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Schlenz MA, Schlenz MB, Wöstmann B, Glatt AS, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 36-month results. Clin Oral Investig 2024; 28:350. [PMID: 38822893 PMCID: PMC11144131 DOI: 10.1007/s00784-024-05740-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/24/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES The study continues our longitudinal observation of wear aiming to further monitoring of progression and lesion morphology and to identify relationships with assumed aetiological factors. MATERIALS AND METHODS Molars (FDI #36 or #46) of 74 participants (23.8 ± 2.2 years) were scanned (Trios 3, 3Shape) at the third follow-up (T3; observation period 1,111 ± 10 days). Data sets from T3, T2 (24-month follow-up) and T1 (12-month follow-up) were superimposed with baseline in a 3D analysis software (GOM Inspect). Wear was quantified as maximum vertical tissue loss (µm; median, 95% CI) in various occlusal areas (4/5 cusps and 2 ridges). Morphologies were classified into cupping (C), facet (F), and combined cupping-facet (CF). Aetiological factors were assessed with questionnaires. RESULTS Wear increased at T3 significantly at low rates in all areas of the occlusal surface (median between 7.0 (4.0;10.5) and 9.5 (6.0;15.0) µm). There was a clear trend for higher loss values in males, but no association with other factors such as nutrition. C and CF showed significantly higher loss values than F. Areas without initial wear developed F first, which either persisted or developed into C and CF. CONCLUSIONS Wear continued at low rates with C/CF morphology and sex as significant factors. Cupped lesions seem to develop from facets and thus may not be a valid diagnostic criterion for erosive tooth wear. CLINICAL RELEVANCE Wear is a cumulative process that apparently follows complex mechanisms that cannot be conceptualized in simplified terms; C and CF may be indicators for higher progression rates.
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Affiliation(s)
| | - Moritz Benedikt Schlenz
- Department of Oral and Maxillofacial Surgery, Dr. Horst Schmidt Clinic Wiesbaden, Wiesbaden, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
| | - Anna Sophia Glatt
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
- Department of Operative Dentistry, Endodontics and Paediatric Dentistry, Section Cariology of Aging, Dental Clinic of the Philipps-University Marburg, Marburg, Germany
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Rius-Bonet O, Roca-Obis P, Zamora-Olave C, Willaert E, Martinez-Gomis J. Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase. J Oral Rehabil 2024; 51:861-869. [PMID: 38186266 DOI: 10.1111/joor.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/19/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition. OBJECTIVE This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population. METHODS We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models. RESULTS Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values. CONCLUSIONS The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.
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Affiliation(s)
- Ona Rius-Bonet
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Paula Roca-Obis
- Department of Oral Medicine, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Zamora-Olave
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Eva Willaert
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Jordi Martinez-Gomis
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
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Ning K, Yang F, Bronkhorst E, Ruben J, Nogueira L, Haugen H, Loomans B, Leeuwenburgh S. Fatigue behaviour of a self-healing dental composite. Dent Mater 2023; 39:913-921. [PMID: 37643923 DOI: 10.1016/j.dental.2023.08.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Novel self-healing resin-based composites containing microcapsules have been developed to improve the mechanical performance of dental restorations. However, the long-term fatigue behaviour of these self-healing composites has still been hardly investigated. Therefore, this manuscript studied the fatigue behaviour of self-healing composites containing microcapsules by subjecting the specimens to traditional staircase tests and ageing in a custom-designed chewing simulator (Rub&Roll) to simulate oral ageing physiologically relevant conditions. METHODS To prepare self-healing composite, poly(urea-formaldehyde) microcapsules containing acrylic self-healing liquids were synthesized. Subsequently, these microcapsules (10 wt%) and initiator (benzoyl peroxide, BPO, 2 wt%) were incorporated into a commercial flowable resin-based composite. Microcapsule-free resin-based composites with and without BPO were also prepared as control specimens. A three-point flexural test was used to measure the initial flexural strength (Sinitial). Subsequently, half of the specimens were used for fatigue testing using a common staircase approach to measure the fatigue strengths (FS). In addition, the other specimens were aged in the Rub&Roll machine for four weeks where after the final flexural strength (Sfinal) was measured. RESULTS Compared to Sinitial, FS of all tested specimens significantly decreased as measured through staircase testing. After 4 weeks of ageing in the Rub&Roll machine, Sfinal was significantly reduced compared to Sinitial for microcapsule-free resin-based composites, but not for the self-healing composites (p = 0.3658). However, the self-healing composites are still in the experimental phase characterized by a low mechanical strength, which still impedes further clinical translation. SIGNIFICANCE Self-healing composites containing microcapsules exhibit improved fatigue resistance compared to microcapsule-free non-self-healing composites.
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Affiliation(s)
- Ke Ning
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Fang Yang
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Ewald Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Jan Ruben
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Liebert Nogueira
- University of Oslo, Institute of Clinical Dentistry, Department of Biomaterials, Oslo 0317, Norway
| | - Håvard Haugen
- University of Oslo, Institute of Clinical Dentistry, Department of Biomaterials, Oslo 0317, Norway
| | - Bas Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Sander Leeuwenburgh
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands.
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Silva CAM, Sousa FBD, Martinez-Mier EA, Kelly AB, Eckert GJ, Hara AT. Susceptibility of fluorotic enamel to dental erosion-abrasion. Braz Oral Res 2023; 37:e068. [PMID: 37436291 DOI: 10.1590/1807-3107bor-2023.vol37.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/14/2023] [Indexed: 07/13/2023] Open
Abstract
Dental hard tissue conditions can be of pre- or post-eruptive nature, such as enamel fluorosis and erosive tooth wear (ETW), respectively. Dental enamel fluorosis is caused by the chronic and excessive intake of fluoride during enamel development, leading to increased fluoride concentration and increased porosity. ETW has become a common clinical condition and often impairs dental function and aesthetics. This in vitro study tested the hypothesis that fluorotic enamel presents different susceptibility to dental erosion-abrasion. It consisted of a 3×3×2 factorial design, considering a) fluorosis severity: sound (TF0), mild (TF1-2), moderate (TF3-4); b) abrasive challenge: low, medium, and high; and c) erosive challenge: yes or no. A total of 144 human teeth were selected according to the three fluorosis severity levels (n=48), and subdivided into six groups (n = 8) generated by the association of the different erosive and abrasive challenges. Enamel blocks (4×4 mm) were prepared from each tooth and their natural enamel surfaces subjected to an erosion-abrasion cycling model. After cycling, the depth of the lesions in enamel was assessed by profilometry. ANOVA showed that the three-way and two-way interactions among the factors were not significant (p > 0.20). Enamel fluorosis level (p=0.638) and abrasion level (p = 0.390) had no significant effect on lesion depth. Acid exposure caused significantly more enamel surface loss than water (p < 0.001). Considering the limitations of this in vitro study, fluorosis did not affect the susceptibility of enamel to dental erosion-abrasion.
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Affiliation(s)
- Cristiane Araújo Maia Silva
- Universidade Federal da Paraíba - UFPB, Health Sciences Center, Department of Morphology, Federal University of Paraiba, João Pessoa, PB, Brazil
| | - Frederico Barbosa de Sousa
- Universidade Federal da Paraíba - UFPB, Health Sciences Center, Department of Morphology, Federal University of Paraiba, João Pessoa, PB, Brazil
| | - Esperanza Angeles Martinez-Mier
- Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, IN, USA
| | - Adam Benjamin Kelly
- Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, IN, USA
| | - George J Eckert
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, Indianapolis, IN, USA
| | - Anderson Takeo Hara
- Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, IN, USA
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Schlenz MA, Schlenz MB, Wöstmann B, Glatt AS, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 24-month results. Clin Oral Investig 2023; 27:2775-2785. [PMID: 36625960 PMCID: PMC10264267 DOI: 10.1007/s00784-023-04858-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023]
Abstract
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.
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Affiliation(s)
- Maximiliane Amelie Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany.
| | - Moritz Benedikt Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Anna Sophia Glatt
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
- Department of Operative Dentistry, Endodontics and Paediatric Dentistry, Section Cariology, Dental Clinic of the Philipps-University Marburg, Marburg, Germany
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Kitagawa K, Kodama N, Manda Y, Mori K, Furutera H, Minagi S. Effect of masseter muscle activity during wakefulness and sleep on tooth wear. J Prosthodont Res 2021; 66:551-556. [PMID: 34955483 DOI: 10.2186/jpr.jpr_d_21_00171] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the effect of masseter muscle activity during wakefulness and sleep on tooth wear. METHODS Sixteen participants with no or mild tooth wear (NMTW group) and sixteen participants with moderate-to-severe tooth wear (MSTW group) were enrolled. The severity of tooth wear was evaluated using the occlusal and incisal indices of the tooth wear index. Surface electromyography was performed to record the electrical activity of the left masseter muscle during wakefulness and sleep. Electromyographic activity was detected using an electromyographic threshold of 5% and 20% of maximal voluntary clenching (MVC). The total duration of electromyographic activity and bruxism episodes were calculated. RESULTS The mean ages of the NMTW and MSTW groups were 71.75 ± 7.61 years and 71.69 ± 7.49 years, respectively. The mean cumulative duration of electromyographic activity during wakefulness using a threshold of >5% MVC was 6.44 ± 4.52 min/h and 13.62 ± 10.08 min/h for the NMTW and MSTW groups, respectively (p=0.048). The mean total durations of electromyographic activity during wakefulness and sleep using a threshold of >20% MVC were 1.08 ± 1.70 min/h and 1.05 ± 3.02 min/h, respectively, in the NMTW group and 4.78 ± 6.37 min/h and 1.61 ± 1.79 min/h, respectively, in the MSTW group (p=0.048 and p=0.003, respectively). CONCLUSION These results suggest that masseter electromyographic activity during wakefulness and sleep may be related to the severity of tooth wear.
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Affiliation(s)
- Keisuke Kitagawa
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Naoki Kodama
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yousuke Manda
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Keitaro Mori
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Hiroshi Furutera
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Shogo Minagi
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
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Schlenz MA, Schlenz MB, Wöstmann B, Jungert A, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 12-month results. Clin Oral Investig 2021; 26:1869-1878. [PMID: 34498100 PMCID: PMC8816769 DOI: 10.1007/s00784-021-04162-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/24/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To investigate tooth wear in young adults, intraoral scanning was used for digital monitoring of the mandibular first molar over 12 months. A possible influence of aetiological factors obtained by a questionnaire on tooth wear was investigated. MATERIALS AND METHODS A total of 109 participants (mean age at the start of the study: 21.0 ± 2.2 years) were included in this clinical study. At baseline (T0), an intraoral scan (Trios 3, 3Shape) of the study tooth (FDI # 36 or #46) was conducted. After a mean observation period of 373 ± 19 days, a second intraoral scan (T1, n = 94) of the same tooth as at T0 was performed and standard tessellation language datasets were superimposed with 3D analysis software (GOM Inspect). The occlusal surface of the study tooth was divided into 7 areas (5 cusps, 2 ridges) and maximum vertical substance loss was measured between T0 and T1 (n = 91). Three types of tooth wear were defined: cupping (C), facet (F) and combined cupping-facet (CF). Furthermore, a questionnaire on aetiological factors, such as dietary behaviour, was filled out at T0. Data were analysed with non-parametric tests (p < 0.05). RESULTS Only one study tooth exhibited no tooth wear at T0, whereas 3 teeth showed C, 47 teeth F and 40 teeth CF. A progression of vertical substance loss for all three types was shown. Most affected were the mesiobuccal cusps (43, 38/47 µm; median, 95%CI) followed by distobuccal (36, 33/39 µm), mesiolingual (35, 26/40 µm), distolingual (34, 27/36 µm) and distal (31, 25/34 µm). On mesial and distal ridges, only F was detected with the lowest vertical substance loss of all areas (mesial ridge: 0, 0/0 µm; distal ridge: 0, 0/0 µm). An association between aetiological factors and loss values could not be shown. CONCLUSIONS All study teeth showed clear signs of wear, and after only 1 year, further substance loss was detectable. This result is of significance for young adults. CLINICAL RELEVANCE Since data of young adults regarding tooth wear are scarce, the results give a first idea of the amount of vertical loss per year and its relation to aetiological factors such as dietary behaviour. Therefore, further studies over a longer observation period are highly recommended.
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Affiliation(s)
- Maximiliane Amelie Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany.
| | - Moritz Benedikt Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Alexandra Jungert
- Biometry and Population Genetics, Institute of Agronomy and Plant Breeding II, Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Justus Liebig University Giessen, Giessen, Germany
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
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Chipping and wear patterns in extant primate and fossil hominin molars: 'Functional' cusps are associated with extensive wear but low levels of fracture. J Hum Evol 2020; 151:102923. [PMID: 33360110 DOI: 10.1016/j.jhevol.2020.102923] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 01/01/2023]
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de Oliveira JC, Sordi MB, da Cruz ACC, Zanetti RV, Betiol EAG, Vieira SR, Zanetti AL. Number of dental abutments influencing the biomechanical behavior of tooth‒implant-supported fixed partial dentures: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2020; 14:228-234. [PMID: 33575012 PMCID: PMC7867679 DOI: 10.34172/joddd.2020.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
Background. Local or systemic issues might prevent installing a sufficient number of dental implants for fixed prosthetic rehabilitation. Splinting dental implants and natural teeth in fixed dentures could overcome such limitations. Therefore, this study aimed to evaluate the influence of the number of dental abutments in the biomechanics of tooth‒implant-supported fixed partial dentures (FPDs). The null hypothesis was that increasing the number of abutment teeth would not decrease the stress over the abutments and surrounding bone. Methods. Left mandibular lateral incisor, canine, premolars, and molars were reconstructed through computed tomography and edited using image processing software to represent a cemented fixed metal‒ceramic partial denture. Three models were set to reduce the number of abutment teeth: 1) lateral incisor, canine, and first premolar; 2) canine and first premolar; 3) the first premolar. The second premolar and first molar were set as pontics, and the second molar was set as an implant abutment in all the models. Finite element analyses were performed under physiologic masticatory forces with axial and oblique loading vectors. Results. After simulation of axial loads, the stress peaks on the bone around the implant, the bone around the first premolar, and prosthetic structures did not exhibit significant changes when the number of abutment teeth decreased. However, under oblique loads, decreasing the number of abutment teeth increased stress peaks on the surrounding bone and denture. Conclusion. Increasing the number of dental abutments in tooth‒implant-supported cemented FPD models decreased stresses on its constituents, favoring the prosthetic biomechanics.
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Affiliation(s)
| | - Mariane Beatriz Sordi
- Postgraduate in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | | | - Artêmio Luiz Zanetti
- Department of Prosthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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