el 81% de los pacientes con edades comprendidas entre 45 a 59 años presentaban abfracciones, EDAD se asocia significativamente con las. DENTALES. abfraction la abfracción abrasive elabrasivo abrasion of teeth abscess abutment acid acidulated phosphate fluoride acrylic appliance active caries. Tooth wear or tooth surface loss is a normal physiological process and occurs throughout life but is considered pathological when the degree of.
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Tooth wear abffracciones tooth surface loss is a normal physiological process and occurs throughout life but is considered pathological when the degree of destruction is excessive or the rate of loss is rapid, causing functional, aesthetic or sensitivity problems. The importance of tooth wear as a dental problem has been increasingly recognized.
The findings of a study in Trinidad indicate that the prevalence of tooth wear in a Trinidadian population is comparable to the United Kingdom UK and, indeed, that the level of moderate and severe wear is nearly twice as high. The aetiology of tooth wear is attributed to four causes: Erosion is generally considered to be the most prevalent cause of tooth wear in the UK and Europe.
Acids that cause dental erosion originate mainly from the diet or the stomach and, to a lesser extent, the environment. Underlying medical problems can contribute to influence the progress of tooth wear due to erosion and the patient may not be aware of these conditions. Moderate to severe tooth wear poses a significant clinical challenge to dental practitioners and may result in treatment that is more complex and costly to the patient, both in terms of finances and time spent in the dental chair.
This paper provides an overview of aetiology and diagnosis of tooth wear, in particular tooth wear due to erosion, so that medical and dental practitioners may recognize tooth wear early, institute preventive measures and manage patients appropriately. Tooth wear is defined as the loss of tooth substance in the absence of caries and plaque 1.
It is a normal physiological process and occurs throughout life but is considered pathological when the degree of destruction is excessive or the rate of loss is rapid, causing functional, aesthetic or sensitivity problems. The findings of a study in Trinidad indicate that the prevalence of tooth wear in a Trinidadian population is comparable to the United Kingdom UK and, indeed, that the level of moderate and severe wear is nearly twice as high 2.
Terms such as erosion, abrasion, attrition 3 and abfraction have traditionally been used to describe pathological loss of tooth tissue, reflecting some aetiological factors associated with such occurrences.
Although the loss caused by each of the above factors has a distinctive appearance, tooth wear rarely occurs from a single cause 4. As such, clinicians may encounter significant difficulties in determining the abfraccipnes aetiology. Subsequently, controlling or preventing the loss of tooth structure may be difficult.
Erosion is generally considered dentqles be the most prevalent cause of tooth wear in the UK 4 and Europe 5. Defining the various aetiological factors in tooth surface loss and associated activities which may contribute to this Table 1 will aid in classifying the condition, understanding its causes and planning intervention. Erosion is the abdracciones loss of dental hard tissue by acid from a non-bacterial source 8. The most common cause dfntales tooth wear in the UK population is erosion 4.
The causes of erosive lesions are varied Table 2. Some of these causes may point to underlying medical conditions which may be elucidated during centales taking and clinical examination. The acid that causes erosive wear may be classified as intrinsic or extrinsic 10 depending on the source of the acid from either the stomach intrinsic or the diet and other environmental sources extrinsic.
Regurgitation erosion refers to tooth abfraccionss caused by the regurgitation of hydrochloric acid from the stomach. This occurs in patients with digestive disorders such as gastroesophageal reflux disease including those with hiatus hernia and chronic indigestion.
Reflux past the upper oesophageal sphincter has been shown to increase the risk for erosion in the mouth 5. Stomach acid can also enter the oral cavity during vomiting episodes due to alcohol hangovers, chronic alcoholism, morning sickness associated with pregnancy, eating disorders such as anorexia and bulimia nervosa 11 and with voluntary regurgitation or rumination Rumination is a condition when patients eat their food and voluntarily regurgitate the food with gastric acids into their mouths.
Dietary erosion is due to food or drink containing a variety of acids such as from citrus and other fruits, fruit juices citric acidsoft drinks, wine and other carbonated drinks carbonic acid and other acidspickles, vinegar dressings and preserves acetic acid.
There is a high consumption of fruits, fruit juices and carbonated beverages in Trinidad abfraccoines Tobago and this may be similar to other Caribbean islands. There is also an association with vegetarian diet and erosion 2. Table 3 shows the acidity of some common foods and beverages. Industrial and environmental erosion is due to exposure to processes in the work place eg battery factories which produce acid fumes or droplets, and leisure activities eg chlorinated swimming pools.
Before any intervention or restorative treatment is started, a diagnosis of tooth wear should be made based on the clinical signs and a carefully elicited history.
Diagnosis may not be easy because patients may not want to volunteer information eg in eating disordersor they may not associate heartburn or stomach upsets with having any abfracciomes on teeth, or that the dentist may need to know this. Thus, in addition to the routine medical history, emphasis must be placed on medical conditions and eating disorders that predispose to regurgitation erosion. Also, medical problems that cause a reduction in salivary flow Table 4 can affect the extent of dental erosion.
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Referral and collaboration with medical practitioners may be necessary for further investigations, diagnosis and management of these underlying medical conditions. Particular questions to be asked are type of toothbrush used, whether hard or soft, toothbrushing frequency and history of bruxism grinding or clenching.
It is also important to ask if grinding or bruxism sounds are heard by bed partner, if there is masticatory or facial muscle fatigue or pain abfraccionws the mornings and if the patient ever used a mouthguard or occlusal guard.
A diet sheet is useful to determine the intake frequency of acidic food and beverages. A thorough examination is needed both extra-orally and intra-orally.
Extra-oral examination may reveal facial signs of alcoholism such as facial flushing and spider angiomas and enlarged parotid glands which can also be an indicator of autoimmune disease or anorexia. Masseteric muscle hypertrophy may also indicate a clenching or grinding habit bruxism.
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Intra-oral examination may reveal signs of salivary hypofunction such as dry mouth with a reduced amount of saliva or saliva that is foamy, viscous or ropy. Shiny facets or wear on the teeth or restorations may also be observed. Clinical features of erosive lesions include: The eroded enamel stands higher than the underlying dentine as the dentine is less mineralized compared to enamel and wears away faster once exposed.
In the anterior teeth, there is increased incisal translucency, incisal chipping and, in moderate to severe cases, cupping out of the incisal edges Figs. Erosion caused by vomiting typically affects the palatal inner surfaces of the upper teeth but can be due to dietary acids as well. The provision of restorative dental care requires a multi-disciplinary approach and may encompass treatment ranging from simple restorations to comprehensive full mouth rehabilitation. Management includes monitoring and prevention and it is necessary to establish a diagnosis, but even if a definitive diagnosis is not clear initially, general preventive suggestions can be made such as: More active restorative treatment involving simple restorations Fig.
The description of the dental restorative management is outside the scope of this article. National Center for Biotechnology InformationU. West Indian Med J. Published online Jun 5. A Paryag and R Rafeek. A Paryag 1 From: R Rafeek 1 From: Author information Copyright and License information Disclaimer.
Faxe-mail: Copyright Material printed in the West Indian Medical Journal is covered by copyright and may not be reproduced in whole abfracviones in part without the written permission of the Editor. Single photocopies may be made by individuals without obtaining prior permission.
This article has been cited by other articles in PMC. ABSTRACT Tooth wear or tooth surface loss is a normal physiological process and occurs throughout life but is considered deentales when the degree of destruction is excessive or the rate of loss is rapid, causing functional, aesthetic or sensitivity problems.
Dental erosion, medical conditions, tooth wear.
Table 1 Definitions of the aetiological factors in tooth surface loss. Aetiological factor Definition and associated causative activities Attrition The loss by wear of tooth substance or a restoration caused by mastication or contact between occluding or approximal surfaces.
Erosion The progressive loss of hard dental tissues by chemical process not involving bacterial action 8.
Abrasion The loss by wear of tooth substance or a restoration caused by factors other than tooth contact. Associated with non-dental objects eg hair grips 9or overly vigorous tooth brushing 8. Abfraction The pathologic loss of hard tooth substance caused by biomechanical loading forces.
Open in a separate abfravciones. Adapted from Kelleher and Bishop; Erosion Erosion is the progressive loss of dental hard tissue by acid from a non-bacterial source 8.
Table 2 Causes of erosive lesions.
Type of erosion Causative factors Regurgitation intrinsic erosion Regurgitation may be an involuntary occurrence as a complication of gastrointestinal problems, or be voluntary or patient-induced as in anorexia nervosa or bulimia. Environmental extrinsic erosion Acidic environments for work or leisure may expose patients to factors which cause tooth surface loss.
Table 3 Acidity of some abfraccionfs foods and beverages.
Item pH range Lime juice 1. Table 4 Factors that reduce the flow of saliva. Dental and dietary history Particular questions to be asked are type of toothbrush used, whether hard or soft, toothbrushing frequency and history of bruxism grinding or dentaales. Examination A thorough examination is needed both extra-orally and intra-orally. Lower anterior teeth showing cupping out of incisal edges due to erosion.
Management The provision of restorative dental care requires a multi-disciplinary approach and may encompass treatment ranging from simple restorations to comprehensive full mouth rehabilitation. Deentales anterior teeth restored by bonding tooth-coloured composite dental materials. Tooth surface loss from abrasion, attrition and erosion.
3-STEP Technique, a simplified protocol for ADDITIVE adhesive rehabilitations
Debtales surface loss in adult subjects attending a university dental clinic in Trinidad. Kelleher M, Bishop K. A comparison of patterns of tooth wear with aetiological factors. The role of erosion in tooth wear: The prevalence of toothwear in year old school children in Liverpool.
An alternative treatment in cases with advanced localized attrition. Wear in dentistry — current terminology. The distribution of erosion in the dentitions of patients with eating disorders.