The impact of e-training on tooth wear assessments using the BEWE

OBJECTIVE: To investigate the impact of an e-training resource with the consistency of tooth wear scoring using the Basic Erosive Wear Examination (BEWE). METHODS: Gold standard (GS) BEWE scores were attained from a trained examiner using the photographic and dental cast records for three conveniently selected cases representing low, medium and severe tooth wear. Four successive cohorts of first year post-graduate students, (n = 76, mean age, 35.4 years) undertook a training exercise. Each was given written guidance on using the BEWE. Following e-training, scoring was repeated, and the results expressed as mean, confidence Intervals, (95% ci) and p-values (values <0.05 were considered statistically significant). RESULTS: The e-training resulted in a mean improvement in the agreement with the GS score by 15.6% and 15.3%, using the records of the medium and severe tooth wear cases, (cumulative BEWE scores of 13 and 15 respectively). Post-training reductions were reported, with the mean number of disagreements with the GS and the mean change in the size of disagreement with the GS scores with records for the medium and severe cases (p = 0.001 and p < 0.001). No significant difference was revealed for the low wear case. CONCLUSION: e-training resulted in significant improvements in scoring BEWE, compared to the gold standard. CLINICAL RELEVANCE: Online training resources can help provide training with the BEWE

Longevity and Performance of Materials used for the Restorative Management of Tooth Wear:A Review

This article provides an overview of the available evidence on the performance, with particular consideration of the longevity of restorative materials used in the management of tooth wear. Different materials can be employed depending on whether a subtractive or additive strategy is used. Preference should be given to the latter to help preserve remaining tooth tissue. The use of both direct and indirect materials may yield acceptable survival results when considering data with at least 5 years of follow-up. Patients should be informed that because tooth wear is a continuous process, a certain level of maintenance of the restorations will be necessary and that this may impact on the success of the treatment

Developing diagnostic criteria for tooth wear, a preliminary beta version based on expert opinion, and a narrative literature review

Background: Tooth wear is a multifactorial condition, leading to the irreversible loss of dental hard tissues. The availability of an unambiguous, universally applicable assessment protocol remains lacking. Objectives: The goal of the authors is to develop a set of diagnostic criteria for the assessment of tooth wear (DC-TW). A two-step approach will be used to achieve this objective: (1) to develop a preliminary beta version of the DC-TW, based on the authors' clinical experience and their shared expertise and supported by a narrative review of the existing literature, and (2) to develop the final DC-TW, with input from a larger group of experts using an international Delphi process. This paper relates to the first step. Methods: The authors outlined the components that should be incorporated into the DC-TW. The literature search was performed to investigate if their concept was in line with the available literature. The search was conducted to identify eligible publications from inception to July 11, 2022. Two authors independently screened all publications, and differences in judgements were resolved through a consensus procedure. Results: The search yielded 5362 publications, resulting in the final inclusion of 383. These publications were divided into four main topics: (1) nomenclature/taxonomies; (2) self-report tools; (3) clinical assessment tools; and (4) clinical decision-making. Conclusions: The information from the publications was used and fused with the clinical experience and shared expertise of the authors to contribute to the development of a preliminary beta version of the DC-TW.</p

A comparative evaluation between the reliability of gypsum casts and digital greyscale intra-oral scans for the scoring of tooth wear using the Tooth Wear Evaluation System (TWES)

BACKGROUND: The Tooth Wear Evaluation System (TWES) is a type of tooth wear index. To date, there is the lack of data comparing the reliability of the application of this index on gypsum cast records and digital greyscale intra‐oral scan records. OBJECTIVES: A comparative evaluation between the use of gypsum cast records and digital greyscale intra‐oral scan records with the reliability of tooth wear scoring using the TWES amongst a group of patients with tooth wear. METHODS: Records for 10 patients with moderate to severe tooth wear (TWES ≥ 2) were randomly selected from a larger clinical trial. TWES grading of the occlusal/incisal, buccal and palatal/lingual surfaces was performed to determine the levels of intra‐ and interobserver agreement. Intra‐observer reproducibility was based on the findings of one examiner only. For the interobserver reproducibility, the findings of two examiners were considered. One set of models/ records were used per patient. Cohen's weighted kappa (κ(W)) was used to ascertain agreement between and within the observers. Comparison of agreement was performed using t tests (P < .05). RESULTS: For the scoring of the of the total occlusal/incisal surfaces, the overall levels of intra‐ and interobserver agreement were significantly higher using the gypsum cast records than with the digital greyscale intra‐oral scan records, (P < .001) and (P < .001), respectively. For the overall buccal surfaces, only a significant difference was found in the intra‐observer agreement using gypsum casts, (P = .013). For the palatal/lingual surfaces, a significant difference was only reported in the interobserver agreement using gypsum casts, (P = .043). At the occlusal/incisal surfaces, grading performed using gypsum casts, culminated in significantly higher TWES scores than with the use of the digital greyscale intra‐oral scans (P < .001). At the buccal and palatal/lingual surfaces, significantly higher wear scores were obtained using digital greyscale intra‐oral scan records (P < .009). CONCLUSIONS: The TWES can offer a reliable means for the scoring of wearing occlusal/incisal surfaces using gypsum casts. The reliability offered by digital greyscale intra‐oral scans for consecutive scoring was in general, inferior

The effect of pre-treatment levels of tooth wear and the applied increase in the vertical dimension of occlusion (VDO) on the survival of direct resin composite restorations.

Contains fulltext : 236969.pdf (Publisher’s version ) (Open Access

Clinical performance of direct composite resin restorations in a full mouth rehabilitation for patients with severe tooth wear:5.5-year results.

Item does not contain fulltextOBJECTIVES: To evaluate the 5.5-year performance of direct resin composite restorations, prescribed for patients with severe tooth wear, requiring full-mouth rehabilitation. METHODS: A convenience sample of 34 patients were recruited to a prospective trial between December 2010 and June 2013. The participants were provided 1269 full-mouth direct resin composite restorations (Clearfil AP-X) by 5 experienced operators, using the DSO-technique. Treatment resulted in an increase in the vertical dimension of occlusion (VDO). Failure was assessed at three levels. Frequencies of failure were analysed using Kaplan Meier survival curves and the effects of the relevant variables calculated with a multifactorial Cox regression (p < 0.05). RESULTS: Annual failure rates (for all levels of failure, 'Level 3- ') of ≤ 2.2% and ≤ 2.9% were respectively reported for the anterior and posterior restorations with a mean observation time of 62.4 months. The completion of an anterior restoration with the need for further appointments resulted in significantly more Level 2- & 3- failures. An evaluation of the performance of the premolar and posterior maxillary restorations showed significantly lowered risks of certain types of failures, compared to the molar and posterior mandibular restorations. CONCLUSIONS: At 5.5 years, 2.3% of the overall restorations displayed catastrophic, (Level 1) failures. Molar restorations, posterior mandibular restorations and the anterior restorations requiring two further sessions for completion, were associated with significantly higher risks for failure. CLINICAL SIGNIFICANCE: Direct resin composite can offer an acceptable medium-term option for the treatment of severe, generalized tooth wear; molar restorations may require higher maintenance