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      Biologically Based Restorative Management of Tooth Wear

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          The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.

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          Most cited references 42

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          A critical review of the durability of adhesion to tooth tissue: methods and results.

          The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
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            The impact of exposure to the thin-ideal media image on women.

            The purpose of this study was to experimentally examine the effects of exposure to the thin-ideal body image on women's affect, self-esteem, body satisfaction, eating disorder symptoms, and level of internalization of the thin-ideal. College women (N=145) were randomly exposed to photographs from popular magazines containing either thin-ideal images or neutral images. Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, although it did not cause more internalization of the thin-ideal. Exposure to thin-ideal media images may contribute to the development of eating disorders by causing body dissatisfaction, negative moods, low self-esteem, and eating disorders symptoms among women.
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              Possible role of tensile stress in the etiology of cervical erosive lesions of teeth.

              A tensile stress hypothesis for the etiology of idiopathic cervical erosions of human teeth is presented. It is proposed that when occlusion is not ideal, lateral forces cause the teeth to bend. The tensile stresses created during bending disrupt the chemical bonds of the crystalline structures of enamel and dentin. Small molecules may enter between the crystals and prevent the reestablishment of the chemical bonds. As a result, the disrupted tooth structure is more susceptible to loss through dissolution and abrasion and results in the development of the typically wedge-shaped lesions. Patients with lesions typical of hundreds examined by the authors were presented to illustrate the concept. The possible consequences of the proposed hypothesis were discussed. The hypothetical conclusions made in this article will be tested by experimentation.

                Author and article information

                1King's College London Dental Institute, Denmark Hill, London SE5 9RT, UK
                2Eastman Dental Hospital, 256 Gray's Inn Road, London WC1X 8LD, UK
                3King's College London Dental Institute, Guy's Hospital, London Bridge, London SE1 9RT, UK
                Author notes

                Academic Editor: Ridwaan Omar

                Int J Dent
                International Journal of Dentistry
                Hindawi Publishing Corporation
                18 January 2012
                : 2012
                Copyright © 2012 Martin G. D. Kelleher et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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