Wear 1 Flashcards
what is physiological tooth wear
normal wear associated with ageing and normal function
what is pathological wear
tooth wear in excess of what would be expected for that age
what are the types of NCTSL
attrition
abrasion
erosion
abfraction
what is attrition
wearing away of a tooth structure as a result of tooth to tooth contact found on occlusal and incisal contacting surfaces
what is the early appearance and progression of attrition
polished facet
reduction in cusp height and flattening of occlusal inclined planes
what is attrition related to
parafunctional habit
what is abrasion
wear of tooth through abnormal mechanical process independent of occlusion on buccal/cervical canines and premolars
what is abrasion related to
foreign objects repeatedly contacting the tooth (toothbrushing)
what does abrasion look like
v-shaped or rounded lesions with sharp margins at enamel edge
what is erosion
loss of tooth surface by a chemical process that does not involve bacterial action
what is the cause of erosion
chronic exposure of dental hard tissues to acidic substances
what is the early appearance and progression of erosion
enamel surface has loss of detail and then becomes flat and smooth
bilateral concave lesions
cupping of occlusal surfaces
what is abfraction
loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth
what causes abfraction
biomechanical loading forces
what can cause cervical wear
overzealous toothbrushing
abrasion
how do you assess toothwear
recognise problem
grade severity
diagnose causes
monitor progression
what are the medical causes of erosion
low pH medicines
dry mouth medicines
alcoholism
heartburn
GORD
hiatus hernia
rumination
pregnancy
what do you examine extraorally
TMJ for movement
musculature for hypertrophy
mouth opening for restriction and deviation
parotic hypertrophy
overclosure
what do you examine occlusal wise
FWS
OVD and resting face height
dento-alveolar compensation
overbite and overjet
stable contacts in centric relation
tooth contacts in excursive movements
what is the wear index used
BEWE
what is BEWE wear index scores
0 = no erosive wear
1 = initial loss of surface texture
2 = distinct defect, hard tissue loss <50% surface
3 = hard tissue loss >50% surface
what special tests are used for wear
sensibility testing
radiographs
articulated study models
intra-oral photographs
salivary analysis
diagnostic wax-up
dietary analysis
