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Background Erosive tooth wear has significant impacts on oral and general health. This study aimed to measure the awareness of dental erosion to establish the relationships among sociodemographic factors, awareness and knowledge of dental erosion, and beverage consumption behaviours, in a sample of university students in Australia. Methods All undergraduate students enrolled in the targeted programs at an Australian University were invited. A total of 418 students consented to participate. Each was assessed with an online questionnaire. Results The awareness rate of dental erosion was 92.1%. Soft drinks and fruit juice were most often perceived as acidic beverages by the respondents. The students of greater age, and studying pharmacy, paramedicine, physiotherapy or science, were less likely to be aware of dental erosion. Those students that were aware of dental erosion also had better knowledge of dental erosion, which was associated with a reduced quantity of daily acidic beverage consumption as well. The students that predominantly resided overseas had less knowledge of dental erosion. The students that were of greater age, that were studying clinical science, pharmacy, medical science, paramedicine, or science, and that correctly identified more types of acidic beverages, more often consumed acidic beverages in high-risk patterns. Conclusions Erosive tooth wear is a relevant matter in dentistry, nutrition and public health. Within a university setting, the effect of education on oral health literacy and beverage consumption behaviour is confirmed. Dental and health professionals should actively educate the individuals and communities about dental erosion and motivate them to change acidic beverage consumption behaviours.

Aim: The aim of this study was to evaluate the erosive potential of saliva on dental enamel sucking the acidic candies, and their effects on the pH, titratable acidity (TA) and buffering capacity (β) of saliva. Methodology: Human enamel specimens (n = 216) were randomly in 17 acidic candy groups and one negative control (paraffin wax) group. Three human volunteers sucked each candy for 5 min while spitting into a covered and chilled vial. The pH, TA and β were measured immediately after the saliva collection. For erosive challenge, each specimen was immersed in saliva at room temperature for 120 min without agitation. The erosion was measured by surface microhardness (SMH) tester and with 3D non-contact optical profilometer for depth of surface loos (DSL). Percentage of SMH change (%SMHC) was calculated. ANOVA followed by Tukey test and Pearson correlation were performed (α=0.05). Results: All candies lowered saliva pH below 5.5, and produced significant DSL (P

Introduction: Non-carious lesions are an oral health pro-blem in adults, consequently it is necessary to create mechanisms for their diagnosis and prevention. Objective: To determine the frequency of erosion, abrasion and related factors in patients treated at a university dental clinic. Material and Methods: A cross-sectional study was conducted in a sample of 153 adults treated at a university clinic in Lima, Peru, in 2018. Personal aspects (age, sex, characteristics of saliva), dietary factors, health condition, oral habits, and tooth brushing were identified. The presence of abrasion was determined according to clinical criteria through direct observation. Erosion was identified using the Basic Erosive Wear index. Generalized linear models with Poisson distribution with robust variances were used. Results: The frequency of dental abrasion (70.6%) is higher than erosion (26.1%). The presence of erosion is associated with asthma (PR= 2.11), abrasion is related to age and poor dental hygiene habits (PR= 1.67 and 1.30, respectively). Conclusion: The presence of dental abrasion is greater than dental erosion. Age and poor dental habits are factors associated with tooth abrasion. The characteristics of saliva regarding pH and salivary flow were within normal p-values.

Dentine hypersensitivity is defined as short, sharp pain from exposed dentin in reaction to thermal, evaporative, tactile, osmotic, or chemical stimuli. This condition is associated with non-carious cervical lesions (erosion, abrasion and abfraction), gingival recessions, periodontal disease, among other dental problems. Due to its multifactorial nature, the diagnosis of dentin hypersensitivity is often difficult and confusing for the dental surgeon. There is no single strategy that can solve this condition in all patients and it is the responsibility of the dental surgeon to know its characteristics in order to propose an effective treatment plan for patients. Therefore, this review aims to show the main characteristics of dentin hypersensitivity, as well as the challenges associated with clinical management, for understanding and mastery in clinical practice. La hipersensibilidad dentinaria se define como un dolor corto y agudo de la dentina expuesta como reacción a estímulos térmicos, evaporativos, táctiles, osmóticos o químicos. Esta condición normalmente está asociada a lesiones cervicales no cariosas (erosión, abrasión y abfracción), recesiones gingivales, enfermedad periodontal, entre otros problemas odontológicos. Por su naturaleza multifactorial, el diagnóstico de la hipersensibilidad dentinaria suele ser difícil y confuso para el cirujano dentista. No existe una estrategia única que pueda resolver esta condición en todos los pacientes y es de responsabilidad del cirujano dentista conocer sus características para proponer un plan de tratamiento eficaz para sus pacientes. Por tal motivo, la presente revisión tiene como objetivo mostrar las principales características de la hipersensibilidad dentinaria, así como los desafíos asociados a su manejo clínico, para su entendimiento y dominio en la práctica clínica.

Erosive tooth wear (ETW) refers to the chemical dissolution of mineralized tissues by acids of non-bacterial origin. It occurs in the primary as well as the permanent dentition. In this study, our objectives were to investigate and compare the impact of chlorhexidine gluconate (CHX), essential oils (EO), and cetylpyridinium chloride (CPC) on ETW protection produced by conventional fluoride kinds of toothpaste. A clinically relevant in-vitro erosion/abrasion pH cycling model was employed to test the effect of the aforementioned mouthwashes on modulating the ability of NaF and SnF2 types of toothpaste. The mean dentin surface loss associated with NaF toothpaste was significantly lower than for the SnF2 toothpaste. On the other hand, enamel surface loss with SnF2 toothpaste was significantly lower than for the NaF toothpaste. Also, the surface loss of erosion was significantly higher when associated with abrasion than without brushing and for both enamel and dentin. There was no significant difference in the surface loss among all types of mouthwash. Commonly used types of mouthwash containing antimicrobial agents or additional fluoride do not impact fluoride toothpaste action on erosion/abrasion. Also, considering erosion only, the tested SnF2 dentifrice provided better protection against surface loss of enamel than the other.

Background: Tooth wear is the loss of tooth structure from physical or chemical attack of nonbacterial origin. Predominant causative factor for tooth wear in primary dentition is erosion. This study was conducted to assess the prevalence of tooth wear and its associated factors in primary dentition.Methods: Analytical cross-sectional study was conducted after obtaining ethical approval among 425 children aged two to 12 years, enrolled in different preschools/schools located in Kathmandu valley. Informed consent from parents as well as assent from children were obtained. Oral examination for assessing tooth wear was done using Smith and Knight Tooth Wear Index. Self-administered questionnaires were sent to parents for considering the factors associated with tooth wear. Data were entered in Microsoft Excel Sheet and analysed in Statistical Package of Social Sciences. The chi-square/fisher’s exact test was done to establish the association between tooth wear and various factors.Results: Among total participants, 295 (69.4%) had tooth wear in at least one or more teeth. Tooth wear was seen significantly higher in children with increasing age (p

The effect of solutions and gels containing a sugarcane-derived cystatin (CaneCPI-5) on the protection against enamel and dentin erosion in vitro was evaluated. Bovine enamel and dentin specimens were divided into 2 groups (n = 135 and 153/group for enamel and dentin, respectively) that were treated with solutions or chitosan gels containing 0.1 or 0.25 mg/mL CaneCPI-5. The positive controls for solutions and gels were Elmex Erosion Protection™ solution and NaF gel (12,300 ppm F), respectively. Deionized water and chitosan gel served as controls, respectively. The solutions were first applied on the specimens for 1 min and the gels for 4 min. Stimulated saliva was collected from 3 donors and used to form a 2-h acquired pellicle on the specimens. Then, the specimens were submitted to an erosive pH cycling protocol 4 times/day for 7 days (0.1% citric acid pH 2.5/90 s, artificial saliva/2 h, and artificial saliva overnight). The solutions and gels were applied again during pH cycling, 2 times/day for 1 min and 4 min, respectively, after the first and last erosive challenges. Enamel and dentin losses (µm) were assessed by contact profilometry. Data were analyzed by 2-way ANOVA and Tukey’s test (p < 0.05). All the treatments significantly reduced enamel and dentin loss in comparison with controls. Both CaneCPI-5 concentrations had a similar protective effect against enamel erosion, but only the higher concentration was as effective against dentin erosion as the positive control. Regarding the vehicles, only the 0.1 mg/mL gel performed worse than the positive control for dentin. CaneCPI-5 reduced enamel and dentin erosion to a similar extent as the fluoride-containing vehicles. However, dentin requires higher CaneCPI-5 concentrations, in the case of gels. Solutions or gels containing CaneCPI-5 might be a new approach to protect against dental erosion.

Objective: As a preventive measure, tin (Sn2+)-containing products have a great potential to prevent enamel surface loss during erosive challenges, but adverse effects of high Sn2+ concentrations, such as astringent feeling of the teeth, are reported. Therefore, the main aim of this in vitro study was to develop a solution with lower Sn2+ concentrations that can still prevent dental erosion. Methods: A total of 162 enamel specimens were prepared from human premolars, which were selected from a pool of extracted teeth. The specimens were randomly distributed to 9 groups (each group n = 18 enamel specimens) according to the different test treatments: a humid chamber (no treatment) as the negative control, the commercial Elmex® Erosion Protection mouth rinse as the positive control, and 7 solutions either with lower Sn2+ concentrations and/or containing flavoring. The experiment included 4 cycles, consisting of pellicle formation by incubating the specimens with 200 μL of human saliva at 37°C for 1 h, then placing the specimens in the treatment for 2 min (60 mL, 30°C, shaking at 70 rpm), and later submitting them to an erosive challenge for 1 min in citric acid (60 mL 1%, pH 3.6, 30°C). Surface hardness was measured with a Vickers diamond and surface reflection intensity was measured with a reflectometer. Results: The control group performed significantly worse than all other solutions containing Sn2+. In general, there were no significant differences among the Sn2+-containing groups, and they presented similar protective effects on the enamel even when Sn2+ concentrations were reduced and flavorings were added. Conclusion: Sn2+ concentrations in mouth rinses may be lowered to 200 ppm without compromising the anti-erosive properties of the solution.

Objectives: To compare the prevalence of parafunctional habits, erosive tooth wear and occurrence of tooth injuries among children being under the care of Social Welfare Centre and children treated in the Department of Children’s Dentistry of the Medical University of Warsaw. Study design: The study contains environmental and medical interviews, record-based analysis and clinical examination. Parafunctional habits were rated on the base of dental interviews and clinical examinations. The occlusal surfaces were evaluated by visual examination using modified tooth wear index (TWI). Tooth injuries were reported from a medical interview labeled using Andreasen classification. The consent of the bioethics committee and guardians of children participated in the study was obtained. Results: The study involved 782 patients, including 404 children from dysfunctional families (average age 11,4 ± 3,7) and 378 from ordinary families-control group (8,53 ± 3,92). In the study group we observed higher prevalence of erosive tooth wear (44,66% vs 18,02% p=0,000), dental trauma (9,4% vs 3,44% p=0,001) and a presence of parafunctional habits (67,8% vs 20,4 % p=0,000). Conclusion: The occurrence of parafunctional habits, erosive tooth wear and tooth injuries may be an indicator of domestic violence and a component of maltreated child syndrome.

Background: The fluoride drug is mentioned as a double-edged weapon due to its positive and negative outcomes. Reducing dental caries in large population, cost effective and excess fluoride in teeth or body may lead to systemic diseases and even death. Dental erosion affects the hard tissues of the teeth rendering them vulnerable to decay. Methods & Materials: A school based descriptive cross-sectional survey. Purposive sampling was performed. All examiners were calibrated and trained for the criteria to identify dental fluorosis and dental erosion. The World Health Organisation Oral Health Assessment form 2013 was used to fill and measure dental fluorosis and erosive tooth wear. For Univariate analysis, mean, frequencies of both genders (dental erosion and Fluorosis) while Chi square was calculated and for bivariate analysis. Results: 22.7 % students were found to have fluorosis (ranging from questionable level to severe). Male students (primarily teenagers) had more enamel erosion as compared to the female’s ones. Conclusion: The higher levels of fluoride in water may make children and adults more susceptible to erosive tooth wear. Consuming excess fluoridated water may turn the mild fluorosis cases into moderate or severe ones. Keywords: Fluorosis, Erosive Tooth Wear, Gender, Fluoride

Objective The aim of the present study was to evaluate the effect of quercetin on the acid resistance of human dentin through both laboratory and clinical studies. Methods Two hundred and twelve dentin blocks (2 mm × 2 mm × 2 mm) were prepared and used. For the laboratory study, dentin specimens were randomly divided into 8 groups (n = 12): deionized water, ethanol, 1.23 × 104 μg/ml sodium fluoride (NaF), 120 μg/ml chlorhexidine, 183.2 μg/ml epigallocatechin gallate (EGCG), and 75 μg/ml, 150 μg/ml, and 300 μg/ml quercetin (Q75, Q150, and Q300). The specimens were treated with the respective solutions for 2 min and then subjected to in vitro erosion (4 cycles/d for 7 d). The surface microhardness loss (%SMHl), erosive dentin wear, and surface morphology were evaluated and compared. For the impact on MMP inhibition, the release of crosslinked carboxyterminal telopeptide of type I collagen (ICTP) and the thickness of the demineralized organic matrix (DOM) were measured using additional dentin specimens. For the clinical study, the specimens were treated with NaF or Q300 for 2 min and then subjected to in vivo erosion (4 cycles/d for 7 d). The %SMHl and erosive dentin wear of the specimens were measured to determine whether quercetin similarly inhibits erosion in situ. Results The quercetin-treated group had a significantly lower %SMHl and erosive dentin wear than any other group, and the effect was concentration-dependent in vitro (P Significance The application of quercetin was shown, for the first time, to increase the acid resistance of human dentin, possibly through MMP inhibition and DOM preservation.

Controversy exists regarding the effectiveness of delayed toothbrushing in decreasing erosive tooth wear (ETW). The purpose of this systematic review and meta-analysis was to assess the effects of delayed toothbrushing on ETW. This systematic review and meta-analysis was conducted according to the PRISMA statement and registered in PROSPERO (CRD42020200463). PubMed, Embase, and Web of Science databases were systematically searched with no publication year limits. Screening and data extraction were performed independently by two reviewers. In situ and in vitro studies comparing ETW after delayed and immediate toothbrushing following an erosive attack were included. Review Manager software 5.3 (The Cochrane Collaboration, Oxford, UK) was used for statistical analyses. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Of the 565 potentially relevant studies, 26 full-text articles were assessed for eligibility. Twelve articles were included in the systematic review, and 11 were included in the qualitative analyses. No significant difference in the ETW of human enamel was observed between delayed and immediate toothbrushing (P = 0.13), whereas significantly less ETW of bovine enamel was observed after delayed toothbrushing (P

Introdução: Nos estudos de prevalência em desgaste dental encontramos poucos trabalhos relacionados com adultos jovens. Objetivos: Explorar a associação de variáveis comportamentais, médicas e sociodemográficas com desgaste dentário em uma amostra de adultos jovens, utilizando uma versão modificada do índice Tooth Wear Index (TWI). Métodos: A amostra foi composta por 116 estudantes universitários de Odontologia, com média de 23.3 anos de idade, que responderam a um questionário relacionado às variáveis sociodemográficas, de autopercepção e comportamentais em saúde. Além disso, esses indivíduos foram submetidos a avaliação clínica do desgaste dental por um examinador treinado usando o TWI modificado por Smith e Knight. Regressão logística foi realizada em nível individual. Resultados: Um total de 9.906 superfícies dentárias em 116 indivíduos foram examinadas, 72,27% das superfícies não apresentavam desgaste dentário (grau 0), mas todos os indivíduos apresentavam pelo menos uma superfície desgastada. Dentre os indivíduos 78,4% apresentaram grau 1 (esmalte) como o nível mais alto e 21,6% grau 2 (dentina) como o mais alto. A presença de desgaste dentário de grau 2 foi principalmente prevalente nos seguintes indivíduos: sexo masculino; fumante; com bruxismo, e entre aqueles que relataram ter realizado tratamento ortodôntico. Analisando os fatores relevantes que afetam o desgaste dentário por análise de regressão múltipla, se verificou que tabagismo (OR = 6,67; IC 1,73-25,76) e bruxismo (OR = 4,05; IC 1,29-12,7) tiveram o maior efeito associado sobre o desgaste dentário. Conclusões: Nossos resultados sugerem que ser do sexo masculino, tabagista, relatar bruxismo e ter realizado tratamento ortodôntico prévio está associado ao desgaste dentário. Introduction: In studies on the prevalence of tooth wear, few publications related to young adults are found. Objectives: To explore the associations of behavioral, medical, and socio-demographic variables with prevalence and severity of tooth wear of the whole dentition, in a sample of young adults, using a modified version of the Tooth Wear Index (TWI). Methods: Sample consisted of 116 university dental students with an average age of 23 years, who answered a questionnaire related to sociodemographic variables, self-perception and health behaviors. In addition, individuals underwent a clinical evaluation of tooth wear by one trained examiner using the TWI modified by Smith and Knight. Logistic regression was carried out at individual level. Results: A total of 9,906 dental surfaces in 116 individuals were examined, 72.27 % dental surfaces had no tooth wear (grade 0), but all individuals had at least one worn surface. Among the individuals, 78,4 % had grade 1 (enamel) as the highest level and 21.6% grade 2 (dentin) as the highest level. The presence of grade 2 tooth wear was mainly prevalent in the following individuals: male; smoker; with bruxism, and among those who reported having undergone orthodontic treatment. Analyzing the relevant factors that affect tooth wear by multiple regression analysis, it was found that smoking (OR 6.67; IC 1.73- 25.76) and bruxism (grinding) (OR 4.05; IC 1.29- 12.7) had the greatest effect on tooth wear. Conclusions: Our results suggest that being male, being a current smoker, having grinding bruxism and having previous orthodontic treatment are associated with tooth wear.

Tooth-erosion is the surface loss of dental hard tissue mostly associated with an acid attack. The aim was to compare dentin and enamel erosion depth measurements using micro-computed tomography (microCT) and light microscopy (LM). Enamel/dentin blocks were prepared from caries-free human molar-teeth (N = 12). Teeth were sectioned to a rectangular shape of 4 × 4 × 6 mm. Specimens were treated with water (NC) or 1.0% citric-acid solution (PC). After treatment, specimens were scanned with micro-computed tomography. On completion, specimens were sectioned and observed under a light-microscope. Lesion depth was observed with 10× magnification and images transferred to Simpleware software. Vertical distance from lesion surface to bottom was measured. Pearson correlation test was used to evaluate correlation and Wilcoxon Signed Rank test to evaluate differences in the two-analysis methods. Mean enamel erosion depth was 0.63 and 38.38 μm (microCT) and 0.54 and 39.43 μm (LM) for NC and PC, respectively. Dentin erosion depth was 0.72 and 48.05 μm (microCT) and 0.56 and 49.92 μm (LM) for NC and PC, respectively. There was a significant correlation between the two-analysis methods (r = 0.998; p < .001). No statistically significant difference in results were obtained when microCT and LM were compared (p = .584). This results obtained from the current study suggested that erosion depth measurements made using microCT and LM yielded comparable results. The microCT method is preferred if the conservation of specimens is desired.

espanolObjetivo: Este estudio investigo el efecto de la erosion endogena sobre la microdureza de la dentina y una resina compuesta de nanorrelleno. Tambien se estudiaron los procedimientos para prevenir la erosion. Materiales andMetodos: 90 muestras de dentina bovina se dividieron en tres grupos de acuerdo con el metodo para prevenir: control negativo, aplicacion topica de fluoruro y barniz de ionomero de vidrio modificado con resina. Se distribuyeron 120 muestras de resina compuesta en cuatro grupos, que tambien incluian un sellador de resina, entre los procedimientos preventivos. Las muestras se dividieron al azar en tres subgrupos de acuerdo con la exposicion para simular la solucion de acido gastrico y la remineralizacion posterior: control negativo, 9 y 18 ciclos. El analisis de la superficie se realizo midiendo la dureza Knoop. Los datos obtenidos se analizaron estadisticamente mediante ANOVA de 2 vias y prueba de Tukey. Resultados: La dureza media de la dentina y de la resina de muestras compuestas exhibio una dureza mas baja despues de 18 ciclos. Sin embargo, el barniz de ionomero de vidrio modificado con resina resulto en valores mayores en comparacion con los otros procedimientos preventivos.Conclusion: Un barniz de ionomero de vidrio modificado con resina parece ser un metodo prometedor para minimizar el dano causado por el acido endogeno, pero su proteccion puede reducirse dependiendo de la intensidad del desafio erosivo. EnglishObjective: This study investigated the effect of endogenous erosion on the microhardness of dentine and a nanofilled composite resin. Procedures for preventing erosion were also studied. Materials and Methods:90 bovine dentine specimens were divided into three groups in accordance with the method for preventing: negative control, topical application of fluoride and resin-modified glass ionomer varnish. 120 composite resin specimens were distributed into four groups, which also included a resin sealant, among the preventive procedures. Specimens were then randomly divided into three sub-groups according to the exposure to simulate gastric acid solution and subsequent remineralization: negative control, 9 and 18 cycles. Surface analysis was carried out by measuring the Knoop hardness. The data obtained were statistically analyzed using 2-way ANOVA and Tukey test. Result: The mean hardness of dentine and of the composite specimens resin exhibited lower hardness after 18 cycles. However, the resin-modified glass ionomer varnish resulted in greater values compared to the other preventive procedures. Conclusion: A resin-modified glass ionomer varnish seems to be a promising method for minimizing the damage caused by endogenous acid, but its protection can be reduced depending on the intensity of the erosive challenge.

The aim of this study was to compare the effects of a single application of a new calcium mesoporous silica nanoparticle (Ca2+-MSN) versus other calcium and/or fluoride products against dental erosion. Enamel blocks were half-covered and assigned to six groups (n = 10): Ca2+-MSNs; casein phosphopeptide-amorphous calcium phosphate mousse (CPP-ACP); CPP-ACP/F− (900 ppm F−); titanium tetrafluoride (TiF4 1%); sodium fluoride (NaF 1.36%); and Milli-Q® water (negative control). A single application for each product was completed on the exposed areas of the blocks and were submitted to an erosive challenge. Differences in volumetric roughness (Sa), and tooth structure loss (TSL) by use of three-dimensional noncontact optical profilometry were evaluate. Scanning electron microscopy (SEM) was performed. Analysis of variance and Tukey’s test for Sa and the Kruskal-Wallis and Mann-Whitney U tests (p< 0.05) for TSL, respectively. Results: When evaluating Sa, all products presented differences in roughness when compared with the control group (p< 0.05) but not with each other (p > 0.05). However, when analyzing the TSL, it was observed that Ca2+-MSNs, TiF4, and NaF were more effective in preventing dental erosion versus CPP-ACP, CPP-ACP/F−, and Milli-Q® water (p< 0.05). In the SEM images, the negative control presented the worst loss of dental structure, with more porous enamel. Ca2+-MSNs were as effective as TiF4 and NaF to reduce the tooth structure loss.

In the investigation the assessment of the distribution of the elementary composition in the superficial layers of the tooth enamel in the field of erosion was held using XRF analysis. The results showed the increased content of Zn, S, Cl, K and Sr. And its maximum appeared in the middle of the erosion. Besides that in the investigation the assessment of the qualitative changes in the elementary composition of the tooth enamel in the field of erosion was held using XRF analysis. It showed that in the field of erosion the content of phosphorus decreases more intensively in comparison with calcium and, as a result, Са/Р increases.

Objectives: Tooth surface loss (TSL) or tooth wear (TW) is an irreversible loss of hard tooth structure caused by factors other than those responsible for dental caries. TSL is observed clinically as attrition, abrasion, abfraction, and erosion. It may be associated with symptoms such as tooth hypersensitivity and function impairment, and may lead to change in the morphology of the affected tooth. However, it may also be asymptomatic, meaning the patient may not be aware of it. In this instance, the dentist is encouraged to make the patient aware of this issue.The aim of this review is to provide an overview of the classification and management of TSL. Material and methods: The PubMed (MEDLINE) search engine was used to gather the most recent information on TSL. The search was restricted to a five year period (1 September 2014–31 August 2019), and only English-language studies were included. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: (Tooth surface loss OR tooth wear) AND (tooth attrition OR tooth Abrasion OR tooth erosion OR tooth abfraction OR non-carious cervical lesions) AND (humans). Studies were also obtained by manual searches and from Google Scholar. Results: By this process, 560 articles and studies were obtained. More studies were also obtained by manual searches and from Google Scholar. The most relevant published studies were chosen and used in the current review. The selected articles are included in the reference list. Conclusion: TSL is a clinical problem that dentists face on a daily basis. Therefore, a sound clinical approach by which TSL can be prevented and managed is essential. While this approach requires that dentists are knowledgeable about the issue, increasing public awareness of TSL is also vital. Keywords: Tooth surface loss, Tooth wear, Non-carious cervical lesions, Carbonated drink, Gastro-oesophageal regurgitation

vomiting, which in long term can result in irreversible loss of dental tissue, most commonly manifested as dental erosion. Frequent purging, xerostomia, lack of oral hygiene and acidic environment are also suitable for caries development. The aim of the research was to determine the presence, localization and degree of dental erosion using Basic Erosive Wear Examination (BEWE) index system, as well as to determine the Decayed, Missing and Filled Teeth (DMFT) index in purging bulimic patients. Methods. The study involved 30 purging bulimic patients and 30 healthy subjects. Used methods were survey (questionnaire) and clinical examination. The clinical examination included intraoral inspection and assessment of dental status using BEWE and DMFT index. Results. On the bases of conducted research, it has been found that dental erosion are significantly more often present in purging bulimics compared to the controls (?2 = 5.963, p < 0.05), that eroded lesions are more severe in the bulimic group (t = 3.925, p < 0.05) and predominantly located on oral surfaces of the teeth (?2 = 10.561, p < 0.05). DMFT index values showed no significant difference between bulimic patients and controls (t = 0.741, p = 0.461). Conclusion. Dental erosion are often encountered in patients suffering purging bulimia, especially on oral surfaces of anterior teeth that come into direct contact with gastric acid, so many bulimics exhibit high values of erosive tooth wear on mentioned surfaces. DMFT index score did not show significant differences compared to healthy participants, but due to complexity of carious process further investigation is necessary.

Made available in DSpace on 2020-12-12T02:34:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 This in vitro study evaluated the protective effect of fluoride varnishes containing sodium trimetaphosphate (TMP) against dentin erosion and abrasion. Specimens of coronal dentin were divided into: Placebo, 2.5% NaF, 5% NaF, 2.5% NaF + 5% TMP, and 5% NaF + 5% TMP groups (n =24/group). After single application of the varnishes, the samples were immersed in citric acid (0.05 mol/L, pH = 3.2, 5 min) followed or not by brushing, and the dentin wear was assessed after 5 days. Varnishes containing fluoride + TMP led to the lowest wear. TMP varnishes showed a superior effect against dentin erosive wear. Department of Pediatric Dentistry and Public Health School of Dentistry Sao Paulo State University (UNESP), Rua Jose Bonifacio 1193 Centro de Ensino Superior Rezende and Potrich FAMA-Faculdade Mineirense Mineiros Department of Pediatric Dentistry and Public Health School of Dentistry Sao Paulo State University (UNESP), Rua Jose Bonifacio 1193

Dental erosive wear is a multifactorial condition of high prevalence. Nowadays, there is an emphasis on discovering individual genetic predisposition for the development of this condition. Aquaporins (AQPs) are water channel proteins expressed in salivary glands, as well as during tooth development. They are involved in salivary secretion and composition and linked to physiological protection of the oral cavity. The aim of this study was to explore the relationship between different dental erosive wear phenotypes, AQP genes, and selected environmental factors. Data from 705 dental patients were used to investigate the association between dental erosive wear phenotypes and AQPs’ single-nucleotide variants. Phenotypes were further analyzed considering diet and oral hygiene data, using logistic regression analysis, as implemented in PLINK, with the assumption that dental erosive wear is a complex gene-environment model. Associations were found between severe erosive tooth wear and rs2878771 (AQP2) for the genotypic (p = 0.02) and dominant (p = 0.03) models, and rs3736309 (AQP5) for the allelic model (p = 0.02). Logistic regression analyses, after implementing the Bonferroni correction, showed that several significant associations were present when covariates were included, suggesting that a strong environmental component is present. Our results show that dental erosive wear establishes under a gene-environmental complex model.

Assessing the influence of socio-economic characteristics, acid drinking patterns and gastric alterations considering erosive tooth experience in children. Cross-sectional study to assess 08–10-year-old children enrolled in the primary education in public schools in Florianopolis, Brazil (n = 1085). Caregivers have answered questionnaires comprising independent variables (head of the household education frequency consumption of sports drinks, acid juice/soda, chewing gum, recurrent vomiting, gastric disorders and vomiting after overeating). Four trained dental surgeons have examined the children for the erosive tooth wear-dependent variable (O’Sullivan index), as well as collected dental caries (DMFT) and dental crowding (DAI index) information. A two-stage cluster-sampling plan was conducted. Unadjusted and adjusted logistic regression models were applied (Odds ratio, OR; 95% Confidence interval, CI and 5% significance level). The prevalence of erosive tooth wear was 15.67%. Erosive tooth wear was positively associated with high consumption of sports drinks (OR 3.42; 95% CI: 1.18–9.23). Children whose caregivers’ educational level was equal or less than four years of study were less likely to have erosive tooth wear (OR 0.39; 95% CI: 0.17–0.88). High consumption of sports drinks is positively associated with erosive tooth wear. Children whose caregivers’ educational level is low are less likely to present erosive tooth wear.

Background: Dental erosion is a form of tooth wear which occurs as a result of dissolution of dental hard tissues caused by acids of non-bacterial origin. Erosion can occur due to intrinsic acids (within the body) or extrinsic acids (dietary intake). Erosive lesion due dietary or gastric acids forms smooth lesions which typically appear as cupped occlusal/ incisal and concave buccal/facial surfaces Objective: The objective of this study was to evaluate the prevalence of dental erosion among undergraduate dental students in various dental colleges of Pakistan. Material and Method: This study was conducted at Institute of Dentistry, Combined Military Hospital Lahore Medical College, Fatima Memorial Hospital College of Dentistry, Lahore and Sardar Begum Dental College, Peshawar. Sample size calculated was 330 and data was collected over a period of two years. Signs for erosive lesion were observed during clinical examination. Lesions graded according to Basic erosive wear examination (B.E.W.E.) index and reported. Results: A sample of 330 dental students is taken with the mean age 21.62 ± 1.17 years. There were 107 (32.4%) male and 223 (67.6%) female students in the sample. Prevalence of the erosion in the dental students was 14.8% (49/330). Conclusion: 107 (32.4%) male and 223 (67.6%) female undergraduate dental students were examined for dental erosion .The frequency of dental erosion among dental students was reported to be 14.8%.

Purpose Acids contained in foods and drinks are involved in the initiation and progression of dental erosion which causes tooth wear. The authors evaluated the neutralizing activity of alkaline electrolyzed water (AEW) in vitro and in vivo. Methods The neutralizing ability of AEW against eight beverages was investigated in vitro. Furthermore, in an in vivo study, the effect of mouth rinsing with AEW on the pH of the oral cavity acidified with acidic beverages was examined. Following mouth rinsing, the oral pH was measured using a pH meter with a micro pH-sensor at the cervical surface of the mandibular teeth and the surface of soft tissues. Results Regarding the neutralizing ability, the higher the pH of the AEW, the lower the volume required for neutralization of the tooth surface. Changes in the pH by mouth rinsing with AEW and purified tap water (PTW) were analyzed. The degree of increase of pH with AEW was greater than with PTW at almost all sites. Conclusion These results suggest that AEW has the potential to prevent the initiation and progression of dental erosion. Mouth rinsing with AEW could be a simple and effective way to prevent the initiation and progression of dental erosion and dental caries.

Hypselodont (ever-growing) teeth of lagomorphs or rodents have higher wear rates (of a magnitude of mm/week), with compensating growth rates, compared to the non-ever-growing teeth of ungulates (with a magnitude of mm/year). Whether this is due to a fundamental difference in enamel hardness has not been investigated so far. We prepared enamel samples (n = 120 per species) from incisors of cattle (Bos primigenius taurus) and nutria (Myocastor coypus, hypselodont incisors) taken at slaughterhouses, and submitted them to indentation hardness testing. Subsequently, samples were split into 4 groups per species (n = 24 per species and group) that were assessed for abrasion susceptibility by a standardized brush test with a control (no added abrasives) and three treatment groups (using fine silt at 4 ±1 μm particle size, volcanic ash at 96 ±9 μm, or fine sand at 166 ±15 μm as abrasives), in which enamel abrasion was quantified as height loss by before-and-after profilometry. The difference in enamel hardness between the species was highly significant, with nutria enamel achieving 78% of the hardness of cattle enamel. In the control and the fine sand group, no enamel height loss was evident, which was attributed to thein vitrosystem in the latter group, where the sand particles were brushed out of the test slurry by the brushes’ bristles. For fine silt and volcanic ash, nutria enamel significantly lost 3.65 and 3.52 times more height than cattle. These results suggest a relationship between enamel hardness and susceptibility to abrasion. However, neither the pattern within the species nor across the species indicated a monotonous relationship between hardness and height loss; rather, the difference was due to qualitative step related to species. Hence, additional factors not measured in this study must be responsible for the differences in the enamel’s susceptibility to abrasion. While thein vitrobrush system cannot be used to rank abrasive test substances in terms of their abrasiveness, it can differentiate abrasion susceptibility in dental tissue of different animal species. The results caution against considering enamel wear as a similar process across mammals.

The effects of deproteinization using sodium hypochlorite (NaOCl) and the subsequent application of an antioxidant (sodium p-toluenesulfinate, STS) onto the bonding durability of universal adhesives on eroded dentin were investigated. Untreated sound dentin served as the control, whereas eroded dentin, which had been prepared by pH-cycling in 1% citric acid and a remineralization solution, was either untreated, deproteinized with a 10% NaOCl gel or deproteinized with the 10% NaOCl gel and subsequently treated with an STS-containing agent. The dentin surfaces were bonded using a universal adhesive (Clearfil Universal Bond Quick, Scotchbond Universal or G-Premio Bond), and the micro-tensile bond strength (µTBS) test was performed after 24 h or 10,000 thermal cycles. The µTBS data were statistically analyzed using a three-way ANOVA and Tukey’s HSD post hoc tests. The lowest µTBS was measured on untreated eroded dentin (p &lt, 0.001). Deproteinization of eroded dentin resulted in µTBS similar to untreated sound dentin (p &gt, 0.05), but the highest µTBS was obtained if deproteinization was followed by the application of STS. Thermocycling significantly decreased µTBS in all groups (p &lt, 0.001), except for STS-treated, deproteinized, eroded dentin (p &gt, 0.05). This indicated that deproteinization, followed by the application of STS, could enhance the bonding durability of universal adhesives on eroded dentin.

OBJECTIVE This article describes a digital workflow using virtual enamel evaluation and a stereolithographic template for accurate tooth preparation for a complex exogenous dental erosion. CLINICAL CONSIDERATIONS A 22-year-old man with different degrees of defects on the labial surface in esthetic area was diagnosed as exogenous dental erosion. The residual undamaged enamel area and depth of defect were measured and analyzed accurately by creating a digital virtual patient based on the pretreatment data. According to the different conditions of residual enamel and tooth defect, the treatment plans of porcelain veneer, crown and composite resin were chosen for corresponding involved teeth. Based on the virtual wax-up and the suggested material thickness, a template for tooth preparation was designed and three-dimensional printed. This template together with a special bur indicating the reduction depth accurately guided the teeth preparation and achieved a long-term effect. CONCLUSIONS The virtual enamel evaluation contributes to obtaining the appropriate corresponding treatment plan objectively. The stereolithographic template effectively meets the accuracy of tooth preparation, preserving the tooth hard tissue to the greatest extent. CLINICAL SIGNIFICANCE The digital workflow described here may provide a quantifiable evaluation method and an accurate tooth preparation method for exogenous dental erosion.

The prevention and treatment of erosive tooth wear are becoming increasingly important due to its increasing prevalence. The use of natural solutions to modify dental surfaces has become an area of research. Organic materials such as chitosan and hydrolyzed collagen may be a promising option to treat dentin. This in vitro study aimed to evaluate the influence of chitosan or hydrolyzed collagen, alone or combined with acidulated phosphate fluoride (APF) gel, on the composition and morphology of dentin after erosion. Bovine dentin samples were prepared (n = 84) and treated with artificial saliva (AS, negative control); APF gel (F, positive control); chitosan solution (Chi); hydrolyzed collagen solution (Col); fluoride/chitosan composition (F_Chi); and fluoride/hydrolyzed collagen composition (F_Col). Erosive cycles (six cycles of immersion in orange juice for 1 min, followed by immersion in AS for 1 hr) were performed. The materials were characterized by their morphology, composition, and particle size distribution. Micro-energy dispersive X-ray fluorescence spectroscopy and scanning electron were used to evaluate the dentin's inorganic chemical composition and morphology. The F_Col and F groups had a reduction in calcium loss by 17 and 26%, respectively (p

Made available in DSpace on 2022-04-29T08:35:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 OBJECTIVE: To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin. METHODOLOGY: Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva - 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO4/MFP (Regenerate-Unilever), and Si/PO4/MFP/BS (Si/PO4/MFP with dual BS - Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%). RESULTS: For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO4/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness. CONCLUSION: The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW. Universidade de Taubaté - UNITAU Departamento de Odontologia Restauradora Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Odontologia Restauradora Universidade de São Paulo Faculdade de Odontologia - FOUSP Departamento de Odontologia Restauradora Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Odontologia Restauradora

Background: Dental erosion is a disease that causes an irreversible loss of the dental hard tissue due to acids without the involvement of bacteria. During the past decade a rising tendency of the studies about dental erosion has been observed. Objectives: The aim of the present study was to describe the current trends in published scientific articles related to dental erosion between 2011-2020. Data of the authors, year and language of publication were analyzed.Material and methods: A bibliometric analysis of the articles published in Pubmed was conducted using the terms TS (dental erosion) and TS (tooth erosion) using Boolean operator AND. A sample of n=1090 articles published during the past ten years (2011-2020) was obtained. The variables analyzed were the language of the article, the year of publishing, the number of authors, the affiliations of the first and last author and the relationship between them. Results: The ranking of countries of origin of the first and last author according to the number of publications, led by Brazil, UK, and USA. When analyzing the type of article, it is observed that 79,4% of all publications belong respond to research articles. Conclusions: The main findings in this article will help to analyze the scientific results related to dental erosion, to evaluate the management strategies needed and to identify relevant issues which need to be addressed that will lead to future studies. Keywords: Bibliometric, Citation analysis, Almetrics, dental erosion, tooth erosion.

Objective The purpose of the present study was to assess the anti-erosive potential of the acquired enamel pellicle formed in situ under the influence of periodic milk or cream treatment. Methods The pellicle was formed on bovine enamel specimens in the oral cavity at buccal and palatal sites of upper molars in 6 subjects, using removable acrylic splints. During 6-h of intraoral exposure, splints were removed from the oral cavity every 25 min, treated with milk or cream for 5 min, and subsequently re-inserted into the oral cavity. After 6 h, pellicle covered specimens were immersed in citric acid (0.1 or 1.0 %) for 1 min, and processed for measurement of surface microhardness, determination of calcium release by atomic absorption spectroscopy, scanning and transmission electron microscopy. Statistical analysis was performed with SAS. Results Statistical analysis did not indicate major differences between erosive surface alterations on enamel specimens covered by pellicles treated with cream or milk, and those covered by control pellicles. In addition, TEM analysis did not reveal any differences concerning the ultrastructure of the different pellicle treatments during acid exposure. All pellicles were dissolved in part after exposure to 0.1 % citric acid and were nearly completely removed after treatment with 1.0% citric acid. Conclusions It is concluded that periodic treatment with milk or cream during pellicle formation in situ does not improve the protective potential of the acquired enamel pellicle against erosion. Clinical significance Modification of the pellicle by consumption of milk or cream prior to an acidic challenge cannot sufficiently protect enamel from erosion.

Made available in DSpace on 2022-05-01T06:02:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-01 This study aimed to formulate a hybrid coating material (HC) and to modify this HC with fluoride (NaF) and stannous (SnCl2) ions, directly or encapsulated in nano containers, testing the effects of these materials against dental erosion and erosion–abrasion. Enamel and dentin specimens were treated with the HCs, and then tested in erosion or erosion–abrasion cycling models of 5 days (n = 10 for each substrate, for each model). Deionized water was the negative control, and a fluoride varnish, the positive control. Surface loss (SL, in µm) was evaluated with an optical profilometer, and data were statistically analyzed (α = 0.05). For enamel, in erosion, the positive control and HC without additives showed significantly lower SL than the negative control (p = 0.003 and p = 0.001). In erosion–abrasion, none of the groups differed from the negative control (p > 0.05). For dentin, in erosion, the positive control, HC without additives, HC with non-encapsulated F, and HC with encapsulated F + Sn showed lower SL than the negative control (p < 0.05). In erosion–abrasion, none of the groups differed significantly from the negative control (p < 0.05). HC without additives showed a promising potential for protecting the teeth against dental erosion (with upward trend for improved protection on dentin), but not against erosion–abrasion. The presence of additives did not improve the protective effect of the HC, on both substrates. [Figure not available: see fulltext.] Department of Restorative Dentistry University of São Paulo School of Dentistry Department of Chemical Engineering Polytechnic School São Paulo University—USP Department of Restorative Dentistry Institute of Science and Technology São Paulo State University—UNESP Department of Cariology Operative Dentistry and Dental Public Health Indiana University School of Dentistry Department of Restorative Dentistry Institute of Science and Technology São Paulo State University—UNESP

Dental erosion is the progressive loss of the dental structure associated with acids of non-bacterial origin and with irreversible effects. The consumption of beverages and foods with high acid content corresponds to the main extrinsic factor of dental erosion, while the endogenous acids that project into the mouth through the esophagus during vomiting or regurgitation are part of the intrinsic factors that contribute to this injury. The prevention and treatment of eroded teeth are real challenges in dental practice. Therefore, this article aims to collect information available in the current literature on the etiology, clinical characteristics and treatment of erosive dental wear, to provide a practical guide for dental surgeons and students. La erosión dental se define como la pérdida progresiva de la estructura dental asociada a ácidos de origen no bacteriano y con efectos irreversibles. El consumo de bebidas y alimentos con alto contenido ácido corresponde al principal factor contribuyente extrínseco para la erosión dental, mientras que los ácidos endógenos que se proyectan, a través del esófago, en la boca, durante el vómito o regurgitación, forman parte de los factores intrínsecos que contribuyen con esta lesión. La prevención y tratamiento de dientes erosionados constituyen verdaderos desafíos en la práctica odontológica. Por tal motivo, el presente artículo tiene como objetivo recopilar información disponible en la literatura actual sobre la etiología, características clínicas y tratamiento del desgaste dental erosivo, para brindar una guía práctica dirigida a cirujanos dentistas y estudiantes.

Background Tooth wear has been recognised as a growing oral health problem in children and adolescents, with erosion often cited as the main cause of the tooth wear. Most studies on tooth wear have been conducted on children and adolescents, and only few studies focus on adults. Our aim was to study the prevalence of different types of tooth wear in an adult population and investigate related factors to tooth wear. Methods A total of 831 adults in Sweden participated in the study by completing a questionnaire about oral health, a clinical examination, saliva sample and intraoral photographs. Tooth wear was estimated according to the Basic Erosive Wear Examination index, and the aetiology was determined based on the clinical appearance. Results Almost 80% of the individuals had signs of erosion, and over 90% had signs of attrition. A high level of tooth wear was found in 4.6% of the individuals, few of who reported having received information about both attrition and erosion. Significantly, more men had tooth wear. Daily consumption of fruit had a stronger correlation to tooth wear than acidic drinks. Discussion & conclusion A high level of tooth wear was found in 4.6% of the individuals, and it was more common in men than women. Aside from attrition, tooth wear due to erosion was a frequent finding in adults. Only a few of the individuals with a high level of tooth wear reported to have received information about tooth wear from their dentist or dental hygienist.

To investigate the effect of toothpastes on dentine surface loss and tubule occlusion, and the association of toothpaste-related factors to each of the outcomes. One hundred and sixty human dentine specimens were randomly distributed into 10 groups, according to different toothpastes. The specimens were submitted to artificial saliva (60 min), citric acid (3 min), and brushing abrasion (25 s; totalizing 2 min in toothpaste slurries). This was repeated five times and two outcome variables were analyzed: dentine surface loss (dSL; μm) and tubule occlusion by measurement of the total area of open tubules (Area-OT; μm2). Data were analyzed with Kruskal-Wallis and Mann-Whitney tests (α = 0.05); bivariate and multivariate regressions were used to model the association of the chemical (pH, concentration of F−, Ca2+, and PO43− and presence of Sn2+) and physical (% weight of solid particles, particle size, and wettability) factors of the toothpastes to both outcome variables. Toothpastes caused different degrees of dSL and did not differ in Area-OT. All chemical and physical factors, except the presence of Sn2+, were associated with dSL (p

Background The paradigm shift obtained with new dental materials permits minimally invasive dentistry, by following a biomimetic approach. Erosion increasingly affects the adult population through dental substance loss by acid attack. Oral rehabilitation is often extensive and requires careful mouth examination and treatments codified in the literature. Case presentation This clinical report proposes a reasoned approach to erosion treatment for a 39-year-old male patient presenting several old fixed prostheses. These old restorations are all of correct quality and are retained. The temporomandibular joint was free from disorder. Only defective reconstructions are remade together with eroded teeth, according to a three-step technical protocol. In the first step, mock-up manufacturing is performed which occlusal vertical dimension increased to 1 mm provoking passive dental overeruption to the second and third molars. In all, one ceramic crown was remade, and two ceramic onlays and a resin composite were integrated on the posterior teeth. The last step consisted of palatal veneers on the maxillary incisor and canine, and an aesthetic resin composite on the incisor edge. After these treatments, regular assessments were carried out at 4 months then at 6 months with visual, photographic and radiographic examinations. Conclusion The present dental care philosophy is to preserve dental tissue as much as possible, even in large erosion cases, and to respond to the aesthetic and functional expectations of the patient. This methodology requires a thorough evaluation phase, compliance with the protocol and regular patient follow-up.

The wear on the occlusal surfaces of male babirusa cheek teeth was evaluated in 53 skulls of Babyrousa babyrussa from Buru and the Sula Islands and 87 skulls of B. celebensis from Sulawesi, Indonesia. Based on the comparative lengths of their continually growing maxillary canine teeth, the skulls were divided into five ‘age categories’ (A–E). Numerical and symbolic codes representing tooth wear were applied to each pillar (cusp region) of the mandibular and maxillary permanent third and fourth premolar teeth, and the first, second and third permanent molar teeth. There was no significant difference between the tooth wear patters of skulls in groups A and B, or in groups C and D, and so these were amalgamated. There was close correspondence in wear patterns between each side of the mouth in both species and in each age group. The wear patterns of the mandibular and maxillary teeth, although not identical, were very similar, as were the wear patterns of both species. In group A + B for both species tooth wear was relatively slight, with the M1 teeth experiencing most relative wear. There was almost no wear of the M3 teeth. In group C + D substantial wear of upper and lower M1 was evident. In group E more widespread wear of the cheek teeth was seen, with increased severity of M1 tooth wear, yet there was comparatively much less M2 and M3 tooth wear. The pattern of cheek tooth wear of the Babyrousa spp. was different from that shown by Sus scrofa. Differences in diet selection and processing were highlighted as potential contributing factors. The pattern of cheek tooth wear in male babirusa was not adequate for use to monitor their age.

Background: The aim of the study was to evaluate the prevalence and severity of erosive tooth wear (ETW) and its association with dental caries and the use of psychoactive substances among Finnish prisoners. Methods: One hundred voluntary prisoners (90.9%) from the Pelso Prison participated in this cross-sectional clinical study between September 2014 and February 2015. Fifty prisoners were also interviewed using the one-on-one interviewing technique for their background factors and use of psychoactive substances. Basic Erosive Index (BEWE) (0–18) was used to measure erosive tooth wear. Decayed (D), missing (M), filled (F) and the number of remaining teeth (T) and DMFT were reported. The association between the different variables was tested and analysed by using cross tabulation. To test the association between the variables a logistic regression analysis was conducted. Results: Almost all (90%) of the subjects had need for preventive and operative treatment for ETW. In addition, one in five (19%) suffered from severe erosive tooth wear. The use of psychoactive substances and pharmaceuticals is common, yet no association with ETW was found. Smoking and alcohol consumption were more common among younger prisoners than the older ones. There is an increased risk for ETW among older prisoners and major alcohol consumers. Past caries experience was associated with dental erosion. Conclusions: Erosive tooth wear is common among Finnish prisoners in their thirties. ETW is associated with dental caries and daily alcohol consumption.

Microenergy dispersive X-ray fluorescence (μ-EDXRF) spectroscopy and scanning electron microscopy (SEM) were used to test the hypothesis that zirconia modified glass ionomer cement (GIC) could improve resistance to erosion-abrasion to a greater extent than conventional cement. Bovine enamel (n = 40) and dentin (n = 40) samples were prepared with cavities, filled with one of the two restorative materials (GIC: glass-ionomer cement or ZrGIC: zirconia-modified GIC). Furthermore, the samples were treated with abrasion-saliva (AS) or abrasion-erosion cycles (AE). Erosive cycles (immersion in orange juice, three times/day for a duration of 1 min over a 5 day period) and/or abrasive challenges (electric toothbrush, three times/day for a duration of 1 min over a 5 day period) were performed. Positive mineral variation (MV%) on the enamel after erosion-abrasion was observed for both materials (p < 0.05), whereas a negative MV% on the dentin was observed for both materials and treatments (p < 0.05). The SEM images showed clear enamel loss after erosion-abrasion treatment and material degradation was greater in GIC_AE compared to those of the other groups. Toothbrush abrasion showed a synergistic effect with erosion on substance loss of bovine enamel, dentin, GIC, and ZrGIC restorations. Zirconia addition to the GIC powder improved the resistance to abrasive-erosive processes. The ZrGIC materials may find application as a restorative material due to improved resistance as well as in temporary restorations and fissure sealants.

This study aimed to analyse if the erosion-protective potential of the salivary pellicle is different between female and male subjects. Bovine enamel and dentin specimens (each n = 3) were exposed to the oral cavity of healthy female or male volunteers (each n = 25, females: 25.8 ± 3.5 years, males: 26.7 ± 4.0 years) for 120 min to form a salivary pellicle. Subsequently, each 2 enamel and 2 dentin specimens were eroded with hydrochloric acid (pH 2.6, 60 s). Specimens of the control group (each n = 30) were eroded without presenting a salivary pellicle. Calcium release into the acid was determined photometrically. Additionally, total protein content in the pellicle (each n = 1 enamel and dentin specimen/volunteer) and different salivary parameters (flow rate, pH, buffer capacity, protein, albumin, calcium, phosphate, fluoride) were assessed. Statistical analyses were performed by one-way ANOVA, t tests, multiple linear regressions and Pearson correlations (p < 0.05). The erosion-protective capacity was not significantly different among female (calcium release [% of control]: enamel: 82.6 ± 28.1, dentin: 80.7 ± 24.0) and male (enamel: 76.0 ± 27.5, dentin: 87.1 ± 34.9) subjects. The protein content of the pellicle was not different between female and male subjects. The protein content and pH of unstimulated saliva were significantly reduced in female compared to male volunteers. Calcium release was neither correlated with the protein content of the salivary pellicle nor with salivary parameters. Under the conditions of the present study, the erosion-protective capacity of the salivary pellicle of female and male subjects is not different.

Background: Professional swimmers face a hidden occupational hazard due to improper maintenance of pool. Ill maintained pools can lead to erosive effects on dental health and thus needs to be evaluated. Methodology: Fifty-six competitive swimmers from two training centers were contacted and surveyed for swimming exposure and oral health. A visual analog scale was used to rate the tooth sensitivity. Dental erosion and dental caries were recorded according to WHO oral health assessment criteria (2013). The dentinal hypersensitivity experience was assessed using the dentine hypersensitivity experience questionnaire - 15 (DHEQ-15). Data were analyzed using Chi-square test and multivariate analysis. Results: The prevalence of dentinal hypersensitivity and dental erosion was found to be 69.6% and 48.2%, respectively. The common surfaces affected by dental erosion were palatal surfaces of maxillary anterior, followed by lingual surfaces of mandibular anterior. There was a direct association between duration of the stay in pool and dental erosion. The DHEQ-15 questionnaire revealed that more than 80% of the participants never felt these sensations had any serious long-term effects on oral health. Conclusions: Oral health professional must understand dental erosion among competitive swimmers as an occupational oral health hazard and provide early counseling and necessary invasive and noninvasive care.

Objective All soft and solid surfaces exposed to the oral cavity are covered by an acquired pellicle. While the pellicle adsorbed on enamel is well researched, only limited data are available on the dentin pellicle. The purpose of the present review is to summarize studies considering the composition, structure and properties of the dentin pellicle and compare them with the current state of research on enamel pellicle. Methods The literature search was conducted using Medline database and Google Scholar, including checking reference lists of journal articles by handsearching. Thereby, 19 studies were included in the present review. Results and conclusion The dentin pellicle has a similar ultrastructure to the enamel pellicle, which is up to 1 μm thick depending on pellicle formation time and localization in the oral cavity. In contrast, due to the lack of studies on the dentin pellicle regarding its composition and properties, a comparison to the enamel pellicle is difficult. So far, only one study showed anti-abrasive properties and data on anti-erosive properties were controversial. Despite becoming more and more clinically relevant due to the increasing frequency of dentin exposure, the dentin pellicle is largely unexplored. For further investigations it is not only necessary to standardize dentin specimens, but also to assess fundamental research on dentin itself, as its complex morphology and composition may have a crucial influence on pellicle formation. Furthermore, a more detailed knowledge of the dentin pellicle may also reveal target sites for modification in favor of its protective properties.

The aim of this study was to compare the acquired enamel pellicle protein profile of professional wine tasters with mild and moderate erosive tooth wear. Twelve professional wine tasters participated (3 from a low tooth wear group; 9 from a high tooth wear group). Acquired enamel pellicle samples were collected and processed for proteomic analysis (nLC-ESI-MS/MS). The acquired enamel pellicle proteomic profile was different between the groups. The proteins found exclusively in the low tooth wear group were histatins 1 and 3 and mucins 7 and 21. When comparing the wear groups, proteins with higher levels in the low tooth wear group included neutrophil defensins (1 and 3), lysozyme C, lysozyme, myeloperoxidase, and squalene monooxygenase. In conclusion, the findings indicate that the proteins found at higher levels in the low tooth wear group and proteins exclusively found in the low tooth wear group might be protective and, therefore, could be good candidates for further studies regarding their potential to be added to dental products to protect professional wine tasters from extrinsic erosive tooth wear.

Introduction: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux disease (GERD) due to chronic regurgitation of gastric contents to the oropharynx. Thus, in addition to other extraesophageal symptoms, individuals with GERD may have erosive dental lesions.Areas covered: The objective of this systematic review was to evaluate the association and prevalence of erosive wear in patients with GERD. The bibliographic search was performed in the Pubmed and Web of Science databases, using the descriptors 'gastroesophageal reflux disease' AND 'dental erosion', considering clinical studies recently published from 2012 to 2020.Expert opinion: GERD can be considered a risk factor for the development of erosive dental lesions, whose prevalence was significantly higher in this group. However, several other factors can be commonly associated with the prevalence and severity of dental erosion among the world population, such as dietary habits, lifestyle, abrasion and bruxism. Thus, the prevalence and distribution of erosive lesions among healthy and GERD subjects varied widely among studies, which denotes the etiological complexity of dental erosion and reinforces the importance of careful and detailed anamnesis in order to establish an accurate diagnosis.

OBJECTIVES This study evaluated the in vitro effect of different components of palm oil on enamel in a short-term erosive challenge. METHODS The acquired enamel pellicle (AEP) was previously formed in situ for 2��h. Subsequently, the bovine enamel blocks were treated in vitro according to following solutions: G1-palm oil; G2-85% tocotrienol solution; G3-oily vitamin E; G4-oily vitamin A; G5-deionized water (negative control); G6-stannous-containing solution (Elmex�� Erosion Protection Dental Rinse) (positive control). After application of the treatment solutions (500����l, 30��s), the blocks were immersed in 0.5% citric acid (pH 2.4) during 30��s (initial erosion). The response variable was the percentage of surface hardness loss. Data were analyzed by one-way ANOVA and Fisher's Test (p��

Las lesiones dentales no cariosas, como los defectos de desarrollo del esmalte (DDE) y el desgaste dental erosivo (ETW), son objeto de una intensa investigación. Este artículo tiene como objetivo brindar perspectivas sobre DDE, incluida la fluorosis dental y la hipomineralización de incisivos molares (MIH), y ETW, presentando datos epidemiológicos de las Américas y aspectos de diagnóstico asociados. Además, es importante presentar evidencia para guiar el proceso de evaluación clínica, apoyando las decisiones de manejo de los clínicos hacia una mejor salud bucal de sus pacientes. El aumento general en la prevalencia mundial de lesiones no cariosas discutidas en este documento puede reflejar la necesidad de cambios en la percepción. Aunque el número de publicaciones relacionadas con estas condiciones ha ido en aumento en los últimos años, todavía existe la necesidad de concienciación sobre el diagnóstico clínico y el manejo para incluir estas condiciones en la práctica odontológica de rutina. Además, es importante brindar recomendaciones para criterios de evaluación clínica estandarizados, mejorando el proceso y ayudando a la adherencia de los clínicos. En este sentido, este trabajo discute los índices más comúnmente implementados para cada condición. Así, a pesar de la amplia gama de índices diagnósticos, se propone que BEWE sea el índice recomendado para la evaluación de ETW, los índices de Dean o Thylstrup & Fejerskov para fluorosis y preferiblemente los criterios EAPD (o índice DDE modificado) para MIH. En general, las lesiones no cariosas son una preocupación creciente, y es importante implementar medidas preventivas que controlen su gravedad y progresión, y un diagnóstico preciso por parte del odontólogo. Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.

Background The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed. Aim To assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear. Design An epidemiological cross-sectional survey was conducted to evaluate and compare tooth wear and dental erosion using the dental wear index and erosion wear index (EWI). The study was conducted with randomised samples of 2,371 children aged between 4 years and 12 years selected from the State of Sao Paulo, Brazil. Records were used for calculating tooth wear and dental erosion; the incisal edge and canine cusp were excluded. Results As the schoolchildren's ages increased the severity of primary tooth wear increased in canines (P = 0.0001, OR = 0.34) and molars (P = 0.0001, OR = 2.47) and erosion wear increased in incisal/occlusal (P = 0.0001, OR = 5.18) and molars (P = 0.0001, OR = 2.47). There was an increased prevalence of wear in the permanent teeth of older schoolchildren, particularly on the incisal/occlusal surfaces (P = 0.0001, OR = 7.03). Conclusion The prevalence of tooth wear and dental erosion increased as age increased in children. The epidemiological scoring system Dental Wear Index is able to measure both tooth wear and dental erosive wear. This index should be used to monitor the progression of non-carious lesions and to evaluate the levels of disease in the population.

Objectives: The aim of this study was to investigate variations in the interaction between enamel, that is, the acquired enamel pellicle (AEP) and citric or hydrochloric acid. Materials and Methods: A 24-h AEP was formed on natural enamel specimens (n = 40) from pooled whole mouth human saliva. Samples were randomly allocated to citric (0.3%, pH 3.2) or hydrochloric (HCl) acid (0.01 M, pH 2.38) exposure for 30 or 300 s. The total protein concentration (TPC), and phosphorous and calcium concentrations of the pellicle were determined before and after acid exposure, and again after re-immersion in saliva. Surface roughness and tandem scanning confocal microscopy imaging were used to assess enamel changes. Results: After 300 s of citric acid exposure, the mean ± SD TPC reduced from 5.1 ± 1.1 to 3.5 ± 1.1 mg/mL (p < 0.05). In contrast, after 300 s of HCl exposure, the mean TPC did not reduce significantly from baseline (6.6 ± 1.1 to 5.7 ± 0.7 mg/mL) but was significantly reduced in the reformed pellicle to 4.9 ± 1.2 mg/mL (p < 0.001). This reduction occurred after significant release of calcium and phosphorous from the enamel surface (p < 0.001). Thirty seconds of exposure to either acid had no obvious effect on the AEP. The surface roughness of the enamel decreased after acid exposure but no differences between groups was observed. Conclusions: These findings indicate that citric acid interacted with proteins in the AEP upon contact, offering enamel protection. In contrast, HCl appeared to bypass the pellicle, and reduced protein was observed only after changes in the enamel chemical composition.

This laboratory study investigated the impact of tooth age on dental erosion susceptibility and preventive treatment efficacy. Extracted human premolars were selected and had their age estimated (∼10–100 years old) using established dental forensic methods. Enamel and root dentin slabs were prepared, embedded in acrylic blocks, flattened, and polished. The specimens were randomly assigned to one of three treatments (n = 93): Sn+F (800 ppm Sn as SnCl2 and 250 ppm F as NaF, pH 4.5), NaF (250 ppm F, pH 4.5), or deionized water (DIW). Each specimen was subjected for 10 days to a daily cycling protocol consisting of six 5-min erosive challenges (0.3% citric acid, pH 2.6), six 60-min remineralization periods (artificial saliva), and three 2-min treatments with the test solutions. Surface loss (SL) was measured after 3, 5, and 10 days, using optical profilometry. Effects of tooth age, antierosive treatment, and time on SL were evaluated using linear mixed effects regression analysis. SL increased with age for all substrate-treatment-time combinations (p < 0.0001). Sn+F and NaF solutions significantly reduced SL compared to DIW, regardless of substrate, time, or age (p < 0.0001), with best results shown for Sn+F. Efficacy of Sn+F increased with tooth age on enamel, but tooth age did not affect the efficacy of NaF on enamel. For dentin, increased efficacy was observed with age after 5 (for Sn+F) and 10 days (for Sn+F and NaF). In conclusion, increase of tooth age rendered enamel and root dentin more susceptible to dental erosion. NaF preventive efficacy improved with tooth age for dentin, in advanced erosion simulation. Sn+F reduced enamel SL due to erosion regardless of tooth age.

The overall consumption of acidic beverages has become more common, making the prevention and treatment of dental erosion an important consideration. The aim of this in vitro study was to evaluate the effect of various plant extracts in preventing dentin erosion. Seven experimental groups (fluoride-free water, fluoride-containing mouthwash [Colgate Plax], green tea, rosehip, clove, pomegranate, and grape seed) were formed, each consisting of 20 bovine dentin samples. The specimens were exposed daily to demineralization and remineralization cycles three times per day over 5 days through a 5-min plant extract application before each erosive episode. Surface roughness, nanohardness values, and morphological changes on dentin surfaces were examined using atomic force microscopy (AFM), nanoindentation, and scanning electron microscopy (SEM). The data were subjected to Kruskal-Wallis and Friedman tests (p .05). There were statistically significant differences between the groups in terms of nanohardness values (p .05), except for the pomegranate and grape seed groups. The highest nanohardness value was observed in the clove group (1.24 ± 0.34 GPa), whereas the lowest nanohardness value was noted in the grape seed group (0.20 ± 0.04 GPa). The nanohardness values of positive and negative control groups after erosion cycles were statistically higher than the initial nanohardness values (p .05).There was no statistically significant difference between the groups in surface roughness values (p .05). Macromolecular deposits were observed both in the SEM and AFM images of the pomegranate, Colgate, and rosehip groups. It can be concluded that the clove extract group is more successful in preventing dentin erosion than the other groups. Green tea is also effective in preventing dentin erosion, similar to clove extract. The application of plant extracts may be a new treatment strategy in preventing dentin erosion. Plant extracts may also reduce the severity of existing dentin erosion. Clove and green tea extracts may present novel natural therapy potential by inhibiting dentin erosion.