Fogorvosi szemle, 2004 (97. évfolyam, 1-6. szám)

2004-02-01 / 1. szám

FOGORVOSI SZEMLE ■ 97. évf. 1. sz. 2004. 46-56. 4th Preventive Dental Conference Strategies in Oral Health Promotion and Prevention for Europe November 14-15, 2003 Budapest, Hungary Cosponsored by the World Health Organization, Regional Office for Europe Summary of the lectures presented on the Conference AN OVERVIEW OF TOOTH WEAR ADDY Martin Dental School, University of Bristol, Bristol, United Kingdom Tooth wear is the collective term used to describe the non-carious loss of dental hard tissues due to attrition, abrasion and erosion, with the theoretical concept of abfraction acting as a predisposing factor. The termi­nology relating to tooth wear is peculiar to dentistry, not used in tribology and, in the case of erosion, totally incor­rect. Attrition is a 2-body wear system from contacting teeth which can convert to a 3-body wear system when enamel cracks are propagated. Abrasion is a 3-body wear system where a foreign material is interspersed between a contacting material and the tooth surface: tooth brushing with toothpaste being an example. Ero­sion, or more correctly corrosion, is a physico-chemical dissolution of dental hard tissues. Rarely will one factor explain a particular type of site of wear and interactions must occur notably between attrition and abrasion with erosion. Much of tooth wear can be seen as part of the ageing process due to a dose response effect. Wear can, however, reach pathological levels in both dentitions and threaten the longevity, function and aesthetics of teeth. Dentine hypersensitivity is almost certainly a tooth wear phenomenon. Erosion, particularly combined with abra­sion, is perhaps the most significant aetiological factor, particularly with the lifestyle changes towards increased intakes of acidic foods and drinks; making prevention a difficult goal to achieve. This overview will expand upon each of these topics. DENTINE HYPERSENSITIVITY: IS IT STILL AN ENIGMA? ADDY Martin Dental School, University of Bristol, Bristol, United Kingdom Objectives: To discuss available literature on the termi­nology, definition, epidemiology, mechanisms, anatomy, aetiology and management of dentine hypersensitivity (DH) to determine how much has been learnt since the condition was described in 1982 as an enigma. Materi­al and Methods: Search the literature on subject areas - DH (related terms notably dentine sensitivity), tooth wear (abrasion, erosion, attrition, abfraction) and clini­cal trials (DH). Results: DH is probably not accurate ter­minology but has been in common usage for decades. An internationally accepted definition is available which describes DH and differentiates it from other conditions with similar symptoms. DH is variably common with a dis­tribution pattern that implicates tooth wear factors and a negative correlation with plaque. A hydrodynamic mech­anism is the accepted theory of stimulus transmission and lesions show markedly increased open and wider tubules. Loss of enamel and particularly gingival reces­sion localise lesions and abrasive and erosive process­es appear to initiate sensitivity by opening tubules. Man­agement strategies need to be developed, which consid­er the aetiology, and treatments without this are likely to fail. The actual effect of most treatments is poorly under­stood. Conclusions: DH is not the enigma it was but much is still to be learnt. ORAL HEALTH OF LONG-TERM CHILDHOOD CANCER SURVIVORS ALBERTH Márta, KISS Csongor, MÁRTON Ildikó Institute of Dental Sciences and Department of Pediatrics, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary Objectives: Improvement in childhood cancer survivor rate increased the importance of reducing late effects of cyto­toxic therapy. Stomatologic sequela represent an often neglected area with negative impact on quality of life. Material and Methods: 45 children and adolescents, 25 boys and 20 girls in long-term remission previously treated for cancer or immune hematologic diseases were includ­ed in an oral and dental survey. At the time of the survey the mean age was 12.35 years and the mean survival time was 6.9 years. For each patient age and sexmatched con­trols were chosen. DMF-S and DMF-T scores were used. The data were recorded together with occasional devel-

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