIONS: Wear progression in upper anterior teeth was effectively detected by directly measuring the dies or the images of dies under toolmaker microscope. Measuring the dies of worn dentition directly under tool maker microscope enabled detection of wear progression more accurately than measuring die images obtained with Cercon Digital Machine. Conventional method was the least sensitive for tooth wear quantification and was unable to identify wear progression in most cases.

[Considerations in the treatment of tooth wear]. / Overwegingen bij de behandeling van gebitsslijtage.

Since the origin of tooth wear (attrition, abrasion and erosion) is multi-factorial, its diagnosis is complicated but vital. The so-called Tooth Wear Evaluation System, introduced earlier, makes a systematic diagnostic approach possible. The system consists of various modules, which can be used by the practitioner depending on the goal. Two new modules have been added to the Tooth Wear Evaluation System. The Therapy Start Module can be used to determine which one of the possible treatment modalities (counseling, monitoring, or restorative treatment) should be chosen. The Level of Difficulty Module gives the practitioner indications of the level of difficulty that may be encountered during a restorative treatment.

Distribution and characteristics of non carious cervical lesions in an adult Nigerian population.

BACKGROUND: Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity. OBJECTIVE: The study is to investigate the characteristics of NCCLs in adult patients who had a high incidence in them and to see if there are any association with the findings. Methods : The author examined 356 teeth with NCCLs in 34 subjects (male and female aged 22-75 years). The characteristics were based on the location of the lesion and the size (shape, extensiveness and depth). RESULTS: In terms of the location, 61.2% were located on the posterior teeth, and 55.9% on the maxillary teeth. The first premolars (25.8%) and canines (19.4%) were affected most often, followed by the first molars (16.9%) and second premolars (13.8%). There was slight right side preponderance (50.3%) and more lesions in the male subjects (67.4%). Patients tended to be older, with 76.4% in the 40 years and older age group. In terms of the size of the lesion, 75.0% of the lesion had angular shape of < 135 (wedge), 70.2% had axial depth of 1-2 mm, and 51.7% had occlusogingival width (extensiveness) of 2-3.9mm (small). There was association between gender and the severity (extensiveness) of the lesion. The severity (shape and extensiveness) of NCCL was associated with age. There was strong association between the severity of NCCL and site of the lesion (jaws). CONCLUSION: The authors found that NCCLs were significantly related to age. The posterior maxillary teeth especially the first premolars followed by the canines were the teeth commonly involved. No great difference in incidence was found between the right and left sides as a result of right or left hand dexterity. Awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient. In addition, these characteristics help identify which teeth and patients that are more susceptible.

Evaluation of the basic erosive wear examination (BEWE) for use in general dental practice.

OBJECTIVE: The basic erosive wear examination (BEWE) is a relatively new index proposed for the screening and recording of tooth wear in adults. The aim of this study was to test the validity and reliability of the BEWE. DESIGN: Cross sectional study of a sample of 164 adult patients. SETTING: General dental practice in East Lancashire, UK in 2010. SUBJECTS: Patients attending for routine examination or treatment. MAIN OUTCOME MEASURES: By screening patients with the BEWE and comparing the results to the established tooth wear index (TWI) the sensitivity and specificity of the BEWE was established.Results The BEWE predicted moderate to severe wear (BEWE grade 3) with a sensitivity of 48.6% and a specificity of 96.1%, and predicted severe wear with a sensitivity of 90.9% and a specificity of 91.5% (also BEWE score 3). Inter- and intra-examiner reliability for the BEWE were both moderate (κ(w) = 0.43 and 0.57 respectively). CONCLUSION(S): BEWE scores show a similar distribution to TWI scores and the examination is an effective screening test for severe tooth wear. The moderate levels of examiner reliability suggests the BEWE scores should be interpreted with some caution.

Tooth wear among tobacco chewers in the rural population of Davangere, India.

PURPOSE: In India, people chew tobacco either alone or in combination with pan or pan masala, which may cause tooth wear. The purpose of this study was to assess and compare tooth wear among chewers of various forms/combinations of tobacco products in the rural population of Davangere Taluk. MATERIALS AND METHODS: A cross-sectional study was conducted on 208 subjects selected from four villages of Davangere Taluk. Tooth wear was recorded using the Tooth Wear Index by a calibrated examiner with a kappa score of 0.89. The chi-square test was used for statistical analysis. RESULTS: The subjects chewing tobacco had significantly greater tooth wear as compared to the controls (P < 0.001). It was also observed that the frequency and duration of chewing tobacco was directly proportional to the number of pathologically worn sites. CONCLUSION: The abrasives present in the tobacco might be responsible for the increased tooth wear among tobacco chewers.

Severe tooth wear in Prader-Willi syndrome. A case-control study.

BACKGROUND: Prader-Willi syndrome (PWS) is a rare complex multsystemic genetic disorder characterized by severe neonatal hypotonia, endocrine disturbances, hyperphagia and obesity, mild mental retardation, learning disabilities, facial dysmorphology and oral abnormalities. The purpose of the present study was to explore the prevalence of tooth wear and possible risk factors in individuals with Prader-Willi syndrome. METHODS: Forty-nine individuals (6-40 years) with PWS and an age- and sex-matched control group were included. Tooth wear was evaluated from dental casts and intraoral photographs and rated by four examiners using the Visual Erosion Dental Examination (VEDE) scoring system and the individual tooth wear index IA. In accordance with the VEDE scoring system, tooth wear was also evaluated clinically. Whole saliva was collected. RESULTS: Mean VEDE score was 1.70 ± 1.44 in the PWS group and 0.46 ± 0.36 in the control group (p < 0.001). Median IA was 7.50 (2.60-30.70) in the PWS group and 2.60 (0.90-4.70) among controls (p < 0.001). In the PWS group tooth wear correlated significantly with age (VEDE; r = 0.79, p < 0.001, IA; r = 0.82, p < 0.001) and saliva secretion (VEDE; r = 0.46, p = 0.001, IA; r = 0.43, p = 0.002). Tooth grinding was also associated with tooth wear in the PWS group, as indicated by the mean VEDE 2.67 ± 1.62 in grinders and 1.14 ± 0.97 in non-grinders (p = 0.001) and median IA values 25.70 (5.48-68.55) in grinders and 5.70 (1.60-9.10) in non-grinders (p = 0.003). Multivariate linear regression analysis was performed with tooth wear as the dependent variable and PWS (yes/no), age, tooth grinding and saliva secretion as independent variables. PWS (yes/no), age and tooth grinding retained a significant association with tooth wear, VEDE (p < 0.001) and log IA (p < 0.001). The only factor significantly associated with tooth wear in the control group was age. CONCLUSIONS: Our study provides evidence that tooth wear, in terms of both erosion and attrition, is a severe problem in Prader-Willi syndrome. There is therefore considerable need for prosthodontic rehabilitation in young adults with PWS.