PDF(Pubmed)
Abstract：
Tooth wear is multi-factorial presenting as a combination of abrasion, attrition, and erosion. This case report represents a case of combined tooth wear in a 46-year-old Indo-Trinidadian male, with a predominant erosive component with both the clinical signs and features of intrinsic and extrinsic erosion. This patient case is unique since the wear predominated by dental erosion has occurred rapidly evidenced by the physical clinical appearance of a lack of compensation and the upper left premolars and molars relatively unaffected by the overall effects of tooth wear. This lack of compensation, where opposing teeth have not supra-erupted to maintain inter-arch stability, and the maintenance of occlusal vertical dimension on the left due to the non-worn posterior maxillary teeth, provides the benefit of simplifying subsequent restorative management. The medical and diet history corroborates the diagnoses of intrinsic and extrinsic erosion respectively. Complications noted with rapid tooth wear, such as dentine sensitivity and pulpal necrosis are known sequelae of tooth wear however the patient presented in this case report shows a concomitant high caries experience and poor oral hygiene. Cases such as the one presented here require not only comprehensive dental management, utilizing a restorative approach but also medical referral for confirmation of a diagnosis and management of gastroesophageal reflux disease. Inherent to the management of this patient should be a multidisciplinary medical and dental approach, with confirmation and management of the cause of the intrinsic erosion as well as restorative dental management, together with dietary counseling to mitigate the effect of intrinsic and extrinsic sources of acid on dental hard tissue. A key lesson learned from this case is the importance of history and targeted questioning when trying to determine the cause of tooth wear dominated by intrinsic and extrinsic erosion.
摘要：
牙齿磨损是多因素表现为磨损的组合，自然减员,和侵蚀。该病例报告代表了一名46岁的印度-特立尼达男性的牙齿综合磨损病例，具有主要的侵蚀成分，具有内在和外在侵蚀的临床体征和特征。这种患者的情况是独特的，因为牙齿侵蚀占主导地位的磨损已迅速发生，这是因为缺乏补偿的物理临床表现以及左上前磨牙和磨牙相对不受牙齿磨损的整体影响的影响。这种缺乏补偿，相对的牙齿没有上萌出以保持牙弓间的稳定性，以及由于未磨损的上颌后牙而在左侧保持咬合垂直尺寸，提供了简化后续恢复性管理的好处。医学和饮食史分别证实了内在和外在侵蚀的诊断。牙齿快速磨损引起的并发症，例如牙本质敏感性和牙髓坏死是已知的牙齿磨损的后遗症，然而在这个病例报告中呈现的患者显示出伴随的高龋齿经历和不良的口腔卫生。像这里介绍的这种情况不仅需要全面的牙科管理，利用恢复性方法以及医疗转诊来确认胃食管反流病的诊断和治疗。该患者的管理固有的应该是多学科的医学和牙科方法，通过确认和管理内在侵蚀的原因以及修复性牙科管理，与饮食咨询一起减轻内在和外在来源的酸对牙齿硬组织的影响。从这个案例中学到的一个关键教训是，在试图确定由内在和外在侵蚀主导的牙齿磨损的原因时，历史和有针对性的质疑的重要性。
