Relationship between dental erosion and attrition

Interaction between attrition,abrasion and erosion in tooth wear.

relationship between dental erosion and attrition

An overview of tooth wear, i.e. of non-carious destructive processes affecting the teeth including abrasion, demastication, attrition, abfraction, resorption and. Tooth wear is the term used to describe the progressive loss of a tooth's surface Tooth wear is caused by three phenomena: erosion, attrition and abrasion. Dental erosion is a multifactorial process leading to the loss of enamel and dentine attrition, abfraction and erosion to specific lesions will result in inappropriate or distribution and severity of tooth wear and the relationship between erosion.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Since the mids, the focus of studies on tooth wear has steadily shifted from the general condition towards the more specific area of dental erosion; equally, a shift has occurred from studies in adults to those in children and adolescents.

During this time, understanding of the condition has increased greatly. This paper attempts to provide a critical overview of the development of this body of knowledge, from earlier perceptions to the present. It is accepted that dental erosion has a multifactorial background, in which individual and lifestyle factors have great significance.

Notwithstanding methodological differences across studies, data from many countries confirm that dental erosion is common in children and young people, and that, when present, it progresses rapidly.

relationship between dental erosion and attrition

That the condition, and its ramifications, warrants serious consideration in clinical dentistry, is clear. It is important for the oral healthcare team to be able to recognize its early signs and symptoms and to understand its pathogenesis.

Preventive strategies are essential ingredients in the management of patients with dental erosion.

Dental Erosion and Its Growing Importance in Clinical Practice: From Past to Present

Decision to grade whether the erosive wear is acceptable or not, depends on the expected lifespan of the dentition and differs for permanent and deciduous dentition. Nevertheless, damage caused to the permanent teeth due to erosion that occurs during the childhood may compromise the growing dentition for their entire lifespan, and thus, may require increasingly complex restorations which may have to be repeated also. Etiology of tooth wear The distinct definition for each class of tooth wear reinforces the traditional point of view that these processes occur independently and may occur in concomitance of other processes as well.

Hence, it may be that combining the etiologies probably reflects the true clinical scenarios. Saliva can lessen the tooth wear processes via pellicle formation and remineralization; however, cannot prevent it. Abrasion Both patient and material related factors influences the prevalence of this condition. The brushing technique, brushing frequency, and the force applied while brushing are common patient-related factors.

The type of bristle material of toothbrush, stiffness of toothbrush bristles, the abrasiveness, and pH of dentifrice used are factors related to material. Cervical areas are susceptible to toothbrush abrasion, particularly cuspids and first premolars, where thin buccal plates, gingival recession, and exposed root surfaces predispose cervical notching. Habits involving other intraoral objects e.

relationship between dental erosion and attrition

Abfraction These lesions are usually located subgingivally, where the influence of tooth brushing abrasion is unusual; and hence, are hypothesized to be the result of eccentrically applied occlusal stresses leading to tooth flexure, rather than to be the result of abrasion alone. Weakening of the hydroxyapatite present near the cervical region of the teeth is weakened due to tensile stresses, which produces the classical wedge-shaped defects having sharp edges near to the cementoenamel junction.

The causal factors for attrition are parafunctional habits, bruxism, clenching, [23] developmental defects, [24] coarse diet, and natural teeth opposing porcelain. It is caused not only by diet or the habits, but a class III incisal relationship and lack of posterior support also lead to attrition. Evidence also suggests that that erosive wear also predisposes to attrition, and that the two mechanisms very often act together causing tooth surface loss. Intrinsic causes are mostly of gastric reflux and include vomiting in case of anorexia, bulimia nervosa, and rumination.

This has led to better research and clinical applications of the all-ceramic crowns and bridges. The loss of vertical dimension of occlusion, loss of centric occlusion, and muscle fatigue may also lead to temporomandibular disorders. Dental feldspathic porcelain is being used for restoring teeth for many decades, but one of its major disadvantage is that it causes excessive wear of opposing natural dentition.

Careful treatment planning and case selection is recommended during their use.

Clinical measurement of tooth wear: Tooth wear indices

However, whilst the wear characteristics of other materials may be good, they do not satisfy patient's esthetic demands. Recently, high-strength zirconia ceramic is introduced in clinical dentistry having high bending strength and very high fracture toughness. High hardness exhibited by dental ceramics has shown to be associated with the greater abrasive effects overnatural teeth. An investigation on the degree of wear of antagonistic teeth with zirconia using a dual-axis chewing simulator was done in a laboratory.

Using this wear test, the vertical and horizontal movements were more precisely replicated using computer software and the degrees of wearing off were more accurately compared. This was done using volume measurements rather than the height, and the environments of the mouth were more accurately simulated with the associated thermos cycling.

Management Initial management of tooth surface loss depends on accurate diagnosis of the condition, the identification of the etiology and frequent monitoring of the successive changes; hence to prevent further damage. Treatment planning is sometime very challenging and it is very necessary that accurate analysis of the tooth surface loss is made at an early stage and that satisfactory preventive measures are carried out.

Once the risk factors are properly understood, these measures can be accurately initiated. The interrelationship of the four modes of tooth surface loss and individual susceptibility influences the degree of tooth wear. Recognition of the multifactorial nature of the condition is the first step in its management, as failure to appreciate this may lead to inappropriate management and ultimate failure of restorative therapy.

Clinical measurement of tooth wear: Tooth wear indices

Holbrook and Arnadottir [50] stated thatif noncarious destruction of teeth is to be avoided, following must be considered: Recognizing and understanding that the condition exists Grading the severity of the condition Likely causes are diagnosed appropriately Monitoring the preventative measures and the disease progress. History and presenting complain Treatment planning for tooth wear cases is often driven by specific patient concerns.

Some may complain of an esthetic impairment, such as fractured, unattractive teeth or problems concerns due to tooth discoloration. Less commonly, patients may also present due to sensitivity and pain from severely worn teeth. The attitude of the patient to the oral care and the motivation to keep the dentition healthy.

Furthermore, an insight of the social history of a patient may disclose further understanding into the etiology of the condition. These could be details of lifestyle or occupational stress that could have led to the causative factors.

Interaction between attrition,abrasion and erosion in tooth wear.

It is worthwhile mentioning that the cases of tooth surface loss are subdivided into categories. These could be normal or 'physiological' for that person's age, or severe or 'pathological' in relation to what is considered to be acceptable for an individuals of certain age groups. In patients who exhibit only physiological wear with no esthetic or functional complains and associated symptoms of discomfort, the management strategies should be primarily limited to preventive measures and monitoring.

In those patients exhibiting pathological tooth wear, there is a need of active restorative involvement along with the preventive strategies and regimes.

Grading of the severity of tooth wear has been enumerated in a number of indexes and [Table 1] shows the most popular tooth wear index as stated by Smith and Knight.