Longitudinal 3D Study of Anterior Tooth Wear from Adolescence to Adulthood in Modern Humans

Abstract

In modern humans, tooth wear can easily be observed as a loss of tooth substance, but its precise measurement is problematic. The aim of this longitudinal cohort study was to determine the precise amount of occlusal tooth wear in the anterior permanent dentition from adolescence to adulthood. Corresponding tooth crowns from serial 3D digital dental models of 72 individuals were best fit-approximated by applying novel, highly accurate 3D superimposition methods. The superimposed crowns were simultaneously sliced on intact structures, and the differences in the volumes of the subsequent occlusal parts were calculated. Over a thirteen-year period, there was an average loss of anterior occlusal surfaces of 1.58 mm3 per tooth. Tooth surface loss in at least one tooth was higher than 1 mm3 in 93.1% of the human subjects. Tooth wear severity differed by sex and tooth type, with males showing higher values versus females and upper canines versus other anterior teeth. The study revealed the endemic occurrence of occlusal anterior tooth wear, highlighting the need for monitoring of the condition in the population to identify high-risk patients and enable timely interventions. The novel methods applied here on 3D digital models are recommended for this.

Intraoral Scanners for In Vivo 3D Imaging of the Gingiva and the Alveolar Process

“…Similar findings have been evident for dental [ 11 , 17 ] and palatal structures [ 6 ]. Furthermore, if serial intraoral models of an individual are available, techniques have been developed to precisely monitor various outcomes over time, including tooth or material wear [ 12 , 13 , 14 , 31 ], tooth positional changes [ 5 , 15 ], gingival width [ 32 ], and gingival thickness changes [ 33 , 34 ]. Thus, due to the easy and risk-free acquisition of reliable 3D intraoral models through intraoral scanning and the various uses of this information, we recommend the acquisition of an intraoral model for every patient in early permanent dentition to form the basis for comparisons with future intraoral models.…”

Accurate gingival recession quantification using 3D digital dental models

“…Using a single tooth crown superimposition technique allows for reliable long-term assessments, irrespective of the final tooth position. Furthermore, the current method is robust in case of incidental tooth wear, which is expected in almost all individuals already at an early age [18]. Lastly, with the present approach any natural or artificial morphological change in one or more teeth of a dentition does not affect the measurements on other teeth.…”

“…This is only feasible in an in vitro setting, as there is a lack of stable references when ex vivo methods are used. To simulate various clinical conditions, we considered differences in tooth alignment [21] and introduced tooth wear of different severity among various tooth types [18]. The method proved robust under the quite different circumstances, including morphological or spatial changes in the dentition.…”

“…To simulate actual clinical conditions that occur during normal functioning [18], certain teeth that received artificial recessions were also grinded at the same time at their occlusal surfaces, using a pencil and a laboratory handpiece, as described previously [15,16]. As a result, various degrees of tooth wear were simulated (corresponding to 0, 1, and 2 mm of vertical tooth loss), which were equally distributed among tooth types and jaws.…”

“…Therefore, the acquisition of a 3D digital intraoral model can be seen today as an important adjunction to the periodontal documentation of patients at risk, as well as in orthodontic patients before and after treatment and in research studies on gingival recessions. Ideally, the acquisition of a baseline intraoral model could be performed in every patient at the early permanent dentition as, except for gingival tissue changes, patients can also be precisely monitored for other dental outcomes, including tooth or material wear [15][16][17][18] and tooth positional changes [22,36]. Depending on patient needs, subsequent intraoral models can be obtained on an individually defined time-schedule, facilitating future research and improving clinical decision-making.…”