Erosion Abrasion Attrition and Abfrcation1Erosion Abrasion Attrition and Abfrcation1

http://slidepdf.com/reader/full/erosion-abrasion-attrition-and-abfrcation1erosion-abrasion-attrition-and-abfrcation1 1/82
Abfraction; we wonder why our teeth are sensitive!
Sonia Jones RDH ET South "est #ost $raduate Denta% Deanery
D# Advisor Devon&ornwa%%

Ai)s and .b'ectives
Ai)/ to ensure de%eates understand how tooth tissue %oss can be detri)enta% to dentine hyersensitivity
.b'ectives/
0y the end of the session you shou%d be ab%e to/ Distinuish between erosion, abrasion, attrition and
abfraction Deter)ine the causative factors of tooth tissue %oss Describe how to revent further tooth tissue %oss Discuss sensitivity theories and e1%ain the way they
wor+ List toica% )edica)ents avai%ab%e to re%ieve sensitivity
8/18/2019 Erosion Abrasion Attrition and Abfrcation1Erosion Abrasion Attrition and Abfrcation1
Tooth surface %oss can arise as the resu%t of/
Erosion Abrasion Attrition Abfraction
Tooth tissue %oss
The 2 tyes of tooth tissue %oss a%% have their own characteristic aearance
However, the wear of a ersons teeth is
usua%%y fro) a )i1ture of a%% 2, with one tye of TTL redo)inatin*
So)eti)es di3cu%ty in deter)inin the do)inant aetio%oy
The thic+ness of the e%%ic%e and the ressure of the tonue contribute to the e1tent of the condition
Erosion
Described as ear%y as 789: a)on Sici%ian %e)on ic+ers
Denition/ <The %oss of tooth tissue by a che)ica% rocess that does not invo%ve bacteria, acids are )ost co))on%y invo%ved in the disso%ution rocess=
>on carious atho%oica% %oss of tooth tissue
#%a?ue not invo%ved in the rocess
%inica% #resentation .ccurs )ost fre?uent%y on the a%ata%
and %abia% surfaces of the incisor teeth

The %esion ri)ari%y occurs in theena)e% 4n )ore severe cases the dentine
beco)es e1osed As ena)e% %oss roresses sensitivity
E1trinsic causes of erosion
Habitua% consu)tion of hih%y acidic, %ow H carbonated drin+s, sorts drin+s or concentrated fruit
'uices A%co os, fruit avoured a%coho%ic
beveraes and stron ciders ausin a wide sha%%ow %esion
e6ectin the %abia% and a%ata% surfaces of the uer teeth
Swishin or ho%din drin+s in the )outh
@odern ac+ain has a%so been b%a)ed, tetra ac+, %astic bott%es and cans B directiona% ow onto teeth
an e1tend fro) the %abia% and
a%ata% %esions of the uer teeth to a%% surfaces of a%% teeth
Titratab%e acidity
How %on it ta+es for the sa%iva to co)ensate
How )uch sa%iva Cow 0u6erin caabi%ities of the sa%iva itric acid the biest cu%rit
Thic+ness of the e%%ic%e can rotect to a deree
Hiher te)eratures increase
titratab%e acidity
E1trinsic causes of erosion Habitua% suc+in of citrus fruits The %esion )ay occur in either the uer
or %ower anterior teeth
Deendin on the way the fruit is eatenCRe)e)ber fruit eaten as a who%e unit does not enera%%y cause a rob%e)
Acidic foods #ic+%es, sauces, vinears, yohurts,
roasted veetab%es
4ndustria% at)osheric o%%ution he)ica% wor+ers, battery
)anufacturers, crysta% %ass wor+ers Less co))on now due to stricter
wor+in conditions and reu%ations CHS at wor+ act 79F8
Acidic fu)es e6ect the %abia% surfaces of the uer and %ower anterior teeth
"hen ta%+in or the )outh is at rest
h%orine, fro) as ch%orinated swi))in oo%s
#rofessiona% swi))ers 4f the che)ica%s are not roer%y
reu%ated Less co))on now due to reu%ations
4ntrinsic causes of erosion
ro) within the body Gsua%%y hydroch%oric acid fro) the
sto)ach CH : Reu1 Reuritation 5o)itin Ru)ination
Ru)ination
The ter) ru)ination is derived fro) the Latin word ruminare, which )eans to chew the cud* Ru)ination
is characteried by the vo%untary or invo%untary reuritation and rechewin of artia%%y diested food
that is either reswa%%owed or e1e%%ed* This reuritation aears e6ort%ess, )ay be receded by a
be%chin sensation, and tyica%%y
Reu1, Reuritation and 5o)itin of astric contents
Anore1ia 0u%i)ia Hiatus Hernia #renancy&Hor)ones @otion sic+ness .besity Eatin too )uch Drin+in too )uch A%coho%is)
The a%ata% surfaces of the uer
anteriors and re)o%ars are eroded #roduces wide sha%%ow %esions Ena)e% )ay be co)%ete%y %ost
Tac+%e the rob%e) with care! #atient )iht not ad)it to
unattractive asect of sycho%oica%
i%%ness
4dioathic causes of erosion
Gn+nown cause #atient wi%% not ad)it to or be aware
of intrinsic or e1trinsic causes 5iorous tooth brushin can
contribute to an over o%ished aearance - shiny
Abrasion
Denition/ <The abnor)a% wearin away of tooth tissue by a )echanica% rocess=
The %ocation and attern of abrasion is direct%y deendent uon its course
4t usua%%y occurs on the e1osed root
surfaces when iniva% recession has e1osed the ce)entu)
4t )ay be seen on the incisa% or
intero1i)a% surfaces of the teeth
auses of Abrasion
4ncorrect or destructive use of a toothbrush Gse of an abrasive detrice
The ena)e% and dentine is worn away to roduce a <5= shaed notch at the nec+ of the tooth Areas )ost a6ected are the %abia% and bucca% surfaces of the canines and re)o%ars #owerfu% bac+ hand, RHS of riht handed erson LHS of Left handed erson

%inica% aearance of Abrasion
"orn, shiny often ye%%ow&brown areas at the cervica% )arin
"orn <notches= on the incisa% surfaces
of the anterior teeth

Sea)stresses B ins, arenters B nai%s, Hairdressers B hairris
#ie s)o+ers, nai% biters, causin <notchin=
Attrition

.cc%usa% and incisa% surfaces of the teeth )ost co))on%y a6ected
@ay a%so a6ect the ro1i)a% surfaces of the teeth due to s%iht )ove)ent of the
teeth in their soc+ets durin )astication Ae re%ated rocess 5aries fro) erson to erson
%inica% aearance of Attrition
#o%ished facets on ena)e% surfaces uin B dentine is e1osed .ccasiona% fu%% %oss of ena)e%,
dentine is e1osed and stains heavi%y
Attrition
Ranes fro) art of the ena)e% bein worn away in the ear%y staes to the fu%% thic+ness of the ena)e%
wearin away in advanced attrition The dentine )ay be e1osed and
stained
4n e1tre)e cases the teeth )ay be worn down to the inivae
Attrition #rocess of attrition is s%ow Secondary dentine is %aid down to rotect the
u% cha)ber and the u% cha)ber narrows #ain is rare%y associated with attrition @en usua%%y show a reater deree of attrition
than wo)en Severe attrition is se%do) seen in deciduous
teeth, Cnot retained for %on However if a chi%d su6ers fro) dentinoenesis
i)erfecta Can hereditary disorder of the dentine ronounced attrition )ay resu%t fro) )astication
Abfraction
Denition/ <The atho%oica% %oss of ena)e% and dentine due to occ%usa% stresses=
Recent%y interest has rown in the
deve%o)ent of cervica% abrasive %esions The ter) abfraction has been used to
describe these cervica% %esions
So)e %inicians do not be%ieve that this is the reason and that erosion and abrasion cause the wear facets, research continues
auses of Abfraction
.cc%usa% forces which cause the tooth to e1, cause s)a%% ena)e% ec+s to brea+ o6, inducin the abrasive %esions
Gsua%%y wede shaed %esions with shar an%es
found at the cervica% )arins However can be found on the occ%usa% surfaces,
resentin as circu%ar areas These %esions can occur with occ%usion a%one or
as with )ost TTL cases which are )u%ti factoria%, can be associated with toothbrush abrasion
These %esions are often dianosed as toothbrush abrasion, but they di6er as their an%es are sharer
o))on in atients with oor tooth a%in)ent
an be associated with/ Anterior oen bite .cc%usa% restorations that chane the
cusa% )ove)ents
Treat)ent of Tooth Tissue Loss
7* Re%ieve sensitivity and ain B uoride, desensitisin aents&toothastes
:* 4dentify aetio%oica% factors B )odify diet&habits, e%i)inate acidic foods&drin+s,
sto habitua% ractices, ent%e tooth brushin techni?ues
* #rotect the re)ainin tooth tissue B reconstruct the e6ected teeth, restorations, in%ays&on%ays, crowns, chec+ occ%usion
2* 0ite raisin devices&s%ints
K* Referra% to TTL E1ert * #revention of further eisodes
E1a)ination Radiorahs 5ita%ity testin #atients wishes&needs
Study )ode%s #hotorahs 4ndices
0asic Erosive "ear E1a)ination
M >o Erosive "ear
7 4nitia% %oss of Surface te1ture : Distinct defect, hard tissue NKMO of
the surface area
Q C:, dentine invo%ved
Tooth wear index according to Smith and Knight Score Surface Criteria
M 0&L&.&4 >o %oss of ena)e% surface characteristics >o %oss of contour 7 0&L&.&4 Loss of ena)e% surface characteristics @ini)a% %oss of contour : 0&L&. Loss of ena)e% e1osin dentine for %ess than one-third of
the surface 4 Loss of ena)e% 'ust e1osin dentine Defect %ess than 7)) dee 0&L&. Loss of ena)e% e1osin dentine for )ore than one-third of the surface 4 Loss of ena)e% and substantia% %oss of dentine
Defect %ess than 7-:)) dee 2 0&L&. o)%ete %oss of ena)e%, or u% e1osure, or e1osure of secondary dentine 4 #u% e1osure or e1osure of secondary dentine Defect )ore than :)) dee, or u% e1osure, or e1osure of secondary dentine
Sensitivity
Dentine Hyersensitivity B Dentine is the hih%y sensitive art of the tooth
#atients su6erin fro) dentine hyersensitivity often thin+ that they have deve%oed a cavity or %ost a %%in
.n e1a)ination there is often no obvious reason for
their ain, iniva% recession is so)eti)es evident The a)ount of recession does not see) to corre%ate
with the a)ount of ain they are e1eriencin
c&o short shar eisodes of ain caused by te)erature, touch by )eta%, sweet foods&drin+s
#atients can be very distressed by the ain of dentine hyersensitivity and often avoid the
causative sti)u%i as )uch as ossib%e
Sensitivity
"o)en )ore re disosed than )en Ae :M-2M Ranes fro) 7K-FM
Dentine
@ade u of dentina% tubu%es Loo+s %i+e honeyco)b under the
)icroscoe Si)i%ar in co)osition to bone an re)ode% itse%f and %ay down
rearative and secondary dentine
"hen e1osed to the ora% environ)ent can be sensitive
Dentine
Larer tubu%es )ore ain @ore oen tubu%es )ore sesitivity
Dentine Hyersensitivity Theories
theories as to how we fee% the ain of dentine hyersensitivity
7* Dentine 4nnervation Theory :* .dontob%ast recetor theory * Hydrodyna)ic theory
Dentine 4nnervation
Dentine 4nnervation Theory
>erve bres fro) the >erve #%e1us of Rasch+ow Cne1t to the dentine &u% boundary, a%on side the .dontob%ast
activity enetrate the dentina% tubu%es and cause i)u%ses
>ot the )ost %i+e%y theory/ whi%st the
nerve bres do enetrate the tubu%es, there are not enouh of the) and they do not enetrate
dee%y enouh into the tubu%es to
.dontob%ast Recetor
.dontob%ast Recetor Theory
#rooses that .dontob%asts receive and ass on i)u%ses and that when they are touched cause the sensation
of ain >ot the )ost %i+e%y theory/ as there are
no synases between the
.dontob%asts and the >erve #%e1us of Rasch+ow
CSynases B 'unctions between
neurones where che)ica%s trans)it
Hydrodyna)ic Theory
@ost %i+e%y theory/ Answers )ore ?uestions Ly)h %i+e uid inside the dentina% tubu%es is
sti)u%ated by te)erature, touch and sweet sensations, causin it to ow bac+wards and forwards within the tubu%es, this ives the sensation of ain
Hot&co%d causes e1ansion&contraction causin the uid to ow

Tacti%e&E%ectrica% CTouch I! B contraction of the uidI
Research continues, what they do +now is how to treat it
Dentine Hyersensitivity
Dentine Hyersensitivity Treat)ents
@ost co))on%y treated by/ @echanica% 0arriers Sti)u%ation of #eritubu%ar or Reactive
Dentine 4ncreasin otassiu) concentrations
@echanica% 0arriers
A%ied over the oen ends of the Dentine Tubu%es
Restorations B $%ass iono)ers,
o)osites, 4n%ays&.n%ays, Dentine bondin aents that for) a che)ica% bond with the dentine %oc+in into
the tubu%es, Resins&Adhesives Tubu%e occ%udin toothastes B need
to be re%aced dai%y
Sti)u%ation of #eritubu%ar or
The dentine %ays down a rotective %ayer
Hih concentration uoride B
Durahat 5arnish, $e% a) C%uoriard e%
Si%o1ane Esters B Tresio%an, Sensitro%
etc 0oth wi%% wear o6 so need to be
rea%ied
%uoride %uoride irritates the dentine 4t irritates the dentine su3cient%y for it to
%ay down a secondary %ayer and therefore rotect the tooth fro) further sti)u%i
4t does this by occ%udin the tubu%es @outhwashes dai%y M*MKO and wee+%y
M*:O so%utions
Hih uoride toothastes - Durahat :8MM, KMMM
5arnishes B Durahat :*:O ::,MMM) $e%s B M*2O stannous uoride
>itrate, #otassiu) itrate found in

This revents action otentia%s bein trans)itted Cnerve i)u%ses
0y +eein the sodiu) outside the
ce%% wa%%
>erve 4)u%ses
Sodiu) is attracted to #otassiu) 0y increasin the #otassiu) %eve%s
outside the nerve ce%% wa%%s, the
Sodiu) stays outside and doesn=t di6use in
This stos the nerve i)u%se
Deo%arisation
Sodiu) #otassiu)
Toothaste %ai)s
>erve Deo%arisin Toothastes Tubu%e .cc%udin Toothastes
Each )anufacturer c%ai)s that their toothaste has the best techno%oy
Do they wor+I
Sensodyne Traditiona%%y >erve deo%arisin
toothastes Active inredients / - #otassiu) >itrate Sodiu) %uoride - #otassiu) h%oride Sodiu) uoride #otassiu) +ees the sodiu) outside the
ce%% wa%%
0y addin the uoride to the newer tyesof Sensodyne you et the tubu%e occ%usion heno)enon caused by dentine irritation and %ayin down of a secondary %ayer
Sensodyne #rona)e%
%ai)s to B reharden softened ena)e% - be %ow in abrasives to
revent further tooth tissue %oss
Active inredient B #otassiu) >itrate
Sodiu) %uoride
Sensodyne Raid Re%ief Active 4nredient Strontiu) Acetate
Sodiu) @ono-uorohoshate
#ub%ished studies suort the )ode of action and tubu%ar occ%usion occurs
but/ Strontiu) h%oride B Sensodyne .riina%,
occ%udes tubu%es! However as it reacts with uoride beca)e %ess ou%ar
o%ate Sensitive #ro
#ro BArin Techno%oy Active 4nredients/ Arinine, a%ciu)
arbonate, Hydro1yaatite, Sodiu) @ono- uorohoshate
The Arinine co)%e1 binds to the tooth
surface, it is ositive%y chared this is attracted to the neative%y chared dentine
4t encouraes a ca%ciu) rich )inera% %ayer into the oen Ce1osed dentine tubu%es
This acts as an e6ective %u Ctubu%ar occ%ude
Resistant to acid attac+s
>eeds to be rea%ied twice dai%y
.ther 0rands
Ena)e% are toothaste - A)orhous a%ciu) #hoshate A# Cso%ub%e sa%ts of a%ciu) and #hoshate/ hih%y so%ub%e and there is %i)ited data in the treat)ent of Dentine Hyersensitivity
Reca%dent CTooth)oose B #-A# asein #hoshates, derived fro) )i%+ roteins )i1ed with the ca%ciu) and hoshate sa%ts/ no aarent ub%ished c%inica% data on its e6ects of reducin
Dentine Hyersensitivity0%an1, 0ioreair- Hydro1yaatite Sodiu) @ono- uorohoshate/ tubu%ar occ%usion but %i)ited ub%ished data
Treat)ent of active tooth tissue %oss %uoride toothastes&
)outhwashes&e%s De sensitisin toothastes Study )ode%s #hotorahs
4ndices 4dentify causative factors
#revention
Li)it acidic food and drin+ to )ea% ti)es E%i)inate fro) diet ut down on carbonated beveraes Eat citrus fruits who%e not suc+ed in 7&2s Do not ho%d&swish drin+s Gse a straw Refer to secia%ist Refer to counci%%or for eatin
disorders&a%coho% addiction Refer to $# B astric rob%e)s @i%+ or cheese after )ea%s to neutra%ise acids Avoid toothbrushin after an acid attac+
Ai)s and .b'ectives
Ai)/ to ensure de%eates understand how tooth tissue %oss can be detri)enta% to dentine hyersensitivity
.b'ectives/
0y the end of the session you shou%d be ab%e to/ Distinuish between erosion, abrasion, attrition and abfraction
Deter)ine the causative factors of tooth tissue %oss Describe how to revent further tooth tissue %oss
Discuss sensitivity theories and e1%ain the way they wor+
List toica% )edica)ents avai%ab%e to re%ieve sensitivity

Date post:	07-Jul-2018
Category:	Documents
Author:	madalina-a-dobre
View:	222 times
Download:	0 times

Erosion Abrasion Attrition and Abfrcation1Erosion Abrasion Attrition and Abfrcation1

Documents

rtupaper.comrtupaper.com/QPapers/Civil Engineering/2012-2013 ENGINEERING... · Ex-plaižy the work of erosion by wind In view of deflation, abrasion and attrition. ... Describe geological

Dag Ørstavik UiO Core Curriculum II Oral Biology 2009 · secondary dentinogenesis and is caused by dental abrasion, attrition, cavity preparation, erosion or dental caries (Torneck

Erosion Abrasion and Cavitation of Concrete

Elastomeric-lined glass reinforced plastic piping systems … · Elastomeric-lined glass reinforced plastic piping systems for improved abrasion-erosion performance Presenting author:

As glaciers travel over land, glacial ice can erode the underlying bedrock. This erosion can happen by: Plucking Abrasion.

GCSE COASTS. COASTAL EROSION Erosion Processes 1.Corrasion / Abrasion 2.Scouring 3.Hydraulic Action 4.Solution 5.Attrition.

Abrasion and Erosion Testing of Materials Used in Power Production From Coal

Eolian Landforms Wind An agent of erosion –“eolian” refers to wind 2 types of eolian erosion: –abrasion: sandblasting YARDANG –deflation: blowing.

Processes Erosion Transport Deposition Abrasion Traction ... · • Upper valley – Rivers and V-shaped valleys with interlocking spurs – created by EROSION • Middle Valley –

Attrition,Attrition,Attrition New

RIVERS - Weebly · Rivers 2.5 5 km . V. shaped . Headward Erosion . River Erosion Indirect Attrition Corrosion Types ... * 'W Shaped Valleys * Interlocking Spurs * Waterfalls Middle

10.9-year survival of pressed acid etched monolithic e.max ... › hubfs › 2241343 › Blog NA › EMAX 10 yr.pdfeases.1 Tooth structure loss through attrition, abrasion, erosion,

JournalofGeophysicalResearch:EarthSurfacebodo/pdf/oskin14_channel_steepness.pdf · between sediment production, transport, ﬂood frequency, channel width, and erosion via impact-abrasion

Unebrèvehistoire Abrasion del’usuredentaire.€¦ · Abriefhistoryoftoothwear. MOTSCLÉS /KEYWORDS Usuredentaire Articlehistorique Attrition Abrasion Érosion Tooth wear Historical

Chapter 10 Weathering, Soil, Erosion. Weathering Mechanical Weathering (Physical) Pressure Release, Frost Wedging, Abrasion, Organic activity Chemical.

[PPT]Erosion, Abrasion, Attrition and Abfrcation. We … Abrasion Attrition... · Web viewClinical Presentation Occurs most frequently on the palatal and labial surfaces of the incisor

Deterioration of CMP: Abrasion and Erosion caused by years of water and debris flowing through the pipe Deterioration of CMP: Abrasion and Erosion caused.

Stream Erosion and Transport Erosion: Hydraulic action – erosion caused by the movement of water against stream sediment Abrasion – erosion caused by particles.