2010 RWISO Journal - Roth Williams International Society of ...

The Effect of Tooth Wear on Postorthodontic Pain Patients: Part 2
Jina Lee Linton, DDS, MA, PhD, ABO ■ Woneuk Jung, DDS
Jin a Le e Li n T o n , ddS, ma, Phd, abo
jinalinton@hotmail.com
■ Graduated from Yonsei University
(DDS, PhD), 1986
■ Graduated from Columbia University,
SDOS, 1988
■ Graduated from Columbia University
Orthodontic Department (MA), 1991
■ Private Practice in Seoul, Korea,
1991–present
Wo n e u K Ju n G , ddS
■ Graduated from Dan Kook
University, 1991
■ Private practice in Seoul, Korea,
1991–present
Introduction
Tooth attrition is classified as tooth disease under the Inter-
national Classification of Diseases, published by the World
Health Organization. According to Jablonski, tooth attrition
takes place when tooth-to-tooth contact, as in mastication,
occurs on the occlusal, incisal, and proximal surfaces. 1 It is
differentiated from tooth abrasion (the pathologic wearing
away of the tooth substance by friction, as brushing, bruxism,
clenching, and other mechanical causes) and from tooth
erosion (the loss of substance caused by chemical action
without bacterial action).
In reality, the wear may be related to a combination of
factors including attrition, abrasion, and erosion; that is,
physical-mechanical and chemical effects can have an impact
on the loss of physiologic and habitual tooth surface morphology.
2 Grippo et al state that three physical and chemical
mechanisms are involved in the etiology of tooth surface lesions.
These mechanisms are stress, corrosion, and friction.
The various types of dental lesion are caused by these mechanisms
acting either alone or in combination. Friction, including
abrasion (which is exogenous) and attrition (which is
endogenous), leads to the dental manifestation of wear. Corrosion
leads to the dental manifestation of chemical or elec-
Summary
Malocclusion and occlusal interference in excursive movement is the major
cause of pathologic tooth wear. Tooth wear starts with shortening of the anterior
teeth. As interference in mandibular movement increases, the posterior
teeth gradually become more flat. Recognizing tooth wear before and after
orthodontic treatment is important for retention of the treated result and for
ensuring functional occlusion. For this reason, orthodontic treatment should
be detailed and completed with restorative rehabilitation of the lost tooth
material.
trochemical degradation. Stress, which results in compression,
flexure, and tension, leads to the dental manifestation
of microfracture. 3
Loss and excessive wear of hard dental tissues is a permanent
problem of the dentition, especially in the modern
man; it is found in almost all age groups. Tooth wear is an
inherent part of the aging process; it occurs continuously but
slowly throughout life. In some individuals, tooth wear occurs
more rapidly than in others, leading to severe morphologic,
functional, and vital damage to the teeth, which cannot
be considered normal. 4 Hand et al found that in a sample of
520 adults, 84.2% had enamel attrition, 72.9% had dentin
attrition, and 4.2% had severe attrition. 5 In cases of severe
attrition, Sivasithamparam et al found that 11.6% of 448
adult patients had either near-pulpal exposures or frank pulpal
exposures. 6
Schneider and Peterson found that 15% of children
demonstrate tooth wear due to bruxism. 7 Most of the prevalence
studies in Europe and North America indicate that the
prevalence of wear on enamel in children is common (up to
60% involvement), while the prevalence of exposed dentin
varies from 2% to 10%. 8,9
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