Awareness of erosive tooth wear (ETW) by the public is still low and most dental
practitioners overlooked the very early stages dismissing minor tooth surface loss of erosive tooth
wear. Therefore, this study aimed to assess knowledge of diagnosis and treatment strategies of
ETW among private dental practitioners (PDP) in Kuantan. (Copied from article).
This clinical case report describes an aspect of restorative management of worn teeth. It illustrates the use of diagnostic overlay removable partial denture or DORPD, which has the same function as occlusal splint but with advantages of providing immediate aesthetic improvement and function.
The prevalence and associated aetiologies of tooth wear were investigated in three ethnic groups in Sabah (Northern Borneo) using the Tooth Wear Index (TWI). The number of surfaces with enamel wear only, dentine exposed for less than a third or dentine exposed for more than a third were categorised into the TW minimal, moderate or severe respectively. A structured questionnaire was used to elicit medical/dental history, oral hygiene practices, satisfaction with body image, diet and other personal habits/details. The sample comprised of a self selected sample of 148 dental hospital attenders; 47 (32 per cent) each of ethnic Chinese and Malay and 54 (36 per cent) of ethnic Kadazan, matched for age and with a similar number of scoreable teeth per subject. Dentine exposure within the total sample was a common finding (95 per cent TW with moderate, 41 per cent TW severe). The Kadazan group had significantly (P < 0.05) more surfaces with severe tooth wear than the Chinese or Malay. Tobacco chewing was positively associated (rho = +0.4, P < 0.05) with both moderate and severe tooth wear, as was the habit of crushing/eating bones. Neither carbonated beverages or fresh fruit intake were associated with tooth wear, but their frequency of consumption was low. The buccal and occlusal surfaces of the posterior teeth were the most severely worn. Generally, wear was greater in the upper anterior sextant compared to the lower anterior sextant, with the exception of the lower incisal edges in the Kadazan group. Tooth wear into dentine was a common occurrence, especially among the Kadazan subjects and least among the Chinese subjects. The aetiological factors associated with this tooth wear are different to those encountered in Western cultures.
Tooth surface loss (TSL) is a complex phenomenon characterized by the loss of hard tooth structure at various locations of the teeth, usually due to more than one factor. TSL due to abrasion can be significant in patients consuming coarse, abrasive diet. The present case reports an interesting incisal edge abrasion in a female patient, attributed to a particular dietary behavior of long-term consumption of sunflower seeds. All her family members and most of the people from her native place were also reported to have similar lesions by the patient. Larger epidemiological studies to assess the prevalence and severity of such abrasive lesions in geographic areas with this particular dietary habit need to be carried out so that people may be made aware and educated about alternative ways of eating sunflower seeds that will not cause any form of tooth wear.
The management of patients with severely worn dentition is challenging due to the loss of occlusal vertical dimension and tooth structure creating an uneven plane of occlusion. This case report describes the importance of every step of the conventional and improvised methods in treating tooth wear patients. Stages from the initial work-up of tooth wear assessment, substantial surgical crown lengthening, the controlled method of increasing vertical dimension, the precise method of crown preparations, advanced impression techniques till the cementation procedure of final restorations.
The whole treatment was in a reorganized approach such that the new inter-cuspal position (ICP) coincided with the retruded axial position (RAP). When restoring worn dentition, cl inician should always have a proper planning, decent implementation for each stages thus guarantee excellent performances. However maintenance and recall visits are the main keys to long term success.
This article describes the occlusal rehabilitation of a partially edentulous patient who did not want a removable partial denture. Implants and extensive fixed restorations were used to restore posterior support and treat severely worn dentition, respectively. The treatment offered the patient a functional and esthetic result.