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Abstract Currently available anti-erosive agents only provide partial protection, emphasizing the need to enhance their performance. By characterizing erosive enamel wear at the nanoscale, the aim of this in vitro study was to assess the anti-erosive effects of SnF2 and CPP-ACP both individually and synergistically. Erosion depths were assessed longitudinally on 40 polished human enamel specimens after 1, 5, and 10 erosion cycles. Each cycle comprised one-min erosion in citric acid (pH 3.0) and one-min treatment in whole saliva (control group) or a slurry of one of the three anti-erosive pastes (10% CPP-ACP; 0.45% SnF2 (1100 ppm F); or SnF2/CPP-ACP (10% CPP-ACP + 0.45% SnF2)) (n = 10 per group). Scratch depths were assessed longitudinally in separate experiments using a similar protocol after 1, 5, and 10 cycles. Compared with the control groups, all slurries reduced erosion depths after 1 cycle (p ≤ 0.004) and scratch depths after 5 cycles (p ≤ 0.012). The order of anti-erosive potential was SnF2/CPP-ACP > SnF2 > CPP-ACP > control for erosion depth analysis, and SnF2/CPP-ACP > (SnF2 = CPP-ACP) > control for scratch depth analysis. These data provide ‘proof of concept’ evidence that SnF2/CPP-ACP has superior anti-erosive potential compared to SnF2 or CPP-ACP alone.

Abstract Background Fluoride has a major role in strengthening the structure of enamel against acids. Despite differences between caries and root resorption processes, both events inherently involve acidic dissolution of dental tissues. The aim of the present study was to investigate the effects of water fluoridation levels on the surface roughness of root cementum and resorption craters. The findings provided more insight into the influence of fluoride on the surfaces of intact cementum surface and resorption craters. Methods Twenty-eight orthodontic patients were recruited from two cities in Turkey, with high (≥ 2 ppm) and low (≤ 0.05 ppm) water fluoridation. These patients needed bilateral maxillary first premolar extraction as part of their orthodontic treatment and were allocated into two study groups (n = 14 in each group) based on water fluoridation exposure level: the high-fluoride group (HF) and low-fluoride group (LF). 150 g of buccal tipping forces was applied to all maxillary first premolar teeth for 12 weeks with a beta-titanium spring which was reactivated every 4 weeks. All maxillary premolars were removed at the end of the experiment for surface roughness assessment using three-dimensional confocal microscopy and the associated software. The buccal root surface and the largest buccal resorption crater were investigated. Results Resorption craters were significantly rougher in LF group compared to HF group (p = 0.002). Craters were rougher than the intact root surfaces (p = 0.000). Cervical and apical regions were significantly rougher than the middle region (p = 0.000 and p = 0.024, respectively). Conclusions Higher water fluoridation level of ≥ 2 ppm resulted in significantly smoother root resorption craters than low water fluoridation level of ≤ 0.05 ppm when the teeth were subjected to 150 g of buccal tipping force. Fluoride seems to have a protective role at the interface of root resorption, and further mineral or histological studies may shed light on the exact protective process against root resorption.

Aim or Purpose: The increasing prevalence of erosive tooth wear among children and young adults is an issue of growing concern, emphasising the need for improvement in the currently used preventive strategies. Our aim was to evaluate individual and synergistic effects of SnF2 and CPP-ACP pastes in inhibiting erosion at a nano-scale. Materials and Methods: Forty flat, polished enamel specimens were subjected to 10 erosion cycles, with each cycle comprising one-min erosion in citric acid (pH 3.0) and one-min exposure to human saliva. In each of the 3 experimental groups (n = 10 per group), a remineralising paste (10% CPP-ACP or 0.45% SnF2 (1,100 ppm F) or SnF2/CPP-ACP (combined 10% CPP-ACP and 0.45% SnF2)) was applied as a slurry in saliva between erosion cycles. No remineralising agent was used in control specimens (n = 10). Erosion was assessed by calculating erosion depth using a novel photolithographic technique combined with high-resolution 3D laser scanning microscopy from baseline to 1 min, 5 min and 10 min. Results: A significant increase in erosion depth was detected in the control group as early as 1 min (69.4 nm) (P < 0.001), with the erosion depths being smaller for all three remineralising agents after 1 min (P ≤ 0.004). The overall trend of erosion depth reduction was SnF2/CPP-ACP > SnF2 > CPP-ACP > control. Conclusions: Application of SnF2-enriched CPP-ACP agent reduces dental erosion more than either SnF2 or CPP-ACP alone, offering a potentially more-effective preventive strategy to manage this condition.

The analysis of dental wear, at both the microscopic and macroscopic scale, is one of the most widely used tools in archeology and anthropology to reconstruct the diet and lifestyle of past human populations. Biomechanical studies have indicated that tooth wear helps to dissipate the mechanical load over the crown surface, thus reducing the risk of tooth fracture. To date, there are only a few studies that have examined functional tooth wear variation in modern humans. Here we propose to study masticatory efficiency through the use of the Occlusal Fingerprint Analysis method, a well-developed digital approach that allows the reconstruction of the occlusal dynamics occurring during mastication. The aim of this study is to provide the first longitudinal quantitative data of molar and premolar macrowear patterns within a functional context. We examined the mixed and permanent dentition of one Australian Aboriginal child (from ages 8 to 17) from Yuendumu, using high-resolution surface scans of dental casts including both upper and lower arches. Our results suggest that the occlusal macrowear patterns of this individual did not significantly change through time. Occlusal contact parameters such as functional area, inclination and direction remain relatively unaltered throughout childhood and adolescence, indicating little change in the masticatory function of this individual. The functional tooth wear pattern in this individual did not change longitudinally indicating the degree of masticatory efficiency has most probably remained unaltered.

Accurate, reproducible three-dimensional (3D) data provide an important contribution to our ability to describe, compare and understand dental morphology but the existing technology is often expensive or has technical limitations. Recently available, inexpensive 3D profilometers interfaced with standard personal computers offer the potential to overcome some of these problems. This technical note describes a system that uses a 3D profilometer and purpose written software to analyse changes in dental morphology resulting from tooth wear. The validity of the derived data was determined by comparing data derived from scans of objects of known dimensions with calculated volumes. These differences were less than 10% from objects that were difficult to scan because of their geometry and were commonly less than 5%. The reproductibility, expressed as intra- and inter-observer coefficients of variation, was less than 1%. The potential applications of systems of this type are outlined.

Corono-radicular grooves (CRGs) are developmental anomalies on maxillary incisor teeth that have both anthropological and clinical significance. Their reported prevalence varies from around 2% in modern Caucasoid populations to 18% in Chinese, although methods of classification have differed between studies. The aim of this study was to determine the frequency of occurrence and configuration of these grooves in a large sample of Caucasoid extracted permanent maxillary incisors collected in South Australia during the early 1900s (The Ramsey Smith Collection). A total of 1481 permanent maxillary incisors was examined using a dissecting microscope and classified according to tooth type and side. CRGs were scored according to their location, length, and depth. They were observed in 78 teeth (5.3%), with three teeth displaying two grooves. No significant difference in frequency occurred between central (4.7%) and lateral (5.7%) incisors, nor between right and left sides. Most of the CRGs (51.8%) were located in the mid-palatal region of tooth crowns, originating from the cingulum and terminating on the root surface less than 5.0 mm from the cemento-enamel junction (CEJ). All CRGs were less than 1.0 mm in depth. A higher proportion of CRGs was observed on the distal surface of lateral incisors (28.6%) than central incisors (9.4%). The frequency of occurrence of CRGs recorded in this study was higher than that of some previous reports, although the possibility of sampling bias in collections of extracted teeth needs to be taken into account. The relatively high frequency of CRGs on the distal surface of maxillary lateral incisors has important clinical implications, as plaque accumulation and loss of gingival attachment in this region may lead to severe localized periodontal involvement.

For many years, research on tooth wear by dental academics has been diametrically opposite to that of anthropological research, with each discipline having a different understanding as to the nature of the wear processes. Dental focus revolved around preventive and restorative considerations while the anthropological focus was a biological understanding related to human evolution, diet, environment, form, and function and included all the craniofacial structures. Introducing the anthropological perspective into modern dentistry gives an insight into the “bigger picture” of the nature and extent of tooth wear. By combining anthropological evidence with clinical knowledge and experience, it is most likely to provide the best-informed and biologically based approach to the management of tooth wear in modern societies.

The increasing prevalence of gastroesophageal reflux disease (GERD) in children and adults, and of “silent refluxers” in particular, increases the responsibility of dentists to be alert to this potentially severe condition when observing unexplained instances of tooth erosion. Although gastroesophageal reflux is a normal physiologic occurrence, excessive gastric and duodenal regurgitation combined with a decrease in normal protective mechanisms, including an adequate production of saliva, may result in many esophageal and extraesophageal adverse conditions. Sleep-related GERD is particularly insidious as the supine position enhances the proximal migration of gastric contents, and normal saliva production is much reduced. Gastric acid will displace saliva easily from tooth surfaces, and proteolytic pepsin will remove protective dental pellicle. Though increasing evidence of associations between GERD and tooth erosion has been shown in both animal and human studies, relatively few clinical studies have been carried out under controlled trial conditions. Suspicion of an endogenous source of acid being associated with observed tooth erosion requires medical referral and management of the patient as the primary method for its prevention and control.