Etiology-Diagnosis-of-Wear PDF

Leila Jahangiri, Chair Department of Prosthodontics Diagnosis & Treatment of Wear Abrasion- Objectives Abrasion- Diagnostic Parameters  Common causes of dental abrasion  Diagnostic parameters  Location  Identification of habits or objects  Restorative considerations Abrasion- Mechanical...

Leila Jahangiri, Chair Department of Prosthodontics Diagnosis & Treatment of Wear Abrasion- Objectives Abrasion- Diagnostic Parameters  Common causes of dental abrasion  Diagnostic parameters  Location  Identification of habits or objects  Restorative considerations Abrasion- Mechanical Abrasion- Habits or Objects  Location  Location  Habits or objects  Habits or objects New York University College of Dentistry Leila Jahangiri, Chair Department of Prosthodontics Abrasion- Habits or Objects  Location  Habits or objects  Remove the cause  Restore the dentition Erosion- Objectives  Common causes of dental erosion Intrinsic factors  Vomiting - Bulimia  Reflux  Diagnostic parameters  Restorative considerations Dental Erosion from Diagnosis to Therapy. A Lussi Dental erosion - an overview with emphasis on chemical and histopathological aspects. Lussi A, Schlueter N, Rakhmatullina E, Ganss C. Caries Res. 2011 New York University College of Dentistry  Regurgitation Leila Jahangiri, Chair Department of Prosthodontics Intrinsic F. Spear Education  Lingual surfaces  Occlusal surfaces  Mandibular anterior teeth protected Extrinsic Factors  Soft drinks  Glossy appearance  Sports drinks  Severe in the maxillary LINGUAL surfaces  Wine tasting Extrinsic Anorexia – Extrinsic factor  Carbonated water  Many surfaces  Lemon juice  Severe in the maxillary FACIAL surfaces  Coffee New York University College of Dentistry Leila Jahangiri, Chair Department of Prosthodontics Extrinsic Factors Extrinsic  Jobs near acid fumes  Many surfaces  Severe in the maxillary FACIAL surfaces Extrinsic Factor  Lemon sucking Extrinsic Factors - Habits  Cocaine  Localized - facial - maxillary anterior Diagnosis Clinical Signs and Symptoms  Sensitivity to cold  Thorough history  Change in esthetics  Location of the lesion(s)  Glossy or porous surface  In severe cases development of “diastemas” Dental erosion - an overview with emphasis on chemical and histopathological aspects. Lussi A, Schlueter N, Rakhmatullina E, Ganss C. Caries Res. 2011 Clinical studies of dental erosion and erosive wear. Huysmans MC, Chew HP, Ellwood RP. Caries Res. 2011;45 Suppl 1:60-8. 2011 New York University College of Dentistry Leila Jahangiri, Chair Department of Prosthodontics  Identify and address the cause  Treat symptoms  Restore the dentition  In attrition cases the occlusion is a perfect fit WEAR – Causes of Attrition  Natural process of aging  Hard grainy diet  Deficiencies of enamel and dentine  Bruxism  Incompatible materials  Occlusion WEAR – Attrition Early signs  Chipping and fracture of teeth or restorations New York University College of Dentistry Advanced Attrition - Bruxism  Teeth are shortened  Typically not mobile  Diastemas are common Leila Jahangiri, Chair Department of Prosthodontics Advanced Attrition - Bruxism  Excessive sensitivity  Tori and buttressing bone  Diastemas are common WEAR - Attrition  Lack of posterior occlusion WEAR – Attrition - malocclusion New York University College of Dentistry Advanced Attrition - Bruxism  “Gummy” smile  Increased attached mucosa WEAR – Attrition - malocclusion  Lack of posterior occlusion  Material incompatibility  Malocclusion – Class II Division 2 Leila Jahangiri, Chair Department of Prosthodontics “ As the occlusal surfaces of teeth wear, the dentoalveolar process elongates by progressive remodeling of the alveolar bone.” P. Dawson Starting at the mid-line, the Width to height ratio of 0.61 to 0.75 is esthetic. geometric formula of proportionality requires that each anterior tooth appears 40% (or a little less) narrower than the tooth immediately mesial. If more than 1 mm of space in premolar region, “loss of vertical” exists New York University College of Dentistry Leila Jahangiri, Chair Department of Prosthodontics  Identify if VD is lost  Treat with caution and methodically  Typically, mobile teeth have good anatomy  Wear of teeth is not seen with lack of PDL  Attrition is associated with excessive bone  Difficult to detect symptoms  Increased attached gingiva  Reconstruction can trigger symptoms New York University College of Dentistry Leila Jahangiri, Chair Department of Prosthodontics Minimum treatment  Treatment - best by maintaining the vertical  Prevent further wear  Esthetics - best achieved by crown lengthening  Stabilize New York University College of Dentistry