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Objectives: Tooth wear, also referred to as tooth surface loss, occurs due to causes other than caries. This involves the loss of hard tissues, namely enamel, dentin, and/or cementum. Types of tooth wear/tooth surface loss are abrasion, abfraction, attrition, and erosion. These multifactorial conditions can be caused by factors such as lifestyle, diet, or even habits, and may not be symptomatic. The focus of this article is to provide clinicians with detailed examples and explanations of the causes of tooth loss to aid in early diagnosis. Through early identification, the preventive measures outlined can be implemented to avoid excessive tooth wear. The provision of a treatment flowchart and general treatment recommendations aims to help clinicians determine when to restore these lesions and the most appropriate treatment measures for the four types of wear. Method and materials: The PubMed (MEDLINE) search engine was used to gather information on teeth restricted to a 5-year period (26 August 2018 to 25 July 2022). Only English-language studies and reviews with the best balance of sensitivity and specificity were considered. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: ("tooth wear" OR tooth attrition OR tooth erosion OR tooth abrasion OR tooth abfraction). Additional articles were selected through Google Scholar. Results: By this process, many articles and studies were obtained, and the 48 most relevant published studies were chosen and used in the current review. Conclusion: Tooth wear affects an increasing number of individuals and can have detrimental effects physically, mentally, and emotionally. It is important to stress early diagnosis and management of tooth wear through monitoring, prevention, and treatment where indicated. [ABSTRACT FROM AUTHOR]

Background: Due to their acidic nature, certain medications can have deleterious effects on tooth enamel. Fluoride is a popular method for reversing these effects. Therefore, this study aimed to assess the impact of acidic medications, specifically anti-asthmatic drugs and vitamin C tablets, on enamel surfaces and to investigate the effects of fluoride following drug exposure. Methods: An in vitro experimental study was conducted on ninety-six healthy human posterior teeth. Forty-eight samples were tested for surface demineralization via quantitative laser fluorescence (QLF), and the other forty-eight samples were tested for enamel microhardness via a Vickers hardness tester. The samples were divided into six groups: (i) Group DW_NF- samples immersed in distilled water with no fluoride exposure; (ii) Group DW_F- samples immersed in distilled water with intermittent fluoride exposure; (iii) Group VC_NF- samples treated with vitamin C only; (iv) Group VC_F- samples treated with vitamin C and fluoride mouthwash; (v) Group SB_NF- samples exposed to salbutamol inhaler with no fluoride exposure; (vi) Group SB_NF- samples exposed to salbutamol inhaler followed by fluoride exposure. For the evaluation of surface morphology by scanning electron microscopy (SEM), two random samples used for QLF from each group were taken. The Wilcoxon signed-rank test, Kruskal‒Wallis test, and post hoc test were applied as appropriate. The p value was set at 0.05. Results: Following exposure to medication, significantly higher QLF values were observed in Group VC_F and Group SB_F than in Group DW-NF (control group) (p = 0.15 and 0.004, respectively). The difference in the QLF values was significantly greater in Group VC_NF than in the control group DW-NF, indicating greater demineralization with acidic medications (p = 0.034). Significant changes in surface microhardness were detected in Group VC_F compared with the control group (p = 0.024). Qualitative analysis of SEM images revealed erosion at the enamel surface in all groups except the control group, with the most prominent erosion in the vitamin C- and fluoride-treated groups (VC_F group). Conclusion: This study demonstrated the erosive potential of vitamin C tablets on enamel surfaces. Furthermore, the use of acidic fluoride mouthwash immediately after exposure to acidic medication exacerbates enamel demineralization. [ABSTRACT FROM AUTHOR]

To investigate the preventive effect of silver diamine fluoride (SDF) modified salivary pellicle (SP) against dental erosion. Enamel and dentin blocks allocated into 4 groups (n = 30 each). Blocks in Group SDF+SP were treated with SDF and SP. Blocks in Group SDF were treated with SDF. Blocks in Group DW+SP were treated with deionized water (DW) and SP. Blocks in Group DW were treated with DW. The blocks were subjected to an erosive challenge at pH 3.2 for 2 mins, 5 times per day for 14 days. Salivary pellicle morphology was assessed by atomic force microscopy (AFM). Crystal characteristics, percentage microhardness loss (%SMHL), surface loss, and surface morphology were assessed by X-ray diffraction (XRD), microhardness test, profilometry, and scanning electron microscopy (SEM), respectively. AFM revealed a modified pellicle morphology in Group SDF+SP. XRD of both blocks revealed hydroxyapatite, silver chloride, silver phosphate, and silver fluoride in Groups SDF+SP and SDF. Fluoroapatite was found in Group SDF+SP only. %SMHL (± Standard deviation in %) of Groups SDF+SP, SDF, DW+SP, and DW were 33.4 ± 2.2, 38.6 ± 2.2, 50.3 ± 2.2, and 58.3 ± 2.4 in enamel and 16.1 ± 2.2, 19.7 ± 2.1, 32.8 ± 2.1, and 39.0 ± 2.3 in dentin, respectively. The presence of SDF and SP reduced %SMHL in both blocks (p < 0.001). The surface loss (± Standard deviation in μm) of Groups SDF+SP, SDF, DW+SP, and DW were 3.6 ± 0.7, 4.1 ± 0.4, 5.3 ± 0.5, and 7.0 ± 0.6 in enamel and 5.4 ± 0.6, 6.1 ± 0.5, 9.1 ± 0.7, and 9.2 ± 0.5 in dentin, respectively. The presence of SDF and SP reduced surface loss in enamel and dentin blocks (p = 0.031 and p = 0.002, res p ectively). SEM showed enamel surface remained relatively smooth and partially dentinal tubule occlusion on dentin blocks in Groups SDF+SP and SDF. SDF had a positively synergistic effect with SP. SDF-modified salivary pellicle provided a superior protective effect against dental erosion. [ABSTRACT FROM AUTHOR]

Introduction and purpose: The topic of apple cider vinegar supplementation and insulin resistance is becoming increasingly widespread, especially on the internet, which carries many potential risks. There is a need to understand both how apple cider vinegar reduces insulin resistance and improves metabolic parameters, as well as the potential risks of its use. Material and methods: Medical databases like PubMed, Google Scholar, and Embase were searched for scientific papers on the safety, benefits, mechanisms, and risks of apple cider vinegar in insulin resistance and related conditions. These were analyzed and summarized in a single review. State of knowledge: Apple cider vinegar supplementation contributes to a reduction in insulin resistance, which is reflected in parameters such as decreased postprandial insulin secretion, lower levels of triglycerides (TG) and total cholesterol (TC), reduced fasting glucose, lower HbA1c levels, and supports weight loss, potentially improving insulin sensitivity. In most cases, no adverse effects or serious side effects were observed with doses of 15-30 ml per day. However, potential risks include delayed gastric emptying, exacerbation of gastroesophageal reflux disease (GERD), gastrointestinal disturbances, tooth erosion, although one study suggests that such supplementation may be associated with acute pancreatitis. Conclusions: More research is needed on supplementation, particularly regarding its duration. Another risk is the search for health information online without critically evaluating the content. Weight loss through a proper diet and exercise appears to be key for improving insulin sensitivity, but supplementation may help achieve results in certain patient groups. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Material and Methods Results Conclusions Clinical Significance To report and compare the survival of minimally invasive direct and indirect restorations of different materials for restoring the worn dentition.A systematic search was conducted in six databases: MEDLINE, Web of Science, Scopus, CENTRAL, VHL, and EMBASE. The eligibility criteria of this systematic review used the PICO framework to address the following research question: “In dentate patients with a worn dentition (P), does rehabilitating their lost tooth structure with indirect restorations (I) or direct (C) effect the survival and success of treatment (O)?”. Study characteristics, survival rates of the restorations were extracted from each article. No language restrictions were applied. Survival and prevalence estimates were calculated using random‐effect models.The electronic search yielded 5009 entries, resulting in 14 publications selected for full‐text analysis. These included 2 RCTs, 7 prospective, and 5 retrospective studies, with a varying level of methodological quality. This included 52% direct and 48% indirect restorations, using varying materials and follow‐up periods. The survival of direct composite resin restorations versus indirect manually processed composite resin restorations showed no significant difference (n = 2; OR, 1.79 [95% CI, 0.64–5.05]; p = 0.270). For the prospective articles, the pooled prevalence estimates of the survival restorations were; direct (n = 3; 99% [95% CI, 0.97–1.00]) and; indirect (n = 5; 100% [95% CI, 0.99–1.00]). Lithium disilicate recorded the least amount of failures at 1.8%.Although the survival estimates of indirect manually processed and direct composite resins were not significantly different, indirect restorations—especially those made of lithium disilicate ceramic—may offer better survival rates, compared to direct resin restorations in patients with worn dentition.Despite the limited evidence, indirect ceramic restorations appear to be well‐suited for long‐term treatment of worn dentition, whilst direct composite resin restorations are more suited as an medium‐term solution. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Clinical Consideration Conclusions Clinical Significance This article presents a clinical case of erosive tooth wear, in which the vertical dimension of occlusion (VDO) has been restored using defect oriented posterior onlays and anterior veneers respecting minimal invasive treatment approaches.A 44‐year‐old female with the history of bulimia nervosa and bruxism expressed the desire to improve the aesthetic appearance and reestablishment of function of her worn dentition. After a 3‐month functional therapy to ease myofunctional problems using a Michigan splint, a diagnostic phase revealed the necessity for a full mouth prosthetic rehabilitation. A slight increase of the VDO of 1 mm at the incisal point was determined. Veneered lithium disilicate ceramic restorations of 0.3–0.5 mm in thickness were produced for the incisors and monolithic lithium disilicate restorations of 0.8–1.0 mm in thickness for posterior teeth.Functional and aesthetic prosthodontic rehabilitation of severely worn teeth can be achieved satisfactory with minimal invasive procedures using defect oriented, indirect lithium disilicate ceramic restorations with increasing the VDO to its original state.Indirect, minimal invasive lithium disilicate ceramic restorations are suitable to restore the VDO of severe dental erosions. [ABSTRACT FROM AUTHOR]

Background: The increase in the prevalence of erosion lesions worldwide has led researchers to develop effective toothpastes with different ingredients to prevent erosion that can protect the tooth surface against acid attacks. There remains a lack of consensus in the literature regarding which toothpaste formulation exhibits the most effective preventive action against erosive tooth wear, highlighting the necessity for further investigation in this field. This study aimed to evaluate the preventive effect of brushing with toothpastes with different ingredients on enamel and dentine erosion. Methods: The crowns and roots of ninety recently extracted bovine incisors were seperated and ground flat to obtain enamel and dentine surfaces. The obtained specimens were then divided into six groups: Curaprox Enzycal Zero Flouride (fluoride-free), Colgate Total 12 (1450 ppm NaF), Splat Biocalcium (fluoride-free and Nano-HAP), Colgate ProRelief (1450 ppm NaF and arginine), Sensodyne Repair and Protection (1450 ppm NaF and novamin), Opalescence Whitening (1100 ppm NaF). The specimens were immersed in a demineralizing solution for 2 min and in an artificial saliva for 60 min 4 times a day for 5 days. Brushing was performed with the aid of a charged toothbrush immediately after the first and last erosive attacks. Initial and final surface roughness (at the end of fifth day) were measured using a 3D profilometer. The Wilcoxon test was used to compare initial and final roughness values (p < 0.05). Results: Opalescence Whitening and Curaprox Enzycal Zero Fluoride significantly increased both enamel and dentine surface roughness compared to baseline, demonstrating rougher surfaces than all other groups except Colgate ProRelief (p < 0.001). Sensodyne Repair and Protection and Colgate Total 12 resulted in the smoothest enamel and dentine surfaces, respectively. The increase in surface roughness was significantly higher for enamel samples compared to dentine samples in the Opalescence Whitening group (p < 0.001). Conclusions: Whitening toothpastes may exacerbate dental erosion by increasing surface roughness. The protective properties of fluoride-free toothpastes vary depending on their active ingredient. [ABSTRACT FROM AUTHOR]

Background: Non-institutionalised older adults is the majority of older adults in Hong Kong. The study aimed to examine erosive tooth wear (ETW) and its association with dental conditions and oral hygiene habits among non-institutionalised older adults in Hong Kong. Methods: This cross-sectional study recruited dentate adults aged 60 or above from nine elderly daycare centres in the five main districts of Hong Kong. The study consists of a questionnaire survey and a clinical examination. A researcher used a questionnaire to collected the participants' demographic information, oral hygiene habits such as toothbrushing habits and dental visit behaviour. A calibrated examiner performed an oral examination in the daycare elderly centre to assess the ETW using basic erosive wear (BEWE) criteria. Oral hygiene was recorded using visible plaque index. Prosthetic status was recorded using the World Health Organization criteria. Logistic regression was used to examine the correlation between ETW and the dental conditions and oral hygiene habits. Results: This study recruited 433 dentate adults and 333 adults were female (77%). Their age ranged from 60 to 99 years and their mean age was 74 years (SD = 7). They all had ETW (BEWE > 0). Over half of them (57%) had BEWE score of 3, indicating severe ETW. Analysis showed increasing age (OR = 1.030, p = 0.029) and older adults with untreated dental caries had higher odds (OR = 1.822, p = 0.002) of presenting severe ETW. No other associations were found between the ETW and the factors studied. Conclusion: Hong Kong non-institutionalised older adults aged 60 or above had ETW and more than half of them had severe ETW. Increasing age and having untreated dental caries were associated with severe ETW. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to assess the prevalence of dental erosion in competitive swimmers using teledentistry and artificial intelligence. Materials and Methods: An opportunistic sample of 20 competitive swimmers was recruited. The participants reported that they carried out an average of 2.40 h of training per day, 4.45 days per week. Data gathering was carried out remotely. The subjects completed a digital questionnaire and uploaded three photos of their mouth. Intraoral photographs were analyzed using the "Intact‐Tooth" application to assess dental erosion. A statistical analysis was carried out to verify a possible correlation between the collected data. Results: The average calculated Basic Erosive Wear Examination (BEWE) index was 13.95, and 11 subjects (55%) had a severe BEWE (≥ 14). More than 40% of the participants disagreed about having social issues related to tooth hypersensitivity. Considering only subjects with a severe total BEWE value, we have observed an indirect correlation between the degree of dental erosion and diet (Pearson coefficient r = −0.57), whereas a direct correlation was observed between dental erosion and age (r = 0.493) and between BEWE and weekly training hours (r = 0.217). Conclusions: Because of their lifestyle, competitive swimmers can be considered at a higher risk of developing dental erosion. In this context, teledentistry and AI tools can be effectively used to intercept those at the highest risk and prevent the occurrence of conditions. Summary: Dental erosion assessment in competitive swimmers using teledentistry and AI. [ABSTRACT FROM AUTHOR]

Introduction: With increasing prevalence of dental erosion, this study explores the protective role of traditional fluoride-based products and newer formulations on eroded enamel. Aims: To assess the protective effectiveness of casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and sodium fluoride (NaF) on human enamel against erosion using surface microhardness (SMH) and Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) analyses. Materials and Methods: Ten extracted human third molars were sectioned to obtain 40 enamel sections and randomly assigned into four groups (n = 10) and treated as follows: G1 (Sound Enamel), G2 (Erosive Challenge), G3 (CPP-ACPF + Erosive Challenge), and G4 (NaF + Erosive Challenge). All samples were subjected to Vicker’s SMH analysis, while changes in surface morphology and elemental composition were validated in few representative samples using FTIR and SEM, respectively. Statistical Analysis: Paired samples test, Kruskal-Wallis test, and Tukey HSD test were performed using SPSS software version 23 setting P value < 0.05 as statistically significant. Results: The mean SMH1 values for the experimental groups G3 and G4 were significantly higher (426.58VHN and 455.83VHN) when compared to G1 (P = 0.000) and G2 (P = 0.000). In SEM analysis, G2 showed eroded honeycomb appearance compared to the smooth homogenous surface of G1, while both G3 and G4 showed deposition of some precipitates. FTIR analysis revealed that in G3 and G4, a characteristic peak of phosphate vibrations between 528 and 823 cm-1 and carbonate bands at 845-932 cm-1 was observed. Conclusions: Both CPP-ACPF and NaF demonstrated a protective effect on enamel against erosive challenge by an orange juice-based beverage.

Abstract An animal model was applied to develop erosive tooth wear (ETW) and to evaluate the efficacy and safety of titanium tetrafluoride (TiF4) in preventing ETW. Forty-eight male Wistar rats were divided into three groups (n = 16): TiF4 (2.45% F−), NaF (2.45% F−) and placebo varnishes. Eight from each group were subjected to erosive challenges (Sprite Zero) and the other received tap water, both ad libitum. After twenty-eight days, the mandibles were resected for histopathological gingival analysis, clinical and microscopic tooth evaluation by 3D confocal laser microscopy, scanning electron microscopy (SEM-EDX) and micro-Raman spectroscopy (MRS). Organs were evaluated with respect to fluoride content. No significant difference was found in F content in tissues. No histopathological damage was seen in gingiva. ETW was clinically more aggressive in rats from placebo group consuming Sprite compared to water (Q²=12.6, p

Abstract Background Erosive tooth wear is an increasingly common pathology in the youth population. It refers to the chronic, localized, painless loss of dental hard tissues caused by non-bacterial acids, often originating from external sources like acidic beverages. Energy drink consumption is on the rise, frequently preceding physical exercise to enhance perceived energy levels. However, there are other types of beverages that also provide energy, such as pre-workout drinks, classified as sports drinks. The main objective of this research study has been conducted with the purpose of analyzing the pH of energy drinks and pre-workout beverages, and studying the frequency of consumption of such beverages in amateur athletes who practice sports. Methods A total of 67 beverages were examined, comprising 43 energy drinks and 24 sports supplementation beverages, also known as pre-workout or pre-training beverages. The participants were given a survey to complete. They were asked to respond whether they consumed any type of pre-workout or energy drink, and they were also asked about the timing of consumption. Results The findings indicated an average pH of 3.3 among the studied beverages, indicating a pH below the critical threshold. Out of the 113 participants, 51% reported taking some form of supplementation. Conclusions Consequently, it was concluded that most of the analyzed beverages recorded pH values low enough to classify them as erosive, posing a threat to enamel surface. When analyzing the frequency of consumption of energy drinks and pre-workout beverages in amateur athletes, we observed that most participants aged 29 years or younger took supplements 3 to 5 times a week, while the older age groups more frequently took supplements 1 to 2 times a week.

Background: The scientific literature has studies that assess the influence of erosive challenges with citric acidic drinks and substances on the adhesive bond strength to enamel and dentin, but does not contain information about the influence of regional components of an acidic diet on this process. Thus, this study evaluated the erosive influence of Amazonian tucupi on enamel and dentin microshear bond strength. Materials and Methods: One hundred and sixty-eight healthy bovine incisors teeth were used, divided into 12 groups (n = 14). For erosive cycling, distilled water (negative control), cola-based soft drink (positive control), or tucupi were used, followed by adhesive strategies of (1) etch-and-rinse (conventional) (Adper™ Single Bond 2) and (2) self-etching (Clearfil SE Bond). All specimens were subjected to erosive cycling for 5 days and, after 24 h, composite resin cylinders were built up for the microshear bond strength test. The data showed normal distribution and were analyzed by two-way ANOVA, followed by the Tukey post and test (P ≤ 0.05). Results: There were no significant differences in enamel (P > 0.05). In dentin, only the groups exposed to cola-based soft drink showed significant differences (P < 0.01). The failure mode showed that Type II (mixed) was predominant (95%). Conclusion: The erosive challenge with tucupi did not influence the bond strength to enamel and dentin, regardless of the adhesive strategy used.

An animal model was applied to develop erosive tooth wear (ETW) and to evaluate the efficacy and safety of titanium tetrafluoride (TiF4) in preventing ETW. Forty-eight male Wistar rats were divided into three groups (n = 16): TiF4 (2.45% F−), NaF (2.45% F−) and placebo varnishes. Eight from each group were subjected to erosive challenges (Sprite Zero) and the other received tap water, both ad libitum. After twenty-eight days, the mandibles were resected for histopathological gingival analysis, clinical and microscopic tooth evaluation by 3D confocal laser microscopy, scanning electron microscopy (SEM-EDX) and micro-Raman spectroscopy (MRS). Organs were evaluated with respect to fluoride content. No significant difference was found in F content in tissues. No histopathological damage was seen in gingiva. ETW was clinically more aggressive in rats from placebo group consuming Sprite compared to water (Q²=12.6, p < 0.01), in accordance with confocal images. TiF4 was superior in reducing cross-section area loss (0.036 ± 0.01µm2) compared to NaF and placebo, respectively (0.044 ± 0.01/0.063 ± 0.01µm2, ANOVA, p < 0.0001). Dentin exposure was detected by SEM in rats belonging to placebo consuming Sprite. Peaks compatible with typical apatite bands were visible. TiF4 reduces the progression of ETW without causing any relevant side-effect and the rats' model was able to simulate ETW in vivo. [ABSTRACT FROM AUTHOR]

Objective: This systematic review investigates the prevalence of erosive tooth wear (ETW) in individuals classified as risk groups (gastroesophageal reflux disease, eating disorders, special diets, acidic beverage, drugs and alcohol, legal drugs and medications, and occupational or sports). Materials and methods: The research was conducted in nine databases (PubMed/MEDLINE, Embase, Cochrane Library, LILACS/BVS, SciELO, Scopus, Science Direct, Open Grey, and Web of Science) up to April 2024 (PROSPERO CRD42021270150), along with a manual search of grey literature. Observational studies involving children and adults from these previously mentioned risk groups, which provided data on ETW prevalence, were included without date or language restrictions. The methodological quality of studies was evaluated using the Joanna Briggs Institute's Prevalence Data Critical Appraisal Tool. General and subgroup data were meta-analyzed using a random-effects model. Results: Overall, 4403 studies were retrieved, out of which 148 met the inclusion criteria. Each risk group showed higher prevalences of ETW in these patients in general and subgroup analysis; although subgroup analysis was not possible for all risk groups due to the heterogeneity of the indices found. Conclusions: The Legal drugs and Medications risk group showed lower overall prevalence values (30%), while the Drugs and Alcohol risk group obtained higher values (67%). Prevalence rates for other groups were: Gastroesophageal reflux disease (54.1%), Eating Disorders (65%), Special Diets (65.9%), Acidic Beverages (40%), Occupational and Sports (51%). Clinical relevance: This systematic review highlights that risk groups are indeed at significant risk for the development of ETW and greater preventive care and dental monitoring are needed. [ABSTRACT FROM AUTHOR]

Implant treatment is provided to individuals with normal, idealized masticatory forces and also to patients with parafunctional habits such as grinding, clenching, and bruxing. Dental erosion is a common increasing condition and is reported to affect 32 % of adults, increasing with age. This oral environment is conducive to tribocorrosion and the potential loss of materials from the implant surfaces and interfaces with prosthetic components. Although several fretting-corrosion studies have been reported, until now, no study has simulated clinically relevant micromotion. Therefore, our aim is to investigate fretting-corrosion using our new micro-fretting corrosion system, simulating clinical conditions with 5 µm motion at the implant-abutment interface under various occlusal loads and acidic exposures. We simulated four conditions in an oral environment by varying the contact load (83 N and 233 N) and pH levels (3 and 6.5). The commonly used dental implant material, Grade IV titanium, and abutment material Zirconia (ZrO 2)/ Grade IV titanium were selected as testing couple materials. Artificial saliva was employed to represent an oral environment. In addition, a standard tribocorrosion protocol was followed, and the pin was controlled to oscillate on the disk with an amplitude of 5 μ m during the mastication stage. After the testing, 3D profilometry and scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) were utilized to analyze the worn surfaces. Inductively coupled plasma mass spectrometry (ICP-MS) was also used to measure the metal ion release. Energy ratios were below 0.2, indicating a fretting regime of partial slip for all groups. Open-circuit potential (OCP) and electrochemical impedance spectroscopy (EIS) were analyzed to compare the electrochemical behavior among groups. As a result, corrosive damage was observed to be more in the Ti4- Ti4 groups than in Zr-Ti4 ones, whereas more mechanical damage was found in the Zr-Ti4 groups than in the Ti4-Ti4 groups. Possible mechanisms were proposed in the discussion to explain these findings. The results observed from this study might be helpful to clinicians with implant selection. For example, for patients with bruxism, a titanium implant paired with a titanium abutment may be preferable, while patients with GERD may benefit more from a titanium implant paired with a zirconia abutment. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: To systematically evaluate the available literature regarding the association of eating disorders (EDs) with oral health. Methods: A search across four databases identified 325 publications. After duplicate removal using Rayyan QCRI and relevance screening, 141 full-text articles were reviewed, leading to the inclusion of 5 studies. Results: We included five studies with a total of 225 diagnosed with EDs and all of them were females. The findings show a clear link between EDs and oral health issues, such as tooth erosion, caries, periodontal disease, and soft tissue damage. Patients with EDs had higher rates of tooth sensitivity, dry mouth, and oral candidiasis. Regular dental visits and educational efforts improved awareness of erosion risks tied to anorexia and bulimia. Although overall erosion rates were similar to controls, ED patients had lower saliva flow and more severe localized erosion. Soft tissue problems like lip redness, cheilitis, and lesions highlight the importance of dental professionals in identifying and managing EDs early. Conclusion: This review highlights the connection between EDs and oral health problems, stressing the importance of dental professionals in early detection and care. Common issues include tooth erosion, cavities, and soft tissue damage. Although research is limited, evidence suggests dental exams can help identify EDs and enhance patient outcomes. Future studies should focus on larger, standardized approaches to deepen understanding of this link. [ABSTRACT FROM AUTHOR]

This study primarily focused on the acid erosion of enamel and dentin. A detailed examination of the X-ray diffraction data proves that the products of the acid-caused decay of enamel belong to the family of isomorphic bioapatites, especially calcium-deficient hydroxyapatites. They are on a trajectory towards less and less crystallized substances. The increase in Bragg's parameter d and the decrease in the energy necessary for the changes were coupled with variability in the pH. This was valid for the corrosive action of acid solutions with a pH greater than 3.5. When the processes of natural tooth aging were studied by X-ray diffraction, a clear similarity to the processes of the erosion of teeth was revealed. Scarce data on osteoporotic bones seemed to confirm the conclusions derived for teeth. The data concerning the bioapatite decays were confronted with the cycles of apatite synthesis/decay. The chemical studies, mainly concerning the Ca/P ratio in relation to the pH range of durability of popular compounds engaged in the synthesis/decay of apatites, suggested that the process of the formation of erosion under the influence of acids was much inverted in relation to the process of the formation of apatites, starting from brushite up to apatite, in an alkaline environment. Our simulations showed the shift between the family of bioapatites versus the family of apatites concerning the pH of the reaction environment. The detailed model stoichiometric equations associated with the particular stages of relevant processes were derived. The synthesis processes were alkalization reactions coupled with dehydration. The erosion processes were acid hydrolysis reactions. Formally, the alkalization of the environment during apatite synthesis is presented by introducing Ca(OH)2 to stoichiometric equations. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusions Clinical Relevance To evaluate the effects of dentifrices containing sodium fluoride (NaF) combined with NovaMin (Sensodyne Repair & Protect—SRP), NaF combined with stannous fluoride (SnF2, Oral‐B Pro‐Gengiva—OBP), and amine fluoride (AmF, Colgate Elmex—ELM) on enamel subjected to simulated erosive cycling.Bovine enamel‐dentin discs (n = 10/group) were subjected to erosive cycling with orange juice (pH = 3.29, 5 min, 3x/day), artificial saliva (SA–2 h, 3x/day and overnight) and treated with dentifrice (2 min, 2x/day) or without treatment (CONT). Surface microhardness (SMH) was evaluated at baseline (T0), on the first (T1) and fifth (T5) days. SMH loss (%SHL) was calculated. Surface roughness (Ra, μm) was determined at T0 and T5. Morphology and mineral content were evaluated under scanning electron microscopy and energy‐dispersive x‐ray spectroscopy. Data were analyzed using ANOVA/Tukey or Bonferroni (α = 5%).No differences in %SHL were detected among groups at T1. At T5, OBP promoted %SHL, Ra, and ΔRa significantly lower than all the other groups (p < 0.05). All groups exhibited morphological changes in topography and similar Ca/P means before and after treatments.Dentifrice containing SnF2 minimized the negative effects on the SMH and Ra caused by exposure to orange juice after 5 days of simulated cycling.Patients who are more exposed to risk factors for dental erosion could benefit from the use of dentifrice containing SnF2. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of solutions containing aminomethacrylate copolymer (AA) and sodium fluoride (F; 225 ppm F−) or fluoride plus stannous chloride (FSn; 225 ppm F−, 800 ppm Sn2+) against enamel and dentin erosion/abrasion. Solutions F, FSn, AA, F+AA, FSn+AA, and deionized water as negative control were tested. Bovine enamel and dentin specimens (n = 13/solution/substrate) underwent a set of erosion‐abrasion cycles (0.3% citric acid [5 min, 4×/day], human saliva [1 h, 4×/day], brushing [15 s, 2×/day], and treatments [2 min, 2×/day]) for each of five days. Initial enamel erosion was evaluated using Knoop microhardness after the first and second acid challenge on day 1, and surface loss with profilometry after day 5. KOH‐soluble fluoride was assessed. Data were analyzed with ANOVA/Tukey tests. The combination of fluoride and AA resulted in higher protection against enamel erosion, whereas this was not the case for the combination of AA and FSn. All treatments protected against enamel and dentin loss. The lowest surface loss values were observed with F+AA and FSn+AA. The polymer did not significantly influence the KOH‐soluble fluoride formation on enamel/dentin specimens. The aminomethacrylate copolymer effectively enhanced the efficacy of sodium fluoride against initial erosion and improved the control of enamel and dentin wear of F and FSn solutions. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the efficacy and cytotoxicity of 35% hydrogen peroxide (HP) gel incorporated with 10% (w/w) biosilicate (BioS) on sound enamel and early‐stage enamel erosion lesions. Methods: Discs of enamel/dentin were selected, subjected to erosive cycles (0.3% citric acid, pH 2.6), and treated with (n = 8): HP (35% HP, positive control); HP_BioS [carboxymethyl cellulose (CMC) + HP + BioS]; BioS (CMC + BioS); CMC (negative control). The discs were adapted to artificial pulp chambers with the enamel exposed for bleaching, and the dentin facing toward the culture medium (Dulbecco's modified Eagle's medium [DMEM]). Bleaching was performed in three 30‐min sessions at 7‐day intervals. After bleaching, the diffusion product (DMEM extract + diffused HP) was pipetted onto MDPC‐23 odontoblastic cell line and inoculated. Color parameters (ΔL, Δa, Δb), color change (ΔE00), and changes in whiteness index (ΔWID) were determined before (T0) and after the last bleaching session (T3). Cell viability (MTT, %), H2O2 diffusion (μg/mL), oxidative cell stress (OxS), and cell fluorescence (live/dead assay, in confocal microscopy) were assessed (ANOVA/Tukey; α = 0.05). Results: No difference in ΔL, Δa, Δb, ΔE00, and ΔWID were found between HP and HP_BioS (p > 0.05). The incorporation of BioS decreased the HP diffusion into the substrates and mitigated oxidative stress in early‐stage eroded enamel (p < 0.05). HP_BioS presented significantly higher cell viability compared with HP under erosion conditions. Live/dead assay indicated that BioS_HP maintained viability with larger clusters of viable cells. Conclusion: Incorporating BioS into HP maintained bleaching effectiveness, favored cell viability, reduced the oxidative stress, and the cytotoxicity in teeth with early‐stage erosion. Clinical Significance: BioS formulation showed promising results for reducing cytotoxicity in patients seeking tooth bleaching and presenting undetectable early‐stage erosion. [ABSTRACT FROM AUTHOR]

The article discusses the impact of cola consumption on enamel demineralization, leading to dental erosion. Studies show that dental erosion affects both children and adults, with diet cola posing a significant threat due to its acidic content. The presence of saliva plays a crucial role in buffering and remineralizing enamel, but its absence can exacerbate the erosion process. Dental professionals can educate patients on preventive strategies and empower them to make informed dietary choices to protect their oral health. Further research is needed to develop more effective preventive measures against enamel erosion caused by acidic beverages like cola. [Extracted from the article]

Highlights: What are the main findings? Anti-citrullinated peptide antibody (ACPA) titer is associated with a lower bone mineral density (BMD) in the hip, and an ACPA-positive status is associated with a higher erosion score Erosions are associated with a lower BMD and T-score in the hip and spine The relation between erosions and hip BMD is not found to be driven by autoimmunity What are the implications of the main findings? The presence of ACPAs or erosions should lead to osteoporosis screening in rheumatoid arthritis patients Background/objectives: Both erosions and osteoporosis in rheumatoid arthritis (RA) have common mechanisms. The aim of this study was to evaluate the relationship between erosion and bone mineral density (BMD) in RA and whether it can be driven by autoimmunity. Methods: Patients fulfilling the ACR 1987- or ACR/EULAR 2010-criteriae for RA. performed radiographs (erosions evaluated by the modified Sharp/van der Heidje erosion score) and biology for anti-citrullinated peptide antibodies (ACPAs), rheumatoid factors (RFs) and anti-nuclear antibodies (ANAs) at intervals of less than 2 years from dual-energy X-ray absorptiometry (DXA) for BMD assessment. Results: A total of 149 patients were included, (75.8% women, mean age of 62 y.o (SD 9.61) and a median disease duration of 132 months [60; 240]). A total of 61.1% patients were ACPA positive, 79.9% were erosive and 10.7% had a hip or spine T-score ≤ −2.5. A higher erosion score was associated with a lower BMD (value: −0.222; p = 0.009) and T-score (value −0.397; p < 0.0001) in the hip. ACPA status was associated with a higher erosion score (63.0 (53.2) vs. 45.5 (44.1) for ACPA- (p = 0.04)). ACPA titers were associated with a lower BMD in the hip (value −0.216; p = 0.01). In linear regression, erosion and BMD were still associated, but this association is not driven by ACPA status or titer. Conclusions: In RA patients, erosions and BMD are inversely associated but this relationship does not seem to be driven by autoimmunity only. However, the presence of ACPA or erosion should lead to osteoporosis screening. [ABSTRACT FROM AUTHOR]

Background. Chewable vitamins are dietary supplements in which vitamins are combined with a flavor that appeals to children. The acidic nature of some vitamins and some flavoring agents may cause dental erosion. We investigated the effect of children’s chewable vitamin supplements on the loss of minerals in teeth. Methods. Forty-two human tooth enamel samples were prepared and randomly assigned to seven groups (n=6). Six groups contained different chewable vitamin tablets dissolved in deionized water, and a control group contained only deionized water. Each tablet was ground before its dissolution, and its pH was measured. Each tooth sample was immersed in a vitamin solution and artificial saliva in periodic cycles for 14 days. Each sample was weighed before and after immersion to calculate its weight loss percentage. Scanning electron microscopy was used to investigate the morphology of the enamel surfaces. For statistical analysis, the weight loss percentages between groups were compared using Welch’s ANOVA, followed by post hoc Dunnett’s T3 analysis (P<0.05). Results. All the tested supplements were acidic, with a pH range of 2.99-4.77. Most of the vitamin groups tested led to significant weight loss; it was greater for the vitamin C groups than the multivitamin groups. Scanning electron microscopy revealed erosion and destruction of enamel surfaces following vitamin exposure. Conclusion. All the chewable vitamin supplements were acidic, with the majority potentially eroding enamel. The erosive potential was less pronounced in vitamin supplements containing minerals. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions Clinical Significance To characterize the composition, flexure resistance, and optical properties of a multilayer translucent zirconia in relation to its multi‐transition zones.A multilayer zirconia (5Y/4Y) and a conventional 3 mol% yttria partially stabilized zirconia (3Y) were investigated. Bar‐shaped specimens were obtained from the enamel and dentin layers, and the vertical cross‐section of 5Y/4Y (N = 10). A four‐point flexural (σf) test was performed using a universal testing machine (1.0 mm/min). Plate‐shaped specimens (N = 6) were also produced from the enamel, transition 1, transition 2, and dentin layers. Translucency parameters (TPab and TP00) were determined using a dental spectrophotometer (N = 6). X‐ray fluorescence and X‐ray diffraction techniques were used to analyze elemental (N = 2) and phase compositions (N = 2), respectively. Data were analyzed using analysis of variance (ANOVA) and Tukey's test (α = 0.05).The yttrium content and σf varied between layers of 5Y/4Y. 3Y had the highest σf, followed by dentin. Enamel and cross‐section showed lower and statically similar σf. 3Y and dentin groups had similar but statistically lower TPab and TP00 than the enamel.Different layers of multilayered zirconia have distinct compositions, which affect their mechanical and optical properties. The weak enamel layer compromises the mechanical properties of cross‐sectional specimens.The development of novel cubic‐containing multilayer zirconia ceramics to produce monolithic restorations brings new challenges to dental clinicians and laboratory technicians. The CAD/CAM design of multilayered 5Y/4Y restorations should consider the esthetic and mechanical requirements of each clinical case, as different properties are found in the different layers of these materials. [ABSTRACT FROM AUTHOR]

Background: Erosive tooth wear is an increasingly common pathology in the youth population. It refers to the chronic, localized, painless loss of dental hard tissues caused by non-bacterial acids, often originating from external sources like acidic beverages. Energy drink consumption is on the rise, frequently preceding physical exercise to enhance perceived energy levels. However, there are other types of beverages that also provide energy, such as pre-workout drinks, classified as sports drinks. The main objective of this research study has been conducted with the purpose of analyzing the pH of energy drinks and pre-workout beverages, and studying the frequency of consumption of such beverages in amateur athletes who practice sports. Methods: A total of 67 beverages were examined, comprising 43 energy drinks and 24 sports supplementation beverages, also known as pre-workout or pre-training beverages. The participants were given a survey to complete. They were asked to respond whether they consumed any type of pre-workout or energy drink, and they were also asked about the timing of consumption. Results: The findings indicated an average pH of 3.3 among the studied beverages, indicating a pH below the critical threshold. Out of the 113 participants, 51% reported taking some form of supplementation. Conclusions: Consequently, it was concluded that most of the analyzed beverages recorded pH values low enough to classify them as erosive, posing a threat to enamel surface. When analyzing the frequency of consumption of energy drinks and pre-workout beverages in amateur athletes, we observed that most participants aged 29 years or younger took supplements 3 to 5 times a week, while the older age groups more frequently took supplements 1 to 2 times a week. [ABSTRACT FROM AUTHOR]

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Introduction: Dental erosion is a multifactorial pathology that leads to the loss of mineralized tooth structure and is strongly influenced by dietary habits, lifestyle, and medical conditions. The prevalence has increased significantly in recent years, posing a major clinical challenge from diagnosis to treatment and prevention. Minimally invasive strategies should be adopted for rehabilitation in patients with this condition, composite resin being a highly indicated material, due to its minimally invasive nature and proven clinical longevity. Objective: This study aims to report the functional and aesthetic treatment of a 24-year-old female patient who sought care due to dissatisfaction with the aesthetics of her upper teeth. Case report: Clinical examination revealed signs of dental erosion and loss of vertical dimension of occlusion. Treatment planning began with photographs and diagnostic impression, followed by a mock-up trial. Rehabilitation was performed using composite resin occlusal veneers fabricated with a technique designed to achieve guided occlusal morphology. Conclusion: It was concluded that this technique allowed the fabrication process to be faster and more faithful to the diagnostic wax-up, resulting in minimal occlusal adjustment at the end of the procedure. [ABSTRACT FROM AUTHOR]

Dental erosion represents the gradual and irreversible depletion of dental hard tissues due to a chemical process, independent of bacterial influence. It has emerged as a notable clinical concern in recent years, primarily attributed to substantial lifestyle shifts resulting in the heightened intake and frequency of acid-containing foods and beverages. Apart from the extrinsic erosive agents derived from external sources, such as dietary habits or medication, intrinsic erosive agents may exist due to pathological reasons with the contents of the stomach including gastric juice, mainly composed of hydrochloric acid, being their sole source. Currently, bioactive materials are used in various forms for the prevention of dental erosion. Such materials include, among others, bioactive glasses (BAGs). BAGs are a type of glass that, when in contact with biological fluids, can elicit a specific biological response. When they come into contact with bodily fluids, they can initiate a series of processes, including the formation of a hydroxyapatite layer on the glass surface. This bioactivity is particularly advantageous in medical and dental applications, where BAGs are used for bone regeneration, tissue repair, and dental restorative or preventive techniques. The aim of this literature review was to analyze and discuss the role of BAGs in protecting the tooth structures from dental erosion. The analysis of the existing literature regarding this topic indicated that the use of BAGs in preventive treatments against tooth erosion can be useful in dental practice. Further clinical evidence is necessary to confirm the effectiveness of the particular preventive measures. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion. [ABSTRACT FROM AUTHOR]

Background and Objective: Limited access to health services and low educational levels are factors in the rural population that are associated with the development of oral pathologies. However, the specific risk indicators contributing to erosive tooth wear (ETW) in these populations remain unclear. The objective of this study was to identify risk indicators associated with the prevalence of erosive tooth wear (ETW) in schoolchildren aged 8–12 years from rural and urban areas in the State of Mexico. Methods: A cross-sectional study was carried out in public schools in rural and urban areas. The prevalence of ETW was evaluated using the Basic Erosive Wear Examination (BEWE). The risk indicators studied were gastroesophageal reflux, vomiting, vitamin C, food, beverages, dental hygiene, bruxism, and hyposalivation. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The prevalence of ETW was higher in the rural area (77.3%) compared to the urban area (51.2%) (p = 0.001). The odds of presenting ETW were more than twice in schoolchildren from rural areas compared to those from urban areas (OR: 2.25, 95% CI: 1.11–3.98). Risk indicators varied between rural and urban populations, with different factors such as the consumption of fresh tomato sauce, orange, tangerine, atole (artisanal corn-based drink), and teeth grinding in the rural area, and lemon, soft drink, fruit juice consumption, and the simplified oral hygiene index in the urban area (p < 0.05). Conclusions: To prevent ETW, strategies offering tailored dietary and hygiene advice should be proposed, considering the specific conditions of each geographic area. [ABSTRACT FROM AUTHOR]

Objective: To evaluate in vitro the erosive effect of long-term liquid oral pediatric medicines on human enamel teeth and the preventive action of fluoride in an erosive challenge. Material and Methods: Three commonly used medicines were selected for this study, and their endogenous pH was measured in triplicate. Thirty permanent tooth enamel specimens were prepared and divided into six groups (n=5): E1 (Zetalerg), E2 (Betamethasone), E3 (Anemifer), E4 (Anemifer+Duraphat), E5 (Coke), and E6 (artificial saliva). Specimens were immersed in 5 ml of medicine solution for 5 min, 2x/ day for 12 days, and stored in artificial saliva at 37°C between immersions. Data analysis was performed according to the enamel surface morphology using SEM. Results: The medicines showed an acidic pH range from 2.09 to 4.14. All the specimens exposed to pediatric medicines presented some pit-like erosion pattern under SEM analysis, except for the E4 group. The degree of destruction was inversely proportional to pH formulation values. Morphology alterations could be ranked as follows: E3>E2>E1=E5. The E4 group, protected with varnish fluoride, did not present signs of surface erosion wear like E6. Conclusion: All the pediatric medicines used promoted some enamel tooth wear, with higher severity with low pH medicines. The presence of fluoride reduced the deleterious effect of pediatric medicines on human tooth enamel.

Abstract The aim of this study was to assess the effect of a chlorhexidine digluconate solution (CHX) applied as an antiproteolytic agent for controlling erosive tooth wear or as part of the adhesive treatment on long-term bond strength to eroded dentin. Dentin specimens were abraded with a 600-grit silicon carbide (SiC) paper for 1 min (sound dentin - S), subsequently treated with 2% CHX for 1 min (with excess removed, followed by a 6-hour rest), and eroded by exposure to Coca-Cola for 5 min, three times a day, for 5 days (CHX-treated and eroded dentin - CHXE), or only eroded (eroded dentin - E). The specimens were acid-etched (15 s), rinsed (30 s), dried (15 s), and rehydrated with 1.5 μL of distilled water for 1 min, with excess removed (control - S.C/CHXE.C/E.C) or 2% CHX (S.CHX/CHXE.CHX/E.CHX). Adper Single Bond 2 was scrubbed twice on the surface for 15 s each and then light-cured for 10 s, and resin composite cores were built up. Specimens were sectioned into beams and microtensile bond strength was tested (μTBS; 0.5 mm/min) immediately or after 18-month aging. Failure modes were analyzed using a digital microscope. Data (μTBS/MPa) were analyzed by three-way ANOVA, followed by Tukey’s test (α = 0.05). μTBS to E and CHXE, irrespective of the rehydration solution and aging period, were equivalent to each other and lower than that to S. CHX as the rehydration solution reduced immediate and long-term µTBS to S. Aging reduced μTBS. By controlling tooth wear or interface aging, CHX could not influence long-term bonding to eroded dentin.