Dept. of Prosthetic Dentistry, Folktandvården Eastmaninstitutet, Stockholm, Sweden; Dept. of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Dept. of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Scandinavian Centre for Orofacial Neuroscience (SCON), Denmark.
J Dent. 2019 Jul;86:60-68. doi: 10.1016/j.jdent.2019.05.028. Epub 2019 May 24.
To assess the clinical presentation of wear lesions in two phenotypes of tooth wear (TW) patients based on distribution and morphological features of wear.
103 patients (mean age = 43.1 years) were divided into two groups based on cluster analysis; cluster A (61 patients) and cluster B (42 patients). The distribution of wear lesions, scores of presence or absence of 10 defined morphological TW criteria and number of teeth fulfilling each criteria were compared between groups. Intra- and inter-examiner reliability of the 10 TW criteria was determined by Cohen's kappa and intraclass correlation coefficient.
While cluster A had more wear in maxillary anterior teeth and mandibular molars compared with the same opposing tooth groups (p < 0.001, p < 0.007 respectively), there were no differences for cluster B. Cluster A was characterized by higher prevalence of 4 chemical morphological criteria and the highest number of teeth affected by one chemical criteria, whereas cluster B had a higher prevalence of one mechanical criteria and higher number of teeth affected by an additional mechanical criteria. Both intra- and inter-examiner values for the defined TW criteria were fair to excellent.
The results may indicate a more chemical background for TW in cluster A and mechanical background in cluster B. Furthermore, clinicians may use certain clinical features of TW to distinguish between individuals who belong to a specific TW cluster with a presumed chemical or mechanical etiology. These preliminary findings need to be confirmed in future studies.
根据磨损的分布和形态特征，评估两种牙齿磨损（TW）表型患者的磨损病变的临床表现。
根据聚类分析，将 103 名患者（平均年龄 43.1 岁）分为两组；组 A（61 名患者）和组 B（42 名患者）。比较两组间磨损病变的分布、10 项定义的形态 TW 标准的有无评分以及符合每个标准的牙齿数量。通过 Cohen's kappa 和组内相关系数确定 10 项 TW 标准的内部和内部检查者可靠性。
与相同的对颌牙齿组相比，组 A 的上颌前牙和下颌磨牙磨损更多（p<0.001，p<0.007），而组 B 则无差异。组 A 的化学形态标准的患病率更高，受一种化学标准影响的牙齿数量最多，而组 B 的机械标准的患病率更高，受额外机械标准影响的牙齿数量更多。定义的 TW 标准的内部和内部检查者值均为良好至优秀。
结果可能表明组 A 中 TW 的化学背景更多，组 B 中 TW 的机械背景更多。此外，临床医生可以使用 TW 的某些临床特征来区分属于特定 TW 簇的个体，这些 TW 簇具有假定的化学或机械病因。这些初步发现需要在未来的研究中得到证实。
