The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions

SummaryIn 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxismrelated masticatory muscle activities should be assessed in the behaviour’s continuum.

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“…For a comprehensive clinical protocol for the qualification and quantification of tooth wear, see Wetselaar & Lobbezoo. 32 …”

Section: Bruxism Assessmentmentioning

confidence: 99%

International consensus on the assessment of bruxism: Report of a work in progress

Lobbezoo

Ahlberg

Raphael

et al. 2018

J of Oral Rehabilitation

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“…Pindborg classified the loss of hard tissues as erosion, attrition or abrasion . Erosion is chemical wear, not caused by caries, as a result of intrinsic or extrinsic acids . Attrition is intrinsic mechanical wear caused by two‐body interactions .…”

Section: Introductionmentioning

confidence: 99%

Comparison of wear between occlusal splint materials and resin composite materials

Reyes-Sevilla

Kuijs

Werner

et al. 2018

J of Oral Rehabilitation

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Tooth wear in bruxing patients often results in a need for treatment with composite restorations. In some cases, bruxing patients receive an occlusal splint as a protective means as well. However, the wear between these opposing materials has not been investigated yet. The aim of this in vitro study was to assess the wear of different splint materials against resin composite materials. A two-body wear test was conducted using the ACTA wear machine. The materials selected for this study were three composites used for direct restorations (Filtek Z250, CLEARFIL AP-X, and Filtek Supreme XT) and four occlusal splints materials, viz. a polyamide resin (ThermoSens) an conventional (hand-processed), milled and printed polymethylmethacrylate (PMMA). As antagonistic materials, stainless steel, Filtek Supreme XT and CLEARFIL AP-X were used. The wear rate of the seven materials was determined after 200 000 cycles, using a profilometry. The rates were analysed using two-way ANOVA and post hoc Tukey's tests. The wear rates were significantly higher for the conventional and milled PMMA materials than for all other materials (P < .001). The wear rates of printed PMMA and the polyamide resin were comparable to composite wear rates. The antagonist materials have minor or no influence on the amount of wear of the various splint materials (P < .001). In conclusion, different splint materials yielded different wear rates for all antagonist materials tested. Keeping in mind that this study is an experimental in vitro study, this finding enables practitioners to choose the splint material necessary according to their patients' needs.

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“…2,3 When tooth wear progresses, it can cause problems for (a) the individuals, namely deterioration of aesthetic appearance, sensitivity, pain, discomfort and functional problems 4 and hence an impaired oral health-related quality of life 5,6 ; (b) the oral caregivers, namely having to perform restorative treatments of increasing complexity 3,7 ; for the community, meaning increasing costs because of dental and medical treatments or absenteeism. 2,3 When tooth wear progresses, it can cause problems for (a) the individuals, namely deterioration of aesthetic appearance, sensitivity, pain, discomfort and functional problems 4 and hence an impaired oral health-related quality of life 5,6 ; (b) the oral caregivers, namely having to perform restorative treatments of increasing complexity 3,7 ; for the community, meaning increasing costs because of dental and medical treatments or absenteeism.…”

mentioning

confidence: 99%

“…4 Intrinsic mechanical tooth wear (IMTW, attrition, tooth to tooth contact) is a physiological phenomenon that no one can escape, because it is a result of normal function (chewing). In addition, both subgroups can be divided in intrinsic and extrinsic.…”

mentioning

confidence: 99%

“…1 The loss of hard dental tissues on the surfaces that are involved in the occlusion and articulation (occlusal, incisal and palatal surfaces of the second sextant) is of more importance for the dentition than the other surfaces (non-occlusal and non-incisal surfaces). 4,10 The dental team has two treatment options available, namely counselling/monitoring and a restorative treatment. Consequently, when time progresses, these surfaces become more difficult to restore.…”

mentioning

confidence: 99%

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A methodology for evaluating tooth wear monitoring using timed automata modelling

Wetselaar

Lobbezoo

Jong

et al. 2019

J of Oral Rehabilitation

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Objectives Tooth wear is a multifactorial condition leading to the loss of dental hard tissues. A counselling/monitoring protocol is of importance in order to keep that loss as limited as possible. Since many factors are involved and a time span of decades is included, research to disentangle all these processes in patients is difficult. Instead, a modelling technique was used that is able to deal with time, costs and probabilistic and stochastic information. The aim was to shed light on the question: does a yearly or a once‐in‐five‐years counselling/monitoring protocol yield better outcome measures? Methods A so‐called timed automata model was adopted, analysed with the tool UPPAAL. To our knowledge, this is the first time that formal modelling is applied in dentistry. In this article, a UPPAAL model for the evaluation of tooth wear is described. Results Using the UPPAAL model, it was calculated that with a yearly counselling/monitoring protocol the severity of tooth wear at age 74, the total costs per person and the number of restorative treatments were less, and the number of so‐called “good years” was higher. Conclusions With the use of the UPPAAL model, it may be concluded that a yearly counselling/monitoring protocol can yield better outcome measures. Clinical Significance Regarding dentistry in general and tooth wear in particular, with the use of a timed automata model in UPPAAL, actual research questions can be answered, factors of influence in a multifactorial condition like tooth wear can be clarified, and future research topics can be determined.

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The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions

Cited by 146 publications

References 61 publications

International consensus on the assessment of bruxism: Report of a work in progress

International consensus on the assessment of bruxism: Report of a work in progress

Comparison of wear between occlusal splint materials and resin composite materials

A methodology for evaluating tooth wear monitoring using timed automata modelling

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