Turssi Cecilia Pedroso, Algarni Amnah Abdullah, Eckert George Joseph, Hara Anderson Takeo
Division of Cariology and Restorative Dentistry, Faculdade São Leopoldo Mandic - Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil,
Department of Restorative Dentistry, College of Dentistry, Taibah University, Taibah, Medina, Saudi Arabia.
Am J Dent. 2019 Feb;32(1):3-8.
To investigate the association of dental enamel cracks with estimated tooth age and varying tooth wear severities.
355 premolars were sorted from a pool of extracted human teeth, based on their estimated age range: 21-40, 41-60 years old, determined by a dental forensic method and on the presence/severity of lesions: none, mild, moderate and severe wear (Basic Erosive Wear Examination Index). The buccal and lingual surfaces of the teeth were inspected for cracks under an optical coherence tomography system. Images were evaluated according to the following scores: 0= no crack; 1= crack beginning and terminating within the enamel, not reaching the outer surface; 2= crack extending from outer enamel surface terminating within the enamel; 3= crack extending from within enamel terminating at or beyond the dentin-enamel junction (DEJ); 4= crack extending from outer enamel surface terminating at or beyond the DEJ. Data were analyzed by Spearman correlations and Mantel-Haenszel chi-square tests.
Estimated tooth age and crack score were moderately correlated. Crack scores increased between each range of estimated tooth age (P< 0.050). Occlusal surfaces showing moderate or severe wear had higher buccal crack scores than occlusal surfaces having no wear (P< 0.020) and mild wear (P< 0.001). Buccal surfaces presenting severe wear had higher buccal crack scores than buccal surfaces with no wear, mild or moderate wear (P< 0.001). Premolars having severe wear had significantly higher crack scores than premolars showing no, mild or moderate wear lesions.
Knowing that older and more severely worn teeth are more prone to enamel cracks allows clinicians to better diagnose, monitor, and prevent further damage to teeth.
研究牙釉质裂纹与估计牙龄及不同牙齿磨损严重程度之间的关联。
从拔除的人类牙齿中挑选出355颗前磨牙，根据通过法医牙科学方法确定的估计年龄范围（21 - 40岁、41 - 60岁）以及病变的存在情况/严重程度（无、轻度、中度和重度磨损，采用基本侵蚀性磨损检查指数）进行分类。在光学相干断层扫描系统下检查牙齿的颊面和舌面是否有裂纹。根据以下评分对图像进行评估：0 = 无裂纹；1 = 裂纹起始并终止于牙釉质内，未到达外表面；2 = 裂纹从牙釉质外表面延伸并终止于牙釉质内；3 = 裂纹从牙釉质内延伸并终止于或超过牙本质 - 牙釉质界（DEJ）；4 = 裂纹从牙釉质外表面延伸并终止于或超过DEJ。通过Spearman相关性分析和Mantel - Haenszel卡方检验对数据进行分析。
估计牙龄与裂纹评分呈中度相关。在每个估计牙龄范围内，裂纹评分均有所增加（P < 0.050）。显示中度或重度磨损的咬合面的颊面裂纹评分高于无磨损的咬合面（P < 0.020）和轻度磨损的咬合面（P < 0.001）。呈现重度磨损的颊面的颊面裂纹评分高于无磨损、轻度或中度磨损的颊面（P < 0.001）。有重度磨损的前磨牙的裂纹评分显著高于无、轻度或中度磨损病变的前磨牙。
了解年龄较大且磨损更严重的牙齿更易出现牙釉质裂纹，可使临床医生更好地诊断、监测并预防牙齿的进一步损伤。
