Bruxism has been defined in recent years and analyzed in detail as the repetitive activity of the muscles of the masticatory system. Both adults and children experience two different forms of bruxism: daytime and nighttime bruxism. According to the WHO, bruxism affects 5% to 50% of the world\'s pediatric population. The symptoms of this disease include tooth wear and fractures, temporomandibular disorders, headaches, behavioral and sleep disorders, and parafunctional habits such as nail biting. According to scientists, psychosocial factors are the most likely factors causing bruxism in children. To this day, we do not have established standards of treatment for children, especially for those with disabilities. The issue of bruxism in children with Down syndrome (DS) is still unexplained. Anatomical abnormalities in the facial skeleton, reduced muscle tone, personality traits, and sleep problems in these people may cause the symptoms of bruxism. Our study aimed to present a clinical case of a 13-year-old girl with DS and symptoms of bruxism. Diagnostics and dental examination in children with intellectual disabilities and a lack of understanding of the disease create a great challenge for the treatment team, including the dentist, physiotherapist, psychologist, and family. Creating standards for treating and preventing bruxism symptoms is demanding, among other things, due to the lack of sufficient scientific research.

OBJECTIVE: To evaluate the survival rate of minimally invasive semipermanent occlusal polymethyl methacrylate (PMMA) onlays/veneers in previous temporomandibular disorder (TMD) patients with severe tooth wear and with a loss of vertical dimension after up to 7 years.
METHODS: This case series was designed as a follow-up evaluation with consecutive patient recruitment. All patients bearing the indication for this kind of rehabilitation were treated by the same clinician using the same adhesive methodology. The study included 22 patients (3 men/19 women), with a mean ± SD age of 50.7 ± 11.6 years. Controls followed within the first 4 weeks (and subsequently as required). Failure criteria included damage by fracture, chipping, and retention loss. Survival rates were determined based on the Kaplan-Meier analysis.
RESULTS: 328 semipermanent occlusal/incisal veneers were included (142 maxillary/186 mandibular teeth). Almost 80% of the restorations were in place and in function when starting the follow-up treatment after 180 days; failures predominantly occurred within the first 3 to 6 months but proved reparable. Depending on the patients\' priorities, scheduled replacements followed successively, and more than 65% did not show repair or any renewal needs for more than 360 days.
CONCLUSIONS: Within the limitations of this study the survival rates of occlusal veneers made of PMMA were sufficiently high to allow for consecutive treatment of the respective teeth by means of permanent restorations while preserving the restored vertical dimension. In patients with severe tooth wear and a TMD history, semipermanent restorative therapy with occlusal PMMA onlays/veneers would seem a noteworthy option.

Surgery for palate lesions may result in oro-nasal/antral communication, which reduces a person\'s quality of life by affecting swallowing, speech, and food reflux. The shape and size of this obturator prosthesis might vary based on the severity of the defect. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis and generalized attrition of teeth using an obturator and full mouth rehabilitation.

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.

Tooth wears in general term means loss of tooth structure. Tooth loss increases with age and thus causes difficulty in chewing and increased sensitivity. Wear facets on the occlusal surface are subjected to high occlusal stresses leading to repeated dislodgment of the restoration. This article presents the use of bonded amalgam as a restorative material for restoring localized occlusal wear facets.

BACKGROUND: Dentinogenesis imperfecta (DI) is an autosomal-dominant disorder. The most common clinical manifestations, including obliterated tooth tissues and severe tooth wear, usually lead to tooth extractions. It remains a great challenge for dentists to preserve the residual tooth tissue and establish the esthetics and occlusion of dentitions.
METHODS: 25-year-old twin sisters, who had suffered from dentinogenesis imperfecta type II for more than 10 years, presented with continuous tooth wear and discomfort from wearing a removable partial denture for more than 3 years.
METHODS: Intraoral examination showed extensive tooth wear with enamel exfoliation and typical amber-brown color with an opalescent discoloration. Their panoramic radiographs revealed completely obliterated tooth tissues and severe tooth wear.
RESULTS: The dentitions were restored with post-and-core crowns and pin lays after preparing root post paths and pin holes guided by computer-aided design/computer-aided manufacturing (CAD/CAM) procedures, resulting in a successful repair.
CONCLUSIONS: Severe tooth wear and tooth tissue obliteration are typical clinical manifestations in DI-affected dentitions, increasing the complexity and difficulty in dental restorations. Early diagnosis and appropriate treatments are essential to achieve a favorable prognosis. CAD/CAM procedures, permitting accurate and effective treatment, possess promising potential in the treatment of DI-affected dentitions.

The reformation of teeth with severe wear is a real challenge for clinicians. Through a clinical case study, this case illustrates a minimally invasive approach using the Dahl technique and bonded restorations for the treatment of a worn dentition with a loss of vertical dimension of occlusion and restoring ideal aesthetics.

BACKGROUND: Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials.
METHODS: The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria.
RESULTS: Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences (p < 0.005) on the survival of the restorations.
CONCLUSIONS: According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.

OBJECTIVE: This study was aimed to compare the risk factors and associated clinical manifestations of patients with temporomandibular disorders (TMDs) in the Indian population.
METHODS: A total of 52 patients were explored according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and compared with 48 controls. The mean age of the study group was 30.96 ± 11.60 years, 41% were males and 59% were females. The mean age in the control group was 31.5 ± 9.9 years (37.5% males), measuring differences in TMD risk factors (self-perceived stress, parafunctions, occlusal interferences, history of orthodontic treatment, and/or extraction).
RESULTS: The most common sign observed in the selected subjects was the joint sound (clicking) (42%), followed by mandibular deviation 39% as the second most common sign. Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (n = 40, 76%), followed by disc displacement with reduction (DDWR) (32.1%), arthralgia (30%), and disc displacement without reduction (DDWoR) (7.6%). More than one DC/TMD diagnosis was established in 63.2% of the patients. The risk factors like presence of clenching, stress perception, parafunctions, tooth wear, and occlusal interferences were significantly more frequent in all the cases than in the respective controls.
CONCLUSIONS: In the studied population, the presence of TMD was found to be positively related to factors namely female gender, parafunction, occlusal interferences, psychological stress, and tooth wear. Myofascial pain is the commonest diagnosis (either single or in combination). It is followed by DDWR (either single or in combination with others). Double diagnosis is also common.
CONCLUSIONS: Temporomandibular disorders showed a female predilection and were found to be positively related to factors, viz., parafunction, occlusal interferences, stress, and tooth wear. Clinicians should also be aware of common clinical manifestations of TMDs and their related stomatognathic risk factors to provide comprehensive oral care and to identify such factors for disease prevention.

BACKGROUND: Erosive tooth wear (ETW) and dental caries have common etiological factors, such as unhealthy eating habits, and reduced salivary flow rate.
OBJECTIVE: To analyze the association between caries experience (CE) and ETW in adolescents 13-14 years.
METHODS: Ninety-seven cases with distinctive ETW were identified and then sex-matched with a group of 97 controls and a group of 97 cases with initial ETW. The variables included were CE, presence of debris/dental calculus, salivary parameters, food and beverage consumption, chewable vitamin C tablet consumption, gastroesophageal reflux, frequent vomiting, and tooth brushing. Multinomial logistic regression models were adjusted.
RESULTS: An association was found between cases with a distinctive ETW defect and CE (OR = 1.09 (95% CI: 1.01-1.17); p = 0.020), sweet carbonated drinks consumption (OR = 1.16 (95% CI: 1.03-1.31); p = 0.012), and frequent vomiting (OR = 3.19 (95% CI: 1.02-10.01); p = 0.047).
CONCLUSIONS: The preventive management of both ETW and dental caries should aim to reduce exposure to foods and beverages with high acid and sugar content. Given the association between ETW and acid attack by gastric juice, this would be an indicator of the need for referral to a specialist for treatment.