Search

Objectives: A priority research area in minimal intervention dentistry is the characterization of the early stages of dental erosion. The aim of this in vitro study was to assess the effect of short, repetitive erosive challenges to human enamel over 2 min at pH 1.5 and 3.0 under conditions simulating gastric regurgitation., Methods: Enamel surfaces were subjected to erosive challenges at pH 1.5 (Group 1, n=10) and pH 3.0 (Group 2, n=9) for periods of 30s (stage 1), 60s (stage 2) and 120 s (stage 3). Quantitative changes were assessed longitudinally by measuring the 3D average surface roughness (Sa) values using 3D confocal microscopy. Qualitative micrographic assessment of surface changes was also conducted by using environmental scanning electron microscopy., Results: Linear mixed model analysis showed significant effects of the pH values (p<0.001) and the stages (p<0.001) on the observed Sa values. Post hoc tests showed significant increases in the Sa values between baseline and other stages in both groups (p<0.01). The mean Sa values also increased significantly from stage 1 to stage 2 in Group 1 (p<0.05). Micrographic analysis displayed severely etched enamel rods in Group 1, but only subtle changes in Group 2., Conclusions: The complexity of the enamel surface is influenced by both acid concentration (pH value) and duration of acid exposure during early stages of erosion. Erosion occurring under conditions simulating GORD can be detected in its initial stages, opening up the possibilities of early diagnosis and management of this condition., Clinical Significance: Erosive tooth wear occurs progressively and insidiously, often creating complex treatment challenges. This emphasizes the need for early diagnosis and management in accordance with minimal intervention philosophy. Our findings provide a foundation for further research that could lead to the development of highly-sensitive clinical diagnostic tools and preventive strategies., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The Enamel Defects Index (EDI) was created based on three innovative principles: (i) a basic level of the three major categories of defects; (ii) more detailed subcategories of each major category; and (iii) each category scored independently as present [1] or absent [0], simplifying decision making. The aim of this investigation was to further test the index in a number of applications and to expand it to record defect subtype and treatment need. Testing was undertaken by operators with different levels of clinical experience. A computer-assisted learning (CAL) package was developed for operator training and calibration. The index was also used on clinical photographs and high-resolution digital images of exfoliated and extracted teeth. Scoring of photographs revealed substantial intra-operator agreement. Training using the CAL package resulted in significant improvement in index use. Intra-operator reproducibility was good to excellent, and interoperator reproducibility was good for buccal surfaces on digital images. Index expansion allowed information on defect subtype, location, and treatment need to be gathered readily. The EDI has high reproducibility and allows more rapid and accurate data collection from clinical and in vitro studies than the Fédération Dentaire Internationale Developmental Defects of Enamel index.

Mutations in human and in mouse orthologous genes Amelx and Enam result in a diverse range of enamel defects. In this study we aimed to investigate the phenotype-genotype correlation between the mutants and the wild-type controls in mouse models of amelogenesis imperfecta using novel measurement approaches. Ten hemi-mandibles and incisors were dissected from each group of AmelxWT, AmelxX/Y64H, AmelxY/Y64H, AmelxY64H/Y64H, and EnamWT, EnamRgsc395 heterozygous and EnamRgsc395 homozygous mice. Their macro-morphology, colour and micro-topography were assessed using bespoke 2D and 3D image analysis systems and customized colour and whiteness algorithms. The novel methods identified significant differences (p ≤ 0.05) between the Amelx groups for mandible and incisor size and enamel colour and between the Enam groups for incisor size and enamel colour. The AmelxWT mice had the largest mandibles and incisors, followed in descending order of size by the AmelxX/Y64H, AmelxY/Y64H and AmelxY64H/Y64H mice. Within the Enam groups the EnamWT incisors were largest and the EnamRgsc395 heterozygous mice were smallest. The effect on tooth morphology was also reflected by the severity of the enamel defects in the colour and whiteness assessment. Amelogenin affected mandible morphology and incisor enamel formation, while enamelin only affected incisors, supporting the multifunctional role of amelogenin. The enamelin mutation was associated with earlier forming enamel defects. The study supported the critical involvement of amelogenin and enamelin in enamel mineralization. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This study investigated hypoplastic enamel defects in a well-defined sample of Romano–Britons from the 3rd to the 5th century AD and compared the findings with a modern British sample investigated by the same authors. All 178 excavated skulls with intact dentitions were examined for hypoplastic defects using the Federation Dentaire International (FDI) Developmental Defects of Enamel Index criteria. Histopathological and microradiographic sections were prepared of 5 teeth. Hypoplastic defects were found in the teeth of 37% of skulls, with 25% having 4 or more teeth affected. The teeth most frequently involved were canines. Of the defects, 75% were horizontal grooves, 12.7% were pitting, and 7.1% were areas of missing enamel. The location of defects was 82% buccal, 16.5% lingual, and 1.2% occlusal. The reproducibility of diagnosis was 84%. Microscopic and microradiographic investigations showed areas of hypomineralization of enamel and wide zones of interglobular dentine related to the hypoplastic grooves. There was higher frequency, different morphology, and greater severity of hypoplastic enamel defects compared with the modern British sample. The defects may be related to repeated environmental stresses between the ages of 2 and 6 yr. Identified environmental stresses in these Romano–Britons, including high lead ingestion, poor nutrition, and recurrent infections, may be important etiological factors for the enamel defects. [ABSTRACT FROM AUTHOR]

Enamel hypoplasia is a quantitative defect of enamel thickness. Methods previously used for its measurement have limitations in clinical studies. The aim of this study was to investigate new methods of measurement using image analysis. Lesions on 8 teeth affected by enamel hypoplasia were quantified from study models and impression surfaces using an image-analysis system. The measurements made included lesion area and tooth surface area; from these the proportion of tooth surface area affected was calculated. For comparison, manual measurement was performed on impression surfaces and study models, using digital callipers. Images were also acquired of lesions on 12 exfoliated teeth, and the lesion area and total tooth area were calculated. For assessment of intra-operator reliability, the +/– repeatability coefficient was calculated. Measurement of the surface of lesions direct from the exfoliated teeth gave the best results overall, followed by direct image analysis of the silicone impression. [ABSTRACT FROM AUTHOR]

Mutations in the amelogenin gene, AMGX, are known to cause X-linked amelogenesis imperfecta (AIH1). We have used DNA single-strand conformational polymorphism analysis and DNA sequencing to diagnose this disorder unequivocally in two related boys aged 3 and 7 years, respectively, from a family in which an existing mutation in the amelogenin gene is segregating. [ABSTRACT FROM AUTHOR]

The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of dental development. The aim of this study was to investigate this relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls. Digital images of dental casts of the permanent dentition from 28 Romanian subjects with mild hypodontia and 28 controls were used. Measurements of the vestibular and occlusal surfaces were performed using a 2D image analysis method. Seven dimensions were measured (mesio-distal, occluso-gingival, bucco-lingual, vestibular perimeter, vestibular area, occlusal perimeter and occlusal area) and cusps on premolars and first molars were counted. Multivariate analysis of variance was performed using SPSS V17 software. The results showed teeth in the hypodontia group were smaller than those of controls, with many measurements being significantly different (significance values varied from p=0.048 to p=0.0001). Lower first incisors and upper first premolar teeth presented the most reduced dimensions. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were the most affected. Upper first molars presented the Carabelli trait in significantly less subjects in the hypodontia group than in controls. This variation was accompanied by a difference in tooth height. Lower premolars showed reduced cusp numbers in hypodontia subjects, accompanied by variation in tooth width or depth. In conclusion, this study demonstrated differences in multiple parameters of crown size and shape in patients with mild hypodontia compared to controls. The degree of these differences varied between different tooth types and dimensions. [ABSTRACT FROM AUTHOR]

Objectives: A priority research area in minimal intervention dentistry is the characterization of the early stages of dental erosion. The aim of this in vitro study was to assess the effect of short, repetitive erosive challenges to human enamel over 2 min at pH 1.5 and 3.0 under conditions simulating gastric regurgitation. Methods: Enamel surfaces were subjected to erosive challenges at pH 1.5 (Group 1, n = 10) and pH 3.0 (Group 2, n = 9) for periods of 30 s (stage 1), 60 s (stage 2) and 120 s (stage 3). Quantitative changes were assessed longitudinally by measuring the 3D average surface roughness (Sa) values using 3D confocal microscopy. Qualitative micrographic assessment of surface changes was also conducted by using environmental scanning electron microscopy. Results: Linear mixed model analysis showed significant effects of the pH values ( p < 0.001) and the stages (p < 0.001) on the observed Sa values. Post hoc tests showed significant increases in the Sa values between baseline and other stages in both groups (p < 0.01). The mean Sa values also increased significantly from stage 1 to stage 2 in Group 1 (p < 0.05). Micrographic analysis displayed severely etched enamel rods in Group 1, but only subtle changes in Group 2. Conclusions: The complexity of the enamel surface is influenced by both acid concentration (pH value) and duration of acid exposure during early stages of erosion. Erosion occurring under conditions simulating GORD can be detected in its initial stages, opening up the possibilities of early diagnosis and management of this condition. Clinical significance: Erosive tooth wear occurs progressively and insidiously, often creating complex treatment challenges. This emphasizes the need for early diagnosis and management in accordance with minimal intervention philosophy. Our findings provide a foundation for further research that could lead to the development of highlysensitive clinical diagnostic tools and preventive strategies. [ABSTRACT FROM AUTHOR]