Genetic Aspects of Dental Erosive Wear and Dental Caries

Knowledge of and Attitudes Toward Erosive Tooth Wear Among Students of a Portuguese University: Pilot Survey

Background/Objectives: To assess and compare the knowledge of and attitudes toward erosive tooth wear (ETW) among university students at the Portuguese University Fernando Pessoa (UFP). Methods: Cross-sectional, prospective pilot study approved by the UFP-Ethics Committee for a bilingual (English and Portuguese) online self-administered questionnaire displayed to all UFP students of the 2023-2024 academic year. Two groups were recruited, dental students (DSs) and non-medical students (NMSs), based on a convenience sample of 344 students. Participants voluntarily answered demographic questions, 15 true/false/do not know questions between knowledge of ETW, and 10 positive statements to score the attitude toward ETW based on a 5-point Likert scale. Differences in scores for DSs and NMSs groups by non-parametric tests and the correlation between knowledge of and attitudes by the Pearson coefficient were considered significant for p < 0.05. Results: A total of 251 (72.9%) students participated, but only 245 (71.2%) fulfilled the survey. The knowledge and attitude scores of the DSs (Md = 12.0; IQR 11.0-13.0 and Md = 43.0; IQR 40.0-48.0) were higher (p < 0.001; p = 0.019) than those of NMSs (Md = 8.0; IQR 6.0-10.0 and Md = 41.0; IQR 38.0-46.0). The attitudes score showed similar (p > 0.05) results for gender, age, nationality, and curricular year. Moderate level of knowledge was higher (p < 0.001) for DSs (Md = 12.0, IQR 11.0-12.0) than for NMSs (Md = 10.0, IQR 9.0-10.0) students. DSs and NMSs revealed differences in attitude level distribution (p < 0.001). Conclusions: This survey highlighted the need for knowledge on ETW among NMSs, but especially the high need for measures to promote more positive attitudes toward ETW among all university students, DSs, and NMSs. It provided valuable insights into the demographic characteristics, response rate, knowledge, and attitude scores of ETW with the implementation of multicenter designs applied to similar populations being important for future research.

The Importance of Basic Sciences in Dental Education

The rapid advancements in biomedical sciences, including genomics, microbiome research, and bioinformatics, underscore the need for dental education to evolve to meet future challenges in public oral health and healthcare delivery. The integration of basic sciences into dental curricula is crucial to ensure that dental professionals are thoroughly prepared in these fundamental areas. Despite the widespread agreement on the necessity of including basic medical sciences in dental education, challenges such as curricular congestion, faculty economics, and infrastructural limits persist, complicating the integration of new scientific knowledge. Furthermore, there remains a significant lack of research concerning the optimal extent, timing, and focus of these subjects, whether biochemical, medical, or dental. Additionally, there is a need to address prevailing conceptions about the irrelevance of basic sciences to the field of dentistry, which necessitates a focus on teaching methodologies and pedagogical strategies. Therefore, it is essential to advance educational research that prepares future educators to integrate basic sciences into dental education through evidence-based teaching methods. The dental curriculum, which encompasses fundamental sciences, laboratory exercises, and clinical practice, must overcome considerable pedagogical challenges to effectively incorporate and balance these basic sciences within its educational structure.

Does different application modes of universal adhesives with universal resin composites affect the microleakage in class V cavities? An in vitro study

AIM

Composite restorations often have gingival margins near the cemento-enamel junction (CEJ), where the microleakage of these margins can significantly contribute to the restoration failure, especially in the cervical lesions. It is important to determine the microleakage is crucial, as it typically occurs through the interfacial gap between the tooth and the restoration. Various resin composites and techniques have been developed to minimize this gap and reduce the risk of microleakage. The aim of this in vitro study was to evaluate the levels of microleakage of different modes of a universal adhesive and two novel resin composites in restoring class V cavities in the central incisors.

METHODS

Sixty-six freshly extracted sound human central incisors of the similar size were randomly assigned to 2 groups (n = 33 per group) according to the brand of resin composite. Each group was further divided into 3 subgroups based on the Scotch Bond Universal (3 M ESPE, Saint Paul, MN, USA) application protocol used: (a) total etch, (b) self-etch and (c) selective etch. After composite restoration completed with Omnichroma (Tokuyama Dental Corp., Tokyo, Japan) and Filtek Universal Restorative (3 M ESPE, Saint Paul, MN, USA), each tooth was immersed in a 0.5% basic fuchsin dye solution at 37C0 for 24 h. After dye penetration, teeth were sectioned and evaluated with conventional (scoring) and digital methods (ImageJ). The intra- and inter-examiner agreement was estimated according to the Kappa statistics and the results were analyzed with the one-way ANNOVA and the Kruskal-Wallis test (p < 0.05).

RESULTS

The rates of microleakage of the gingival and incisal margins are statistically similar, regardless of the composite brand and the method of application of the universal adhesive.

CONCLUSION

The microleakage exhibited by current adhesives and resins is independent of the adhesive application mode and measurement method.

Erosive Tooth Wear, Wine Intake, and Genetic Variation in COMT and MMP2

INTRODUCTION

Erosive tooth wear (ETW) is a multifactorial condition of increasing prevalence in the younger population. This study aimed to explore the association between different ETW phenotypes with MMP2 and COMT single-nucleotide variants and selected environmental factors.

METHODS

Saliva samples, erosive wear, and dental caries experience data and dietary/behavioral information from 16- to 18-year-old patients (n = 747) were used. Genotypes were obtained, and phenotypes were further analyzed considering diet and behavioral data, using logistic regression as implemented in PLINK, with an alpha of 0.05.

RESULTS

When comparing individuals' ETW-free with those with mild ETW, an association was found with COMT rs6269 (p = 0.02). The comparison between ETW-free individuals with individuals with severe ETW also showed an association with COMT rs6269 under the recessive model (p = 0.03). Logistic regression showed that in the presence of less common alleles of MMP2 rs9923304 and COMT rs6269, ETW was more likely to occur when individuals drank wine. The GG genotype of COMT rs6269 was associated with the presence of lower (p = 0.02) and higher (p = 0.02) caries experience when individuals with ETW only in enamel were compared with individuals with ETW involving dentin.

CONCLUSION

The results support a role of genes in ETW, with wine consumption being identified as a significant modulator, suggesting that gene-environment interactions may contribute to the development of ETW.

Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors

This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.

Intraoral scanner-based monitoring of tooth wear in young adults: 24-month results

OBJECTIVES

Tooth wear causes irreversible cumulated surface loss and already occurs at a young age. Therefore, the objective of this clinical prospective observational study was to monitor the occlusal surface of a mandibular first molar in young adults for a period of 24 months. Furthermore, potential aetiological factors obtained by a questionnaire were considered.

MATERIALS AND METHODS

The study teeth (FDI #36 or #46) of 81 participants (mean age 22.8 ± 2.2 years) were scanned with the intraoral scanner (IOS, Trios 3, 3Shape) at the second follow-up (T2) after an observation period of 24 months. Standard-tessellation-language datasets were superimposed with baseline (T0) and T2 scans in 3D analysis software (GOM Inspect). The maximum vertical substance loss was measured between T0 and T2 at 6/7 areas (4/5 cusps and 2 ridges) of each study tooth and data compared to the already published data of the first follow-up (T1) after 12-month observation period. The morphology of tooth wear was classified into three groups: cupping (C), facet (F) and combined cupping-facet (CF). The analysis of aetiological factors, such as acid impacts, was based on a questionnaire filled out by participants at time points T0, T1 and T2. Non-parametric tests were used for statistical analysis (p < 0.05).

RESULTS

The buccal load-bearing cusps (mesiobuccal: median 15 μm, 95%CI 11/18 μm; mesiolingual 8 μm, 0/11 μm) were most affected by tooth wear. Loss values increased significantly at T2 compared to T1 for all areas, although significantly less than in the first 12 months (T0-T1). Areas that already exhibited F at T0 mostly displayed them also at T2 and only rarely developed further into C or CF. The only association between aetiological factors and loss values could be detected for sex as males had significantly higher loss values than females.

CONCLUSIONS

Progression of tooth wear could be clearly shown with high interindividual variations in loss values among participants. This indicates the need for individual monitoring with IOS.

CLINICAL RELEVANCE

IOSs show the potential for patient-specific monitoring to detect the progression of tooth wear. Thus, data of 24 months fills the gap of tooth wear data for young adults in literature. Further studies over a longer observation period are highly recommended to gain more information about the dynamic of tooth wear and aetiological factors.

Caries Management-The Role of Surface Interactions in De- and Remineralization-Processes

BACKGROUND

Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions.

CONCLUSIONS

Despite the fact that organic-inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry.

Characterization of dynamic process of carious and erosive demineralization - an overview

To review the analytical methods for carious and erosive demineralization an initial search of peer-reviewed scientific literature from the digital library database of PubMed/Medline indexed journals published up to early 2022 was carried out based on keywords relevant to the topic criteria including bibliographic citations from the papers to gather the most updated information. This current review aims to provide an updated overview of the advantages, limitations, and potential applications of direct and indirect research methods available for studying various dynamic stages of carious and erosive demineralization in enamel and dentin. This paper categorizes and describes the most suitable, frequently adopted and widely used quantitative and qualitative techniques in in vitro/in vivo research which are well-established, emerging, or comparatively novel techniques that are being explored for their potential validation.