Ellingsgaard Maria Tummasdóttir, Khesrawi Floora, Peutzfeldt Anne, Hermann Nuno Vibe, Sonnesen Liselotte, Benetti Ana Raquel
Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Dent. 2025 Feb;153:105538. doi: 10.1016/j.jdent.2024.105538. Epub 2024 Dec 29.
To assess the degree of tooth wear in children and adolescents by application of a qualitative wear index and by quantitative measurement on digital models. The hypothesis was that the quantitative method would be sensitive to reliably measure tooth wear.
Existing digital models (n = 24) gathered from a prospective clinical study were analysed. The models were obtained at two time points (11-17 months apart) from a cohort of young individuals (11-16 years old) with permanent dentition. Dental wear was scored per sextant on the models according to the qualitative criteria by two examiners and was then quantified on reference teeth (central incisors, canines and first molars). Data were analysed using Cohen's kappa coefficient, Kruskal-Wallis tests followed by Mann-Whitney U, and correlation tests, all with a significance level of 0.05.
According to the qualitative assessment, all subjects showed signs of tooth wear and the severity of scores was higher in the anterior dentition (P ≤ 0.003). Inter-examiner reliability was 0.652 (P < 0.001) while intra-examiner reliability was 0.618 and 0.571 (P < 0.001), respectively. The quantitative analysis showed median tooth wear of 0.09 mm (range: 0 - 0.56 mm). There was no significant correlation between the quantitative measurements of tooth wear and age, sex assigned at birth, time span between scans, or sum of index scores.
The quantitative method was sufficiently sensitive to reliably measure tooth wear on digital models in ≥ 92 % of the investigated teeth. The use of the qualitative wear index on digital models proved dubious due to moderate intra- and inter-reliability ratings.
Our results show increased prevalence and severity of tooth wear in children and adolescents, which raise concern about the current lifestyle habits in our society. Intraoral scanning can be used to quantify tooth wear at an early stage and thus help design individual strategies to prevent further tooth loss.
通过应用定性磨损指数和对数字模型进行定量测量，评估儿童和青少年的牙齿磨损程度。假设是定量方法能够灵敏地可靠测量牙齿磨损。
分析了从一项前瞻性临床研究中收集的现有数字模型（n = 24）。这些模型是在两个时间点（相隔11 - 17个月）从一组恒牙列的年轻个体（11 - 16岁）中获得的。两名检查者根据定性标准对模型上的每个牙 sextant 进行牙齿磨损评分，然后对参考牙齿（中切牙、尖牙和第一磨牙）进行量化。使用 Cohen's kappa 系数、Kruskal-Wallis 检验，随后进行 Mann-Whitney U 检验以及相关性检验对数据进行分析，所有检验的显著性水平均为0.05。
根据定性评估，所有受试者均显示出牙齿磨损迹象，前牙列的评分严重程度更高（P≤0.003）。检查者间信度为0.652（P < 0.001），而检查者内信度分别为0.618和0.571（P < 0.001）。定量分析显示牙齿磨损中位数为0.09毫米（范围：0 - 0.56毫米）。牙齿磨损的定量测量与年龄、出生时指定的性别、扫描之间的时间跨度或指数评分总和之间没有显著相关性。
定量方法足够灵敏，能够在≥92%的被调查牙齿上可靠地测量数字模型上的牙齿磨损。由于信度评级中等，在数字模型上使用定性磨损指数被证明存在疑问。
我们的结果表明儿童和青少年牙齿磨损的患病率和严重程度增加，这引发了对我们社会当前生活方式习惯的关注。口腔内扫描可用于在早期阶段量化牙齿磨损，从而有助于设计个体策略以防止进一步的牙齿丧失。
