Curtis Donald A, Jayanetti Jay, Chu Raymond, Staninec Michal
Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, School of Dentistry, San Francisco, Calif 94143-0758, USA.
Todays FDA. 2012 May-Jun;24(4):44-5, 47-9, 51-3 passim.
The clinical signs of dental erosion are initially subtle, yet often progress because the patient remains asymptomatic, unaware and uninformed. Erosion typically works synergistically with abrasion and attrition to cause loss of tooth structure, making diagnosis and management complex. The purpose of this article is to outline clinical examples of patients with dental erosion that highlight the strategy of early identification, patient education and conservative restorative management. Dental erosion is defined as the pathologic chronic loss of dental hard tissues as a result of the chemical influence of exogenous or endogenous acids without bacterial involvement. Like caries or periodontal disease, erosion has a multifactorial etiology and requires a thorough history and examination for diagnosis. It also requires patient understanding and compliance for improved outcomes. Erosion can affect the loss of tooth structure in isolation of other cofactors, but most often works in synergy with abrasion and attrition in the loss of tooth structure (Table 1). Although erosion is thought to be an underlying etiology of dentin sensitivity, erosion and loss of tooth structure often occurs with few symptoms. The purpose of this article is threefold: first, to outline existing barriers that may limit early management of dental erosion. Second, to review the clinical assessment required to establish a diagnosis of erosion. And third, to outline clinical examples that review options to restore lost tooth structure. The authors have included illustrations they hope will be used to improve patient understanding and motivation in the early management of dental erosion.
牙齿侵蚀的临床症状最初并不明显，但往往会发展，因为患者没有症状，未意识到且未得到相关信息。侵蚀通常与磨损和磨耗协同作用，导致牙体组织丧失，使得诊断和治疗变得复杂。本文旨在概述牙齿侵蚀患者的临床实例，突出早期识别、患者教育和保守修复治疗的策略。牙齿侵蚀被定义为在无细菌参与的情况下，由于外源性或内源性酸的化学作用导致的牙体硬组织病理性慢性丧失。与龋齿或牙周病一样，侵蚀有多种病因，诊断需要全面的病史和检查。它还需要患者的理解和配合以改善治疗效果。侵蚀可单独影响牙体组织丧失，但在牙体组织丧失过程中，它最常与磨损和磨耗协同作用（表1）。虽然侵蚀被认为是牙本质敏感的潜在病因，但牙体侵蚀和丧失往往很少有症状。本文目的有三个方面：第一，概述可能限制牙齿侵蚀早期治疗的现有障碍。第二，回顾确立侵蚀诊断所需的临床评估。第三，概述回顾恢复丧失牙体组织的治疗方案的临床实例。作者提供了一些插图，希望能用于提高患者对牙齿侵蚀早期治疗的理解和积极性。
