A new scoring system, the Basic Erosive Wear Examination (BEWE), has been designed to provide a simple tool for use in general practice and to allow comparison to other more discriminative indices. The most severely affected surface in each sextant is recorded with a four level score and the cumulative score classified and matched to risk levels which guide the management of the condition. The BEWE allows re-analysis and integration of results from existing studies and, in time, should initiate a consensus within the scientific community and so avoid continued proliferation of indices. Finally, this process should lead to the development of an internationally accepted, standardised and validated index. The BEWE further aims to increase the awareness of tooth erosion amongst clinicians and general dental practitioners and to provide a guide as to its management.
Mesotrione is a new herbicide being developed for the selective pre- and post-emergence control of a wide range of broad-leaved and grass weeds in maize (Zea mays). It is a member of the benzoylcyclohexane-1,3-dione family of herbicides, which are chemically derived from a natural phytotoxin obtained from the Californian bottlebrush plant, Callistemon citrinus. The compound acts by competitive inhibition of the enzyme 4-hydroxyphenylpyruvate dioxygenase (HPPD), a component of the biochemical pathway that converts tyrosine to plastoquinone and alpha-tocopherol. Mesotrione is an extremely potent inhibitor of HPPD from Arabidopsis thaliana, with a Ki value of c 6-18 pM. It is rapidly taken up by weed species following foliar application, and is distributed within the plants by both acropetal and basipetal movement. Maize is tolerant to mesotrione as a consequence of selective metabolism by the crop plant. Slower uptake of mesotrione, relative to susceptible weed species, may also contribute to its utility as a selective herbicide for use in maize.
The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.
Data on the prevalence of tooth wear among children and adolescents are inconsistent. Given the impact of extensive tooth wear for over a lifetime, evidence on the extent is required. The aim was to systematically review the literature on the prevalence of tooth wear in children and adolescents. A PubMed literature search (1980–2008) used the keywords ‘tooth’ AND ‘wear’; ‘dental’ AND ‘attrition’ AND ‘prevalence’; ‘dental’ AND ‘wear’ AND ‘prevalence’; ‘erosion AND prevalence’ AND ‘abrasion AND prevalence’. Following exclusion criteria, 29 papers were reviewed using established review methods. There was a total of 45,186 subjects (smallest study 80 and largest study 17,047 subjects) examined from thirteen multiple random clusters, eight multiple convenience clusters and eight convenience clusters. Nine different tooth wear indices were used, but the common denominator among studies was dentin exposure as an indicator of severe wear. Forest plots indicated substantial heterogeneity of the included studies. Prevalence of wear involving dentin ranged from 0 to 82% for deciduous teeth in children up to 7 years; regression analysis showed age and wear to be significantly related. Most of the studies in the permanent dentition showed low dentin exposure, a few reported high prevalence (range 0–54%); age and wear were not related (regression analysis). The results of this systematic review indicate that the prevalence of tooth wear leading to dentin exposure in deciduous teeth increases with age. Increase in wear of permanent teeth with age in adolescents up to 18 years old was not substantiated.
Tooth wear is common in adolescents and the relationship with dietary acid, salivary buffering and symptoms of gastro-oesophageal reflux is complex and requires further investigation.
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