This document provides an overview of tooth wear and its various etiological factors including abrasion, abfraction, attrition, bruxism, and erosion. It discusses the characteristics and mechanisms of each factor in detail. The document emphasizes that tooth wear is usually caused by multiple overlapping factors. It also outlines the steps in evaluating tooth wear, including determining the severity, making a diagnosis, and developing a treatment plan. Treatment options discussed include both preventive measures and various restorative techniques.
The document summarizes the process of examining a patient with tooth wear. It describes collecting a thorough medical and dental history to understand causes and progression of wear. An extraoral exam checks for jaw issues and an intraoral exam documents location and severity of wear and records the dental chart. The occlusion is thoroughly assessed including centric relation to inform diagnosis and treatment planning.
02 classification and indications of rpdAmal Kaddah
This document discusses removable partial dentures. It begins by outlining the indications for removable partial dentures, including when the abutment teeth are not suitable for fixed bridges due to periodontal issues, extensive bone loss, or economic considerations. It then covers classifications for partially edentulous arches, including whether the denture is tooth-borne, tissue-borne, or a combination. Kennedy's classification system categorizes cases based on the location of edentulous spans. The document concludes with the component parts of removable partial dentures.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
This document discusses various types of unconventional or special dentures used to manage compromised patients that cannot be treated satisfactorily with conventional complete dentures. It describes dentures like hollow dentures for extreme ridge resorption, liquid-supported dentures for tissues issues, sectional dentures for microstomia patients, and metal-based dentures for additional strength. It also covers techniques like immediate dentures, duplicate dentures, characterized dentures, and flexible dentures made of thermoplastic resin. Special dentures aim to address complications from conditions like xerostomia, sunken cheeks, undercuts, and limited mouth opening.
Serial extraction is an interceptive orthodontic procedure that involves the planned extraction of certain primary and permanent teeth in a sequence to guide the erupting permanent teeth into a favorable position. It was first described in 1929 as a way to address arch length deficiencies. The most common methods are Dewel's method, Tweed's method, and Nance method, all of which extract primary teeth first, followed by premolars and canines. Potential problems include anterior crossbites from residual spacing or skeletal discrepancies.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
Is a dental condition that is commonly seen in patients with a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth
Sampling is a procedure used to make inferences about a larger population by studying a representative subset of it. There are two main types of sampling: probability sampling, where units have a known, non-zero chance of being selected; and non-probability sampling, where units are selected through convenience. Some common sampling methods include simple random sampling, stratified random sampling, cluster sampling, and multistage sampling. The goal is to select a sample that efficiently and cost-effectively represents the population while addressing requirements like representativeness, measurability, and feasibility.
The document summarizes the process of examining a patient with tooth wear. It describes collecting a thorough medical and dental history to understand causes and progression of wear. An extraoral exam checks for jaw issues and an intraoral exam documents location and severity of wear and records the dental chart. The occlusion is thoroughly assessed including centric relation to inform diagnosis and treatment planning.
02 classification and indications of rpdAmal Kaddah
This document discusses removable partial dentures. It begins by outlining the indications for removable partial dentures, including when the abutment teeth are not suitable for fixed bridges due to periodontal issues, extensive bone loss, or economic considerations. It then covers classifications for partially edentulous arches, including whether the denture is tooth-borne, tissue-borne, or a combination. Kennedy's classification system categorizes cases based on the location of edentulous spans. The document concludes with the component parts of removable partial dentures.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
This document discusses various types of unconventional or special dentures used to manage compromised patients that cannot be treated satisfactorily with conventional complete dentures. It describes dentures like hollow dentures for extreme ridge resorption, liquid-supported dentures for tissues issues, sectional dentures for microstomia patients, and metal-based dentures for additional strength. It also covers techniques like immediate dentures, duplicate dentures, characterized dentures, and flexible dentures made of thermoplastic resin. Special dentures aim to address complications from conditions like xerostomia, sunken cheeks, undercuts, and limited mouth opening.
Serial extraction is an interceptive orthodontic procedure that involves the planned extraction of certain primary and permanent teeth in a sequence to guide the erupting permanent teeth into a favorable position. It was first described in 1929 as a way to address arch length deficiencies. The most common methods are Dewel's method, Tweed's method, and Nance method, all of which extract primary teeth first, followed by premolars and canines. Potential problems include anterior crossbites from residual spacing or skeletal discrepancies.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
Is a dental condition that is commonly seen in patients with a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth
Sampling is a procedure used to make inferences about a larger population by studying a representative subset of it. There are two main types of sampling: probability sampling, where units have a known, non-zero chance of being selected; and non-probability sampling, where units are selected through convenience. Some common sampling methods include simple random sampling, stratified random sampling, cluster sampling, and multistage sampling. The goal is to select a sample that efficiently and cost-effectively represents the population while addressing requirements like representativeness, measurability, and feasibility.
This document provides an overview of regenerative endodontics, which aims to regenerate dental tissues through biologically-based procedures using stem cells, growth factors, and scaffolds. Key elements for pulp regeneration include reliable stem cell sources, such as dental pulp stem cells, growth factors to stimulate cell proliferation and differentiation, and appropriate scaffolds. Potential regenerative therapies include revascularization, stem cell therapy, scaffold implantation, and gene delivery. Measuring clinical outcomes and further applications are areas of future focus to develop regenerative endodontic therapies.
Non-carious lesions can be caused by various factors like attrition, abrasion, abfraction, erosion, and developmental defects. They are managed through treatments like restoration, controlling parafunctional habits, and addressing underlying causes. Localized enamel hypoplasia can result in pits and defects from interruptions during enamel formation, while hypocalcification makes enamel softer and more stainable. Management involves restoration, bleaching, or preventing further demineralization.
Veneers are a conservative treatment to improve the appearance of teeth. They involve bonding thin facings of tooth-colored material to the front of teeth. Veneers can be made of composite resin, porcelain, or other ceramic materials. They are either bonded directly during a single appointment or indirectly with impressions taken and veneers fabricated by a dental laboratory over two appointments. Veneers can repair damage, close gaps, change the shape or length of teeth, or improve discoloration while minimizing the removal of tooth structure. The choice of material and technique depends on the specific needs and preferences of the patient.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
The document discusses common failures of dental amalgam restorations. It states that while amalgams initially perform well, over time technical issues can lead to fracture, recurrent caries, discoloration and corrosion. Failures are often due to faulty cavity preparation, poor matrix adaptation, or improper amalgam manipulation. Specifically, inadequate extension or retention forms during cavity preparation increase risks of secondary caries and fracture. Contamination or delayed condensation of amalgam can also weaken restorations.
The double cord technique involves placing a small diameter cord in the gingival sulcus first, leaving it in place, and then packing a larger diameter cord over the first cord to provide additional retraction and hemostasis for making impressions of multiple prepared teeth or when the gingival tissues are compromised. The small inner cord provides retraction while the outer cord provides additional hemostasis and tissue displacement needed for accurate impressions.
This document discusses resin bonded fixed partial dentures (RBFPDs). It defines RBFPDs as prostheses that are luted to tooth structure using composite resin. Various types are described, including cantilever, fixed-fixed, and hybrid bridges. Advantages include reduced cost and minimal tooth preparation. Indications are for replacing single missing teeth with caries-free abutments. A case example describes using an RBFPD to replace a missing mandibular incisor and splint mobile abutment teeth.
The document provides an overview of occlusion including general aspects, clinical significance, forces acting on restored teeth, occlusal considerations for restoring individual teeth, modes of recording occlusal relations, and checking castings for occlusion. It discusses supporting and non-supporting cusps, functional and non-functional occlusion, centric relation, centric occlusion, occlusal schemes, and guidance of occlusion. Qualitative and quantitative methods for analyzing occlusion are also presented including articulating paper, foils, pastes, silk strips, photocclusion, and computer-assisted dynamic analysis.
This document provides an overview of various methods for classifying malocclusion and summarizes key etiological factors. It describes Angle's classification system, the first and most widely used method based on molar relationships. It also discusses modifications by Dewey, Lischer, and others. Etiological classifications introduced include Moyer's system distinguishing osseous, muscular and dental origins, and Salzmann's prenatal and postnatal factors. The document aims to explain different approaches and highlight the importance of identifying causes to determine appropriate treatment.
The document discusses guidelines for preparing access cavities for root canal treatment. It outlines principles such as removing all caries and defective restorations, conserving tooth structure, and providing straight-line access to canal orifices. Specific guidelines covered include visualizing internal anatomy, evaluating anatomical landmarks, preparing cavities through lingual/occlusal surfaces, and locating all root canals before placing a dental dam. The goal is to efficiently locate and treat all canals following principles of access cavity design.
Tooth wear can occur through abrasion, attrition, erosion, and abfraction. Abrasion involves foreign objects rubbing teeth, while attrition is tooth-to-tooth contact. Erosion is acid etching of teeth and abfraction involves microfractures from occlusal stresses. Diagnosis involves examining location, appearance, and progression of tooth wear. Management focuses on controlling factors, restoring function and aesthetics, and using materials like composites and night guards to minimize further wear. Ongoing maintenance appointments are needed to monitor wear and refurbish restorations as the condition is progressive.
This lecture, which oriented to the level of mind of undergraduate students, discuss the topic of pulpectomy, its indications, contraindications, and procedural steps.
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The document summarizes the International Caries Detection and Assessment System (ICDAS). ICDAS provides a standardized system for detecting and coding dental caries, accounting for both enamel and dentine lesions. It has applications in dental education, clinical practice, research, and epidemiology/public health. ICDAS involves visual inspection of clean, dried teeth and codes lesions from 0 to 6 based on their severity. It also provides codes for caries detection associated with restorations and sealants, as well as root surface caries detection.
Serial extraction involves the planned removal of primary and permanent teeth to address crowding. It aims to guide unerupted teeth into improved positions through space creation. The document outlines the history, principles, objectives, indications, techniques and application of serial extraction for Class I and II malocclusions. Key techniques include Dewel, Nance, Tweed and Grewe's methods, which extract specific primary and permanent teeth in a sequenced manner to resolve crowding through physiologic tooth movement.
Unfavorable Sequelae of Malocclusion discusses the negative psychological, social, developmental, and health impacts of malocclusion. Specifically, it notes that malocclusion can lead to introversion or overassertiveness in children due to speech defects, poor appearance and ridicule, improper growth and muscle function, issues with swallowing and breathing, improper chewing and potential nutritional deficiencies, speech defects, increased risk of dental caries and periodontal disease, temporomandibular joint disorders, higher risk of accidents, impacted teeth, and complications with dental prosthetics. The document provides supporting details for each of these potential unfavorable sequelae.
The document provides information on traumatic injuries to teeth, including concussions, luxations, and fractures. It describes the clinical signs, radiographic findings, and treatment approaches for each type of injury. Concussions involve inflammation of the periodontal ligament without tooth displacement. Luxations occur when a tooth is displaced from its socket, sometimes with alveolar bone fractures. Fractures are classified as enamel fractures, enamel-dentin fractures, enamel-dentin-pulp fractures, or root fractures. Treatment depends on the specific injury but may include repositioning displaced teeth, pulpotomies, root canals, extractions, or orthodontic/surgical repositioning.
Vital pulp therapy aims to preserve healthy pulp tissue and includes procedures like indirect/direct pulp capping, pulpotomy, and apexification. The goal is to stimulate reparative dentin formation and maintain the tooth as a functional unit. Success depends on factors like the patient's age, pulp chamber size, bacterial contamination, and quality of the restoration. Indirect pulp capping involves stepwise caries removal and capping the remaining dentin layer, while direct capping places a material directly over an exposed pulp. Pulpotomy and apexification procedures are used to treat immature teeth and maintain root development.
This document provides an overview of endodontics. It defines endodontics as the branch of dentistry concerned with the morphology, physiology, and pathology of the dental pulp and periradicular tissues. The scope of endodontics includes treating diseases of the pulp, such as pulpal inflammation and infection, through both nonsurgical and surgical root canal treatment and periradicular surgery. Pathogenesis is discussed, noting that while physical and chemical factors can induce inflammation, microbial infection is essential for progression of pulpal and periradicular disease. Routes of canal infection and the focal infection theory are also summarized.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
3.treatment planning restorative management of worn dentition (2)Ashish Choudhary
This document summarizes a seminar on the restorative management of worn dentition, specifically regarding treatment planning. It discusses mounting casts onto articulators using facebow transfers and interocclusal records to simulate jaw movement. It also addresses problems like spaces caused by tooth wear and how to assess the existing vertical dimension when developing a treatment plan. The goal is to properly evaluate the patient's occlusion and develop a restorative plan to rehabilitate worn teeth.
Management of non carious lesions- attrion, abrasion, erosion, abfractionPriyanka Chowdhary
This document discusses the management of non-carious lesions of teeth. It defines non-carious tooth tissue loss as surface loss from causes other than dental caries. The main causes discussed are attrition, abrasion, erosion, abfraction, hereditary enamel/dentin defects, and fractures. For each cause, the document describes the clinical presentation and treatment approaches. Treatment may involve restorations, occlusal equilibration, splints, or full mouth rehabilitation depending on the severity and location of the tissue loss.
This document provides an overview of regenerative endodontics, which aims to regenerate dental tissues through biologically-based procedures using stem cells, growth factors, and scaffolds. Key elements for pulp regeneration include reliable stem cell sources, such as dental pulp stem cells, growth factors to stimulate cell proliferation and differentiation, and appropriate scaffolds. Potential regenerative therapies include revascularization, stem cell therapy, scaffold implantation, and gene delivery. Measuring clinical outcomes and further applications are areas of future focus to develop regenerative endodontic therapies.
Non-carious lesions can be caused by various factors like attrition, abrasion, abfraction, erosion, and developmental defects. They are managed through treatments like restoration, controlling parafunctional habits, and addressing underlying causes. Localized enamel hypoplasia can result in pits and defects from interruptions during enamel formation, while hypocalcification makes enamel softer and more stainable. Management involves restoration, bleaching, or preventing further demineralization.
Veneers are a conservative treatment to improve the appearance of teeth. They involve bonding thin facings of tooth-colored material to the front of teeth. Veneers can be made of composite resin, porcelain, or other ceramic materials. They are either bonded directly during a single appointment or indirectly with impressions taken and veneers fabricated by a dental laboratory over two appointments. Veneers can repair damage, close gaps, change the shape or length of teeth, or improve discoloration while minimizing the removal of tooth structure. The choice of material and technique depends on the specific needs and preferences of the patient.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
The document discusses common failures of dental amalgam restorations. It states that while amalgams initially perform well, over time technical issues can lead to fracture, recurrent caries, discoloration and corrosion. Failures are often due to faulty cavity preparation, poor matrix adaptation, or improper amalgam manipulation. Specifically, inadequate extension or retention forms during cavity preparation increase risks of secondary caries and fracture. Contamination or delayed condensation of amalgam can also weaken restorations.
The double cord technique involves placing a small diameter cord in the gingival sulcus first, leaving it in place, and then packing a larger diameter cord over the first cord to provide additional retraction and hemostasis for making impressions of multiple prepared teeth or when the gingival tissues are compromised. The small inner cord provides retraction while the outer cord provides additional hemostasis and tissue displacement needed for accurate impressions.
This document discusses resin bonded fixed partial dentures (RBFPDs). It defines RBFPDs as prostheses that are luted to tooth structure using composite resin. Various types are described, including cantilever, fixed-fixed, and hybrid bridges. Advantages include reduced cost and minimal tooth preparation. Indications are for replacing single missing teeth with caries-free abutments. A case example describes using an RBFPD to replace a missing mandibular incisor and splint mobile abutment teeth.
The document provides an overview of occlusion including general aspects, clinical significance, forces acting on restored teeth, occlusal considerations for restoring individual teeth, modes of recording occlusal relations, and checking castings for occlusion. It discusses supporting and non-supporting cusps, functional and non-functional occlusion, centric relation, centric occlusion, occlusal schemes, and guidance of occlusion. Qualitative and quantitative methods for analyzing occlusion are also presented including articulating paper, foils, pastes, silk strips, photocclusion, and computer-assisted dynamic analysis.
This document provides an overview of various methods for classifying malocclusion and summarizes key etiological factors. It describes Angle's classification system, the first and most widely used method based on molar relationships. It also discusses modifications by Dewey, Lischer, and others. Etiological classifications introduced include Moyer's system distinguishing osseous, muscular and dental origins, and Salzmann's prenatal and postnatal factors. The document aims to explain different approaches and highlight the importance of identifying causes to determine appropriate treatment.
The document discusses guidelines for preparing access cavities for root canal treatment. It outlines principles such as removing all caries and defective restorations, conserving tooth structure, and providing straight-line access to canal orifices. Specific guidelines covered include visualizing internal anatomy, evaluating anatomical landmarks, preparing cavities through lingual/occlusal surfaces, and locating all root canals before placing a dental dam. The goal is to efficiently locate and treat all canals following principles of access cavity design.
Tooth wear can occur through abrasion, attrition, erosion, and abfraction. Abrasion involves foreign objects rubbing teeth, while attrition is tooth-to-tooth contact. Erosion is acid etching of teeth and abfraction involves microfractures from occlusal stresses. Diagnosis involves examining location, appearance, and progression of tooth wear. Management focuses on controlling factors, restoring function and aesthetics, and using materials like composites and night guards to minimize further wear. Ongoing maintenance appointments are needed to monitor wear and refurbish restorations as the condition is progressive.
This lecture, which oriented to the level of mind of undergraduate students, discuss the topic of pulpectomy, its indications, contraindications, and procedural steps.
Visit us on Facebook:
https://www.facebook.com/iraqi.Dental.Academy
The document summarizes the International Caries Detection and Assessment System (ICDAS). ICDAS provides a standardized system for detecting and coding dental caries, accounting for both enamel and dentine lesions. It has applications in dental education, clinical practice, research, and epidemiology/public health. ICDAS involves visual inspection of clean, dried teeth and codes lesions from 0 to 6 based on their severity. It also provides codes for caries detection associated with restorations and sealants, as well as root surface caries detection.
Serial extraction involves the planned removal of primary and permanent teeth to address crowding. It aims to guide unerupted teeth into improved positions through space creation. The document outlines the history, principles, objectives, indications, techniques and application of serial extraction for Class I and II malocclusions. Key techniques include Dewel, Nance, Tweed and Grewe's methods, which extract specific primary and permanent teeth in a sequenced manner to resolve crowding through physiologic tooth movement.
Unfavorable Sequelae of Malocclusion discusses the negative psychological, social, developmental, and health impacts of malocclusion. Specifically, it notes that malocclusion can lead to introversion or overassertiveness in children due to speech defects, poor appearance and ridicule, improper growth and muscle function, issues with swallowing and breathing, improper chewing and potential nutritional deficiencies, speech defects, increased risk of dental caries and periodontal disease, temporomandibular joint disorders, higher risk of accidents, impacted teeth, and complications with dental prosthetics. The document provides supporting details for each of these potential unfavorable sequelae.
The document provides information on traumatic injuries to teeth, including concussions, luxations, and fractures. It describes the clinical signs, radiographic findings, and treatment approaches for each type of injury. Concussions involve inflammation of the periodontal ligament without tooth displacement. Luxations occur when a tooth is displaced from its socket, sometimes with alveolar bone fractures. Fractures are classified as enamel fractures, enamel-dentin fractures, enamel-dentin-pulp fractures, or root fractures. Treatment depends on the specific injury but may include repositioning displaced teeth, pulpotomies, root canals, extractions, or orthodontic/surgical repositioning.
Vital pulp therapy aims to preserve healthy pulp tissue and includes procedures like indirect/direct pulp capping, pulpotomy, and apexification. The goal is to stimulate reparative dentin formation and maintain the tooth as a functional unit. Success depends on factors like the patient's age, pulp chamber size, bacterial contamination, and quality of the restoration. Indirect pulp capping involves stepwise caries removal and capping the remaining dentin layer, while direct capping places a material directly over an exposed pulp. Pulpotomy and apexification procedures are used to treat immature teeth and maintain root development.
This document provides an overview of endodontics. It defines endodontics as the branch of dentistry concerned with the morphology, physiology, and pathology of the dental pulp and periradicular tissues. The scope of endodontics includes treating diseases of the pulp, such as pulpal inflammation and infection, through both nonsurgical and surgical root canal treatment and periradicular surgery. Pathogenesis is discussed, noting that while physical and chemical factors can induce inflammation, microbial infection is essential for progression of pulpal and periradicular disease. Routes of canal infection and the focal infection theory are also summarized.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
3.treatment planning restorative management of worn dentition (2)Ashish Choudhary
This document summarizes a seminar on the restorative management of worn dentition, specifically regarding treatment planning. It discusses mounting casts onto articulators using facebow transfers and interocclusal records to simulate jaw movement. It also addresses problems like spaces caused by tooth wear and how to assess the existing vertical dimension when developing a treatment plan. The goal is to properly evaluate the patient's occlusion and develop a restorative plan to rehabilitate worn teeth.
Management of non carious lesions- attrion, abrasion, erosion, abfractionPriyanka Chowdhary
This document discusses the management of non-carious lesions of teeth. It defines non-carious tooth tissue loss as surface loss from causes other than dental caries. The main causes discussed are attrition, abrasion, erosion, abfraction, hereditary enamel/dentin defects, and fractures. For each cause, the document describes the clinical presentation and treatment approaches. Treatment may involve restorations, occlusal equilibration, splints, or full mouth rehabilitation depending on the severity and location of the tissue loss.
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The document discusses 4 main causes of hard tooth tissue reduction: attrition from tooth contact during chewing, abrasion from external agents like toothbrushing, erosion from acidic foods/drinks, and abfraction from occlusal stresses that cause flexing and cracks in tooth structure away from the contact point. Each cause is defined and the clinical presentations are described, including locations commonly affected and distinguishing features like sharp edges for abrasions or wedge-shaped defects for abfraction. References are provided.
This document discusses composite material repair methodologies. It begins by defining a composite material as one made of two or more materials with different properties combined to produce a new material with unique characteristics. It then discusses some common applications of composite materials in airplanes. The main types of composite damage on airplanes are then outlined, such as impact damage, erosion, scratches, and damage through the full structure. Various repair techniques are presented, including non-patching methods like resin infusion as well as patching methods like bonded external patches and bonded scarf patches. Equipment used for repairs like vacuum bags are also depicted. Finally, the document concludes that reliable repair methods are necessary to restore structural integrity to composite materials increasingly used in aircraft.
Non-carious cervical lesions are caused by a combination of erosion, abrasion, and abfraction and affect half the population. Erosion is chemical wear from acids like those in citrus fruits and drinks. Abrasion is mechanical wear, like from overly vigorous brushing. Abfraction is stress-related wear from forces like clenching. These lesions are diagnosed through history, examination, and radiographs. Treatment depends on the severity but may include desensitization, restorations using composites or glass ionomers, endodontics, or periodontal procedures.
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The dental pulp is a soft tissue located within the center of a tooth that is surrounded by rigid dental structures. It contains blood vessels and nerves that make it highly sensitive. When bacteria enter through decay or cracks, they can cause inflammation of the pulp, known as pulpitis. Pulpitis can be reversible if caught early through mild symptoms like short pain from hot and cold. But over time, the inflammation can become irreversible as the bacteria spread, causing spontaneous, lingering pain that is worse when lying down and radiates elsewhere. This damages the pulp irreversibly.
DENTAL FLUOROSIS: A CASE STUDY IN VAUVNIYA DISTRICT, DRY ZONE OF SRI LANKASivanesan Somanathar
This document summarizes a case study on dental fluorosis in the Vavuniya district of Sri Lanka. Water samples were collected from 72 wells and tested for fluoride concentration. Fluoride levels above the WHO recommended level of 1.5 mg/L were found to cause dental and skeletal fluorosis. The highest number of fluorosis patients were found in the Chettikulam area, where the highest fluoride level of 1.52 mg/L was recorded. Positive correlations were observed between fluoride levels and electrical conductivity, pH, and well depth. The study identified areas with high fluoride concentrations in groundwater and high rates of dental fluorosis. More research was recommended to develop techniques for removing fluoride from drinking water in affected rural
The document discusses the examination of occlusion and the dentition. It covers topics such as analyzing facial form, dental development from primary to permanent dentition, identifying malocclusions, evaluating wear patterns and occlusal trauma, examining edentulous areas, and diagnosing issues related to dentures.
This document summarizes a literature review on dental erosion. It defines dental erosion as the loss of tooth structure from chemical dissolution by acids not produced by bacteria. The surfaces most commonly affected are the palate and chewing surfaces. Erosion initially appears as dull enamel and progresses to concave lesions lacking ridges. Erosion is often multifactorial, resulting from a combination of attrition, abrasion and erosion. The prevalence of erosion in children ranges from 5-57% according to studies in the UK. Erosion has multiple contributing factors including susceptible teeth, acid exposure time, and intrinsic or extrinsic acid sources.
Odontogenic fibroma is a benign neoplasm derived from odontogenic connective tissue containing islands of odontogenic epithelium and calcifications. It can be central or peripheral. Histopathologically, it displays stellate fibroblasts, fine collagen, scattered islands of odontogenic epithelium, and spherical/diffuse dystrophic calcifications. Odontogenic fibroma presents as an asymptomatic swelling and appears on radiographs as a well-circumscribed radiolucency that may contain radio-opaque flecks.
Biologic and composite mesh for repairSandip Ingle
This document summarizes recent updates on biologic and composite mesh for tissue repair. It discusses the limitations of conventional meshes and need for alternative options. Biologic meshes are derived from human or animal tissues and act as scaffolds for host tissue ingrowth. Composite meshes combine non-absorbable polymers with absorbable barriers. Both biologic and composite meshes aim to reduce complications like infections and adhesions compared to conventional meshes, but more long-term data is still needed before widespread adoption.
The document discusses the criteria for success of dental restorations and causes of failure for amalgam and composite restorations. It identifies inherent factors like conditions in the oral cavity and induced factors like incorrect material selection or cavity preparation as causes. Specific causes of amalgam failure include faulty case selection, cavity preparation, matrix adaptation, and amalgam manipulation. Composite failures include incomplete lesion removal or curing. Proper finishing and polishing are important to prevent composite failures.
This document provides information on haemangioma, lymphangioma, and dermoid cyst. It discusses:
- The different types of haemangioma (capillary, cavernous, plexiform) and examples like salmon patches, port-wine stains, and strawberry angiomas.
- Lymphangiomas are malformations of the lymphatic system that can be capillary or cavernous (cystic hygroma).
- Dermoid cysts are lined by squamous epithelium and contain mixtures of cells/tissues. There are different types like sequestration, implantation, teratomatous, and tubulodermoid cysts.
- It provides
Rifling imparts spin to the projectile which improves accuracy by stabilizing its flight. The spinning motion from the rifling grooves causes the projectile to travel point forward rather than tumbling through the air.
Pulp protection aims to maintain pulp vitality when it is exposed during dental procedures. Conventional direct pulp capping involves cleaning and drying the exposed pulp before placing a biocompatible material like calcium hydroxide over it. Newer materials like MTA, biodentine, and theracal are better at stimulating reparative dentin formation. Indirect pulp capping leaves caries near the pulp and seals it to prevent exposure. Factors like exposure size and patient age affect success rates. Lasers and stem cells may improve future pulp capping methods.
Ectodermal dysplasias (EDs) are a group of inherited disorders that affect two or more ectodermal structures such as hair, teeth, nails, and sweat glands. They are caused by genetic defects that may be inherited or occur spontaneously. EDs are classified based on clinical phenotypes and affected structures. The most common types are hypohidrotic ED (affecting hair, teeth, nails and sweat glands) and hidrotic ED (affecting hair, teeth, and nails). Without proper care, ED patients can experience life-threatening hyperthermia, infections, and failure to thrive. Treatment focuses on managing symptoms and may involve dentures, skin care, eye protection, and environmental thermal
TRAUMATIC INJURIES TO THE TEETH AND SUPPORTING STRUCTURESDrArunSharma7
This document discusses traumatic injuries to the teeth and supporting structures. It begins with an introduction noting that dental trauma is considered an emergency and can affect behavior and psychology. It then defines various types of injuries like fractures, contusions, abrasions, and lacerations. The document discusses the etiology of dental trauma, the severity of injuries depending on factors like energy and angle of impact. It provides classifications of injuries by Ellis-Davey and Andreasen and discusses the prevalence of dental trauma. The remainder of the document outlines the clinical evaluation, emergency care, clinical management of various crown and root fractures, luxation injuries, and splinting guidelines.
Non surgical management of gingival recession- Dr Harshavardhan PatwalDr Harshavardhan Patwal
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This document provides an overview of dental implants. It discusses reasons for dental implants like functional loss and aesthetics. It also discusses how implants maintain bone volume by providing stimulation. Some key points include that bone needs stimulation to maintain its density and loss of teeth leads to loss of bone width and height. The document also discusses medical contraindications for implants, patient attitudes and expectations, treatment planning factors like bone quality and position, and different types of implant prostheses. It provides details on factors like ridge morphology, bone availability/quality, osseointegration and implant surfaces. The two main surgical techniques of submerged and non-submerged implants are compared. Other factors discussed include soft tissue biotype, papilla preservation and
Unidad 1 intro to restorative concepts revisitedDonto2
1. The document discusses the history and principles of operative planning and cavity preparation for direct dental restorations. It covers topics like defining cavities versus preparations, principles of cavity design put forth by Black and others, classification of cavities, and methods for detecting and removing decay while protecting the pulp.
2. Modern cavity preparations aim to be minimally invasive using techniques like adhesive dentistry, laser diagnosis, and pulp protection with sealants or glass ionomer cements. Cavities can be classified based on location, size, depth and other factors to guide the preparation.
3. Outline, resistance, retention, convenience and cleaning steps are discussed as the logical sequence for cavity preparations to efficiently and effectively access decay while
This document discusses furcation involvement and its treatment. It defines furcation, describes the etiology and classification of furcation defects. It discusses diagnosis and examines factors like root morphology. It classifies furcation defects into grades I to IV based on the extent of involvement. Surgical and non-surgical treatment options are presented, including root resection and hemisection procedures. Prognosis depends on preventing further disease and maintaining oral hygiene.
This document discusses minimal invasive endodontics, which aims to preserve natural tooth structure during root canal procedures. It describes various techniques for minimal access cavities that reduce tooth structure removal, such as conservative cavities near the central fossa. Shaping techniques like self-adjusting files and modern burs are also outlined, which better conform to canal anatomy. Disinfection methods like ultrasonics and new photonic devices enhance irrigation along root canals. The goal of minimal invasive endodontics is to destroy microbes while maximizing the tooth's long-term survival through less tissue removal.
The denture-wearing history should provide information on the age of existing dentures, the frequency of denture replacement, the patient's experiences and expectations. It is important to identify whether any previous dentures have been successful as it may be suitable to copy features from a previously successful set. It will be important to manage expectations for those patients with a history of denture intolerance, yet technically satisfactory prostheses.
Clinical examination
Clinical examination should fully evaluate both the patient's anatomy and previous dentures to anticipate challenges and the potential to improve upon retention, stability, support, appearance and/or other factors. This should be undertaken in a systematic manner and would typically involve assessment of anatomy followed by an assessment of any existing dentures. This should follow a diagnostic process to determine if the patient presents with:
Technically adequate dentures on a favourable tissue base
Technically adequate dentures on an unfavourable tissue base
Technically inadequate dentures on a favourable tissue base
Technically inadequate dentures on an unfavourable tissue base.
This document discusses various types of tooth cracks and fractures, including craze lines, fractured cusps, cracked tooth syndrome, and split teeth. It begins with an introduction to how common cracks and fractures are for dentists to encounter. It then provides background on the history and classification of different crack types. The majority of the document discusses each specific crack type in detail, covering definitions, etiology, clinical features, diagnosis, and treatment options. It aims to provide an overview and review of longitudinal tooth cracks and fractures.
This document discusses strategies for minimally invasive endodontics. It emphasizes preserving tooth structure to maximize strength and longevity. Smaller access openings and conservative root canal shaping are recommended to avoid weakening tooth structure. Thorough disinfection can still be achieved with smaller canal preparations when combined with improved irrigation methods. Restorations should maintain coronal and peri-cervical tooth structure to reinforce the tooth through the "ferrule effect." The goal of minimally invasive endodontics is effective treatment while minimizing structural damage to teeth.
Gingival recession is the displacement of gingival tissue away from the tooth surface, exposing the root surface. It can be caused by periodontal disease, traumatic brushing, occlusal issues, or iatrogenic factors. Treatment depends on the severity and classification of the recession. For mild cases with no sensitivity or aesthetic concerns, improved brushing may suffice. More severe recession involving sensitivity or aesthetics may be treated with surgical root coverage procedures like laterally positioned pedicle grafts or coronally advanced flaps, which can achieve 65-98% root coverage depending on the technique and recession classification. The laterally positioned pedicle graft involves sliding keratinized gingiva from an adjacent tooth to cover the exposed root
Immediate implant placement following tooth extraction can help preserve alveolar bone and provide benefits like fewer treatment visits. However, it also carries risks like increased mucosal recession on the facial aspect due to normal bone resorption after extraction. For optimal esthetic outcomes with immediate implants, it is important to have adequate facial bone volume, perform bone grafting if needed, and consider the patient's gingival biotype and bone defect morphology. Careful case selection and experience with the technique are important to minimize esthetic complications.
This document provides information on periodontal plastic and aesthetic surgery procedures. It discusses the objectives of these procedures which include creating an adequate zone of attached gingiva and eliminating muscle pulls. It describes various gingival augmentation techniques used to widen attached gingiva including pedicle flaps and free soft tissue grafts. The document also discusses that while a minimal width of gingiva can maintain health, gingival augmentation may be indicated in situations involving planned orthodontic treatment, subgingival restorations, or patient discomfort.
This document discusses periodontal considerations for surgically exposing impacted canines. It notes that impacted canines require multidisciplinary management by orthodontists and periodontists. The aim is to guide eruption while respecting gingival tissues to avoid periodontal damage. Forced eruption alone is not sufficient; the tooth must achieve a stable, healthy position. Techniques discussed include gingivectomy, apically repositioned flap, closed eruption, and tunnel approach. Location of the impacted tooth influences technique choice to best preserve periodontal tissues and bone. Short-term studies found greater periodontal problems for treated teeth versus controls, though closed-flap techniques showed less attachment loss.
The document summarizes traumatic dental injuries and their management. It discusses the classification, clinical features, treatment, and stabilization periods for various types of dentoalveolar injuries including enamel fractures, crown fractures, root fractures, luxations, and avulsions. Splinting is described as the best method for immobilizing mobile teeth or displaced teeth, with different splinting techniques and materials discussed. Prompt treatment of dental trauma is emphasized to save injured teeth.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
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This document discusses the management of various types of traumatic dental injuries. It begins by classifying injuries based on Andreasen's modified classification system, including enamel infractions, fractures, luxation injuries, and root fractures. For each type of injury, the document describes characteristics, diagnosis, and treatment recommendations. It emphasizes the importance of promptly repositioning displaced or avulsed teeth and splinting when needed to allow for periodontal ligament healing. The document also stresses the need for follow-up evaluations and root canal treatment in mature teeth to prevent complications like pulp necrosis and resorption.
A successful prosthesis comprises an aesthetic restoration, having good functional qualities allowing comfortable and confident use. Absolute success however can only be considered if the histological and morphological normality of the mucosa and deep supporting tissues is maintained.
It is critical to understand the mucosal response to prosthodontic prostheses for the treatment outcome.
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
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Restorative management of worn dentition (PART 1)- AETIOLOGY
1. POSTGRADUATE DEPARTMENT OF CONSERVATIVE
DENTISTRY AND ENDODONTICS
SEMINAR TOPIC:-
RESTORATIVE MANAGEMENT OF WORN
DENTITION - I
(AETIOLOGY )
Presented by-Ashish Choudhary
PG student
UNDER GUIDANCE OF :-
Prof. Dr Riyaz Farooq (HOD)
Dr Aamir Rashid (Asst. Prof.)
Dr Fayaz Ahmed (lecturer)
2. “ Rehabilitation of dentition is not
all about restoring the mouth with
28 crowns or an aesthetic smile ”
“Itz about Cosmetic Functional Oral Rehabilitation”
3. CONTENTS
• Introduction
• Abrasion
• Abfraction
• Attrition
• Bruxism
• Erosion
• Combined Mechanisms
• Severity of wear
• Diagnosis of tooth wear
• Role of wear in occlusion
• Restoration of worn dentition
• Rehabilitation of worn dentition
4. INTRODUCTION
The term ‘tooth wear’ (TW) is a general term
that can be used to describe the surface loss of
dental hard tissues from causes other than
dental caries, trauma or as a result of
developmental disorders
(Hattab F, Yassin O)
Int J Prosthodont 2000; 13: 101–107
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
5. It is a normal physiological process that is
macroscopically irreversible and is cumulative
with age
Lambrechts et al. in 1989 estimated the normal vertical
loss of enamel from physiological wear to be
approximately 20-38 μm per annum
J Dent Res 1989; 68: 1752–1754
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
6. Tooth wear’s multi-factorial aetiology
ABRASION
ABFRACTION
ATTRITION
EROSION
Clinically however, it is difficult (if not at times impossible)
to isolate a single aetiological factor when a patient
presents with tooth wear
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
7. A growing challenge in dentistry
It therefore implies continuous monitoring to control related
pathologies
Quintessence Int 2003;34:435-446
J Oral Rehabil 2008;35:476-494
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
8. Multifactorial preventive & Restorative approach
involve different specialties,
starting with preventive measures &
ending up with full-mouth rehabilitation
adhesive and partial restorations for intermediate stages
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 6 • NUMBER 1 • SPRING 2011
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
9. Aspects which compound difficulties
associated with tooth wear management
include:
• Deriving an accurate diagnosis !!
• When to implement active restorative intervention??
• How to restore such severely worn dentitions, with the
aim of ultimately attaining a functionally and aesthetically
stable restored dentition??
•A lack of knowledge relating to the availability of
contemporary materials and their respective techniques of
application!!!
BDJ;2012 ; VOLUME 212 NO. 1
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
10. A modern approach to the treatment of tooth
wear is to prevent the progression of this
disease before a full prosthetic rehabilitation
would be needed
Such a treatment approach would become totally
ineffective because of potential biological
complications and inadequate biomechanical
rationale
J Prosthet Dent 2003;90:31-41
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
11. A modern treatment model involves
three steps:
1) Comprehensive etiological
clinical investigation
2) Treatment planning and execution
3) Maintenance
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 6 • NUMBER 1 • SPRING 2011
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
12. RESTORATIVE OPTIONS
•Conventional fixed restorations
•Removable onlay/overlay prosthesis
•Minimal preparation adhesive restorations
Tooth wear and sensitivity-clinical advances in restorative dentistry; Martin Dunitz
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
13. AETIOLOGY
ABRASION
derived from the Latin word abrasum (to
scrape off)
can be defined as the surface loss of tooth
structure resulting from direct frictional forces
between the teeth and external objects or from
frictional forces between contacting components
in the presence of an abrasive medium
(Marzouk )
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
14. Hard
Toothbrush
Abrasive
Toothpaste
Intensive Horizontal
brushing technique
“well-defined, V-shaped notches”
in the cervical regions of one or
more facial tooth surface
Location of the abrasion (three-body wear) lesions
depends on tooth alignment and/or which hand is
holding the toothbrush
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
15. In case of toothpaste abuse, the
anatomical detail of the affected surfaces is
faded with a sandblasted appearance
When the enamel wears through to the dentine,
cupping or cratering will form
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
17. Location and pattern of abrasion
may be related to the cause :
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
18. Classification:
(Vimal Sikri)
a) Notch N / V shaped
Oblique occlusal and cervical walls meet
at certain depth.
No definite axial wall.
b) C shaped defect (C)
Cross section C shaped with rounded floors
c) Undercut concave (UC)
Occlusal & cervical walls intersect with definite axial wall
d) Divergent box (DB)
Axial wall present
Occlusal and cervical walls diverge
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
19. 1) Shallow (S): 0.1 - 0.5 mm in depth
2) Deep (D): More than 0.5mm.
but no pulp exposure
3) Exposure (E): Pulp is exposed
Premolars > Canines > Maxillary first molars
Lingual surfaces are rarely affected
Localized lesions may be present on teeth or tooth placed
facial to the remaining dental arch
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
20. Initially may be linear lesion
As lesion progresses, peripheries become
more angularly demarcated from adjoining areas
Extremely smooth & polished surface of lesion
Sometimes surface may exhibit scratches in it
Surrounding walls tend to make a V shape
Probing or application of heat, cold or sweets can elicit
pain.
Intermittent in character
In slowly progressive defects, reparative dentin formation occurs
over a period of time making them asymptomatic
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
21. Diagnose the cause of presented abrasion
Treat the cause: Habit : Break the habit
Iatrogenic : correct it
If the habit cannot be broken , the
Restorative treatment can by-pass the effect
of habit
Desensitization by F-solution (NaP/SnF 8-
30% for 4-8 min) or iontophoresis.
Restorative treatment
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
22. Restorative protocol
ABRASION
Anterior tooth or
Facially conspicuous
area of posterior tooth
Inconspicuous area in
posterior tooth
Adhesive tooth coloured
materials
Metallic restoration
(but if cavity preparation would
compromise the PD organ vitality)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
23. Surgical retraction for restoration of non carious
cervical lesion -
By doing miniflap surgical retraction, it provides
access to the subgingival lesions.
Small vertical incisions are made on the mesial
& distal to the lesion and not involving the papilla
The incision should be made such a way that it
should not extend to the mucogingival junction
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
24. Noncarious Cervical Lesions:
graft or restore
When to graft:
No attached gingiva
No enamel defect
Class I or II recession i.e. there is no loss of interdental
bone or soft tissue
Papilla length and fullness are adequate
Esthetics is important
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
25. When to restore:
Adequate attached gingiva
Defect is mainly in enamel
Lesion is deeper than 2 mm horizontally
Class III recession i.e. there is some loss of interdental bone
height or soft tissue fullness, making complete root coverage
not possible
Esthetics is not of primary importance
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
26. When to graft and restore:
No attached gingiva
Defect in the enamel only
Recession is significant (more or equal 2mm)
Papilla length and fullness are inadequate
Esthetics is important
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
27. Concept of “stress induced cervical lesion”
derived from Latin words
ab – away, plus “fractio” – breaking
Synonyms : Idiopathic cervical erosion
(Grippo)
Abfraction is the microstructural loss of tooth substance in
areas of stress concentration
(JADA2004)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
28. Abfractions are described as
“ wedge shaped defects” in the cervical region
of the tooth
Loss of tooth structure resulting from repeated
tooth (enamel & dentin) flexure produced by
occlusal stresses
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
29. Occurs most commonly in the
cervical region of teeth, where
flexure may lead to a breaking away
of the extremely thin layer of enamel
rods, as well as microfracture of
cementum & dentin
These lesions, frequently have a
crescent form along the cervical
line, where this brittle and fragile
enamel layer exists
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
30. Mechanism of Formation of
Abfraction Lesion:
Compressive
forces Tensile forces
Kornfeld indicated that the cervical surface lesions tended to occur on
the part ofthe tooth opposing the side that had developed an occlusal
wearfacet caused by attrition
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
31. Characteristics of Abfraction Lesion:
Wedge-shaped defects limited to cervical area
Deep, narrow, V-shaped
Single tooth or Sometimes subgingival
More common in mandibular dentition and
among those with bruxism, hyper or malocclusion
Rate of progression : 1 m per day (Xhonga et al)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
32. How it is different from Abrasion????
A single tooth (but not adjacent teeth) is affected
The deep, narrow,
“V-shaped notch” does
not allow the toothbrush
to contact the base of the
defect
Gingivitis is present
34. Treat the cause before restoring
Occlusal loading on the tooth can be tested
in centric occlusion and in excursive
movements with occlusal marking paper
RESTORATIVE
TREATMENT
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
35. derived from the ‘Latin’ word attritum
Surface tooth structure loss resulting from direct
frictional forces between contacting teeth (Marzouk)
Attrition is mechanical wear of the incisal or occlusal
surface as a result of functional or parafunctional
movements of mandible (Sturdevant)
Prevalence of Attrition : 13% to 98%.
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
36. Attrition process begins from the time it erupts
in the mouth and makes contact with reciprocating
tooth surface
While a certain amount of attrition is
physiologic, excessive destruction of tooth
structure is not physiologic
Occlusal wear that
renders itself vulnerable
even to normal function
loading cannot be
regarded as normal
If occlusal wear occurs at a
rate faster than compensatory
physiologic mechanisms, this
is not physiologic
(Russel)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
37. Multifactorial etiology with age
Canine guidance having significant influence
Other Factors:
Para functional habits such as bruxism & clenching
Crowding
Occlusal slides
Cross bites
Chewing habits and Diet
ATTRITION
Continuing and Slow process
(vertical loss of enamel rarely exceeds 50 m / year)
Dental attrition has been
used in archaeology and
forensic sciences to
estimate human age
Teeth continue to erupt in adulthood
even in the absence of masticatory
function and concomitant attrition
(Newman)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
38. Widening of the
proximal contact area
Surface area
Susceptible to decay
Proximal surface attrition
(proximal surface faceting)
M-D dimension
decreases
Drifting of teeth
Decrease Arch length
Altered Occlusion
↓ Embrasure space
Alteration of physiology
of interdental papilla
Difficult plaque control
Periodontitis
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
39. Occluding surface attrition
Flattening/Faceting of
occluding elements
In severe cases, dentine wears
faster than enamel leaving
“scooped area” surrounded by
peripheral rim of enamel
Reverse cusping
If the wear is severe,
generalized &
accomplished in a
relatively short time
Vertical loss might be imparted on the face as
a Loss of Vertical Dimension
Strain in stomato gnathic system
If attrition over a
longer period of
time
vertical
dimension loss
will be confined
to the teeth but
not imparted to
the face
40. Consequences of tooth wear
Deficient masticatory capabilities of the teeth
Cheek biting (cotton roll cheeks)
Gingival irritation
Decay
Tooth sensitivity
Interfering / deflecting points
Predominantly horizontal masticatory movement /
TMJ problems
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
41. (modified from Richards and Brown)
Attrition index:
o - No wear
1- Minimal wear
2 - Noticable flattening ,
parallel to the occluding planes
3 - Flattening of cusps / grooves
4 - Total loss of contour / dentin exposure
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
42. SMITH AND KNIGHT 1984TOOTH WEAR INDEX:
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
43. Diminished vermillion borders and drooping
commisures
Wear facets with sharply defined line angles
Restorations that wear at same rates as adjacent
enamel
Asymptomatic teeth usually
History of parafunctional habits
Loss of
posterior
teeth
Traumatic Anterior
Occlusion
* Role of Occlusal prematurities
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
44. TREATMENT MODALITIES
Depends on the degree of Attrition:
MILD
MODERATE
SEVERE
If surface attrition
Slower
Intrapulpal
dentin
deposition
Faster
Pulpal
exposures
45. In case of mild-moderate Attrition
MONITORING PHASE
1. Periodically Checkup
2. Instructions for oral hygiene
3. FLUORIDE application
4. Hard plastic interocclusal device
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
46. BUT if its severe!!!
1. Endodontic therapy or Extraction,
(in case of pulpally involved teeth)
2. Disocluding-protecting occlusal splints
(to control parafunctional activities)
3. DIAGNOSE & RESOLVE Myofunctional, TMJ, or any other
symptoms in the stomatognathic system
4. Occlusal equilibration
(Selective grinding, coinciding RCP with ICP)
During the last three procedures
Use of Fluorides
Use of Temporary Restorations
Evaluation of PERIODONTAL health
(fortunately favourable)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
47. RESTORATIVE OPTIONS
(ONLY METALLIC!!!!!)
That too WHEN…….
Noticeable loss of vertical dimension that has not
been compensated
Extensive loss of tooth structure (localized or generalized)
Reshaping not effective!!
Superimposed decay
Concern over proper maintainence of Periodontium
Cracked or Endodontically treated
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
48. OCCLUSAL PARAFUNCTIONAL HABIT
May be: Sleep bruxism or Awake bruxism
It is defined as the grinding of teeth during non
functional movements of the masticatory system: it
is a mandibular parafunction
Mechanical wear resulting from bruxism often
results in progressively greater wear towards the
anterior teeth ( with open bite as exception)
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
49. 2 Aetiological Models :
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
STRUCTURAL FUNCTIONAL
Occlusal
Interferences
Altered
maxillo-mandibular
relationships
STRESS
Children Brux
Bruxism produces surface loss, which is related to
the duration and force & frequency of parafunction
50. • Grooving of lateral borders of tongue
• Cheek biting
• Fractured porcelain restorations
•Cupping or cratering of occlusal surface
•Teeth grinding or clenching
•Teeth are worn down, flattened or chipped
•Increased tooth sensitivity
•Jaw pain or tightness in jaw muscles
•Earache
•Dull morning headache
•Chronic facial pain
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
51. No accepted cure as yet
wearing of a full-width acrylic
NIGHT GUARD
Occlusal therapy should only
be carried out after successful
stabilization splint usage, and
careful 'mock' equilibration on
accurately mounted study
models
IMPORTANCE OF USING
INTRERMITTENT
SPLINTS
52. derived from latin verb erosum ( to corrode)
EROSION
defined as loss of tooth structure resulting from chemico
mechanical acts in the absence of specific microorganisms
(Marzouk)
“If it is not abrasion or attrition,
it must be erosion”
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
59. Classification of dental erosion
Grade 1
Early erosion,
Early stage loss of enamel structures minimal
loss of enamel only just measurable
Dull surface appearance (active)
Smooth/shiny (chronic)
Grade 2
Erosion in enamel
Obvious loss of enamel, dentin not
exposed
60. Grade 3
Erosion in dentin
Localized lesions involving dentin for
less than one third of the surface
Grade 4
1/3-2/3 rd of tooth surface has exposed
dentin
Grade 5
more than 2/3 rd of tooth surface
has exposed dentin and/or the
pulp is exposed
61. Management of EROSION
Treatment of
aetiology
Preventive
measures
RESTORATIVE
options
Complete analysis of diet,
occlusion, habits,
environmental factors
Every attempt to correlate
to a cause
Try to eliminate the
probable cause
Diagnostic modalities
Patient education
Counseling
Physcian consultation
Use of sugarless chewing
gum
Pilocarpine
Do not rush to restore
Observe the progression
of lesion (WATCH
strategy)
1. Diminish the frequency and
severity of the acid challenge
2. Enhance the defense
mechanisms of the body (increase
salivary flow and pellicle
formation)
3. Enhance acid resistance,
remineralization and rehardening of
the tooth surfaces
4. Improve chemical protection
5. Decrease abrasive forces
6. Provide mechanical protection
7. Monitor stability
Desensitisation by using fluoride
rinses, gels, and varnishes as well
as high-fluoride toothpastes and
remineralizing toothpastes
Tooth coloured filling material
FULL COVERAGE
RESTORATIONS
Endodontic intervention, if
required
FULL MOUTH
REHABILITATION
62. COMBINED MECHANISMS OF
TOOTH WEAR
Attrition-abfraction: joint action of stress and
friction when teeth are in tooth-to-tooth
contact
Abrasion-abfraction: loss of tooth substance caused by
friction from an external material on an area in which
stress concentration due to loading forces may cause tooth
substance to break away
Toothwear: ABC of the worn dentition; 1st ed
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
63. Corrosion-abfraction: loss of tooth substance
due to the synergistic action of a chemical
corrodent on areas of stress concentration
Attrition-corrosion: loss of tooth substance due to the
action of a corrodent in areas in which tooth-to-tooth
wear occurs. This process may lead to a loss of
vertical dimension, especially in patients with GERD
or gastric regurgitation
Abrasion-corrosion: synergistic activity of corrosion and friction
from an external material. This could occur from the frictional
effects of a toothbrush on the superficially softened surface of a
tooth that has been demineralized by a corrosive agent
Toothwear: ABC of the worn dentition; 1st ed
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of wear
64. Biocorrosion (caries)-abfraction: pathological loss of tooth
structure associated with the caries process, where an area is
micromechanically and physicochemically breaking away
due to stress concentration.
A common site for this synergistic activity is the cervical
area of the tooth, where it may be manifested as root or
radicular caries.
Articulating paper markings
indicate eccentric loading, which
induced stress concentration in the
cervical region (abfraction) and
may have exacerbated the caries
(biocorrosion).
Toothwear: ABC of the worn dentition; 1st ed
67. SEVERITY OF TOOTH WEAR
Tooth Wear Index by
Smith & Knight
Received
criticism
BDJ; VOL-212; NO.1;2012
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of
wear
68. BEWE (Basic Erosive Wear Examination)
(Bartlett ;2010)
Scale from 0 to 3 for each sextant
0 (no wear),
1 (initial loss of surface texture),
2 (less than 50% loss of surface) and
3 (greater than 50% loss of surface)
Tooth most severely affected in a particular sextant is the one
for which the score is based on
On completion of the BEWE, an aggregate score is reached for all
sextants
The latter score can be used as a guide to the clinical
management of the patient concerned
However, further studies are needed BDJ; VOL-212; NO.1;2012
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of
wear
70. STAGES OF TOOTH WEAR (Khan et al & Young)
Toothwear: ABC of the worn dentition; 1st ed
Introduction
Abrasion
Abfraction
Attrition
Bruxism
Erosion
Combined
mechanisms
Severity of
wear