Questions and Answers
What is the primary effect of alkaline materials on tooth surfaces?
Which type of erosive lesion is characterized by a glossy appearance when dried?
What are the possible causes of habitual regurgitation?
In which context might decalcification of teeth be accelerated?
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What is a common characteristic of wedge-shaped erosive lesions?
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What defines attrition in dental terms?
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Where does attrition primarily occur on the tooth?
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Which of the following is a clinical sign of attrition?
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What is one of the consequences of severe attrition?
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Which condition may indicate accelerated attrition due to parafunctional habits?
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How does attrition typically change with age?
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What type of wear pattern is associated with attrition?
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What is the expected wear degree in both dental arches due to attrition?
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What is the purpose of using a varnish on dentin before restoration?
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What material is indicated for desensitization in the case of hypersensitivity?
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Which statement best describes an abfraction defect?
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Under what circumstances should restorative approaches be indicated?
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What is the primary consideration when choosing restorative materials for lesions?
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Which treatment is recommended for aesthetically demanding cases?
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What results from eccentrically applied occlusal forces at the CEJ?
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What percentage of strontium chloride is found in the recommended siloxane ester for desensitization?
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What is a characteristic feature of pathological tooth wear?
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Which method helps determine the progression of tooth wear over time?
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What are some causes of irregularly shaped lesions on teeth?
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What does restoration of worn teeth temporarily address?
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Which of the following is a type of extrinsic erosion?
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Which classification does not belong to non-carious tooth defects?
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Which dietary factors contribute to extrinsic erosion?
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What is one of the common conditions leading to non-carious tooth defects?
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What is one treatment modality for non-carious lesions?
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Why is it difficult to differentiate between acceptable and pathological levels of wear?
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Which intrinsic factor can lead to erosion of teeth?
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Which type of tooth wear is primarily caused by grinding and clenching?
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What could be a consequence of increased use of low pH medications?
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What is a potential outcome if the cause of tooth wear is not identified and prevented?
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Which type of agent is sodium fluoride considered for dental treatment?
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What role does calcium fluoride play in dental treatment?
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Study Notes
Tooth Wear and Sensitivity
- Pulpits and vitality loss can result from tooth wear.
- Uneven wear occurs in one dental arch compared to the other.
- Inability to make incisal or occlusal contact during jaw excursions can indicate significant wear.
- Reduced incisor length creates a disproportionate appearance between length and width.
- Restorative procedures can protect teeth, improve function and aesthetics but will not stop ongoing wear.
- Like dental caries, restoration serves as a temporary solution without addressing the underlying cause.
Diagnosing and Monitoring Tooth Wear
- Diagnosis of tooth wear can be performed easily when teeth are clean and dry.
- Differentiating acceptable wear from pathological levels is challenging and age-dependent.
- A single examination does not determine the wear's progression speed; regular study models help assess changes and effectiveness of preventive measures.
- Classification of non-carious tooth defects includes: Attrition, Abrasions, Demastication, Erosion, Abfraction, Trauma & Fracture, Acquired Developmental Conditions, and Hereditary Conditions.
Attrition
- Defined as the mechanical loss of tooth structure (enamel and dentin) due to normal functional forces between contacting teeth.
- Process begins at tooth eruption and persists through normal oral functions like eating and speaking.
- Clinical signs vary; wear sites are primarily on occlusal surfaces but can also occur on proximal, labial, or lingual surfaces.
- Flattening, faceting, and saucering characterize the appearance of attrition.
- Hypertrophic masseter muscles may indicate bruxism, which accelerates wear.
Erosion
- Erosion can result from extrinsic factors like environmental exposure (acid fumes) and dietary choices (citrus, acidic beverages).
- Intrinsic factors include endogenous acids due to conditions like gastroesophageal reflux, peptic ulcers, and hormonal changes.
- Types of erosive lesions:
- Saucer-shaped concavities primarily on incisors.
- V-shaped notches on premolars and molars, which may lead to pulp exposure.
- Irregularly shaped erosions often on proximal and lingual surfaces due to systemic disorders.
Classification of Erosion
- Extrinsic erosion sources include:
- Environmental factors like acidic fumes.
- Dietary influences from acidic foods and beverages.
- Medications with low pH, increasing risk for dental erosion.
- Intrinsic erosion results from conditions that expose teeth to gastric acids or metabolic/endocrine disorders.
Treatment Modalities
-
Conservative Approaches:
- Surface hardening with stannous fluoride or sodium fluoride paste to reduce sensitivity.
- Remineralization using dentifrices that contain calcium and fluoride.
- Prevention and care for periodontal tissues, including proper oral hygiene techniques.
-
Restorative Approaches:
- Indicated for extensive lesions, utilizing metallic or non-metallic restorations.
- No protective base needed for limited depth lesions; varnish applied to dentin to reduce hypersensitivity.
Abfraction
- Refers to wedge-shaped defects at the cementoenamel junction caused by occlusal forces leading to tooth flexure.
- Stress from masticatory or parafunctional activities targets the CEJ, causing microfractures.
- Restoration may be necessary when clinical consequences, like dentin hypersensitivity, arise, with aesthetic considerations in mind.
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Description
This quiz explores the various aspects of tooth wear, including its effects on vitality and sensitivity. It examines how wear is disproportionate in different arches, the inability to achieve proper contact, and the implications for dental treatments. Understanding these features is crucial for effective dental interventions.
