management of tooth wear Flashcards
what are pathological aspects of tooth wear?
excessive toothwear
attrition
abrasion
erosion
what are clinical signs of physiological attrition?
disappearance of mamelons
flattening of occlusal cusps
exposed dentine- cup shaped lesions
how does pathological attrition display?
confined to local areas
caused by parafunction - eg. bruxism
what is bruxism?
a parafunction
grinding and clenching
often associated with stress
what are signs and symptoms of bruxism?
visable wear facets abnormal rate of attrition hypertrophy of masticatory muscles muscle tenderness TMJ pain tooth mobility
how can bruxism be managed?
remove occlusal interferences
acrylic splint to protect teeth
how does dentine attrition occur?
rate of attrition higher than enamel
results in secondary dentine, protecting from sensitivity
what is abrasion?
pathological wearing away of tooth substance as a result of repetitive mechanical process or habit
what are signs of abrasion?
common in exposed root surfaces
notches in root surfaces
what types of abrasion are there?
cervical abrasion
habitual abrasion
iatrogenic abrasion
features of cervical abrasion?
v shaped groove
causes- horizontal brushing, abfraction
what is abfraction?
tooth flexure from occlusal loading
micro fractures in enamel
causes cavitaion
what is habitual abrasion?
localised to area of habit:
pipe smoking
wind instruments
hair pins
what is iotrogenic abrasion?
opposing teeth grinding to accommodate restorations
ceramic crowns
what is erosion?
progressive loss of dental tissue by acidic chemical processes without bacterial action
what are signs of erosion?
can occur on any surface polished and smooth shallow depressions proud restorations palatal chipping of incisal edge criss cross appearance cupping of lower molar cusps worse at cervical area
what do signs of extrinsic erosion show?
labial surfaces of anterior teeth
occlusal of lower molars
where do signs of intrinsic erosion show?
palatal surfaces of uppers
occlusal of lower molars
what are causes of intrinsic erosion?
reflux vomiting alcohol abuse pregnancy bulimia hiatus hernia gastric ulceration
how can erosion be managed dentally?
remove cause
fluoride therapy
advise not to brush immediately after acid contact
when may a restorative intervention be required re. NCTSL?
poor aesthetics loss of vitality loss of function sensitivity compromised pulp
