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Browsing by Author "Ungar, Peter S."
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Item Exploratory Analysis of Objective Outcome Measures for the Clinical Assessment of Erosive Tooth Wear(MDPI, 2023-08-02) Romero, Maria Jacinta Rosario H.; Ungar, Peter S.; Fried, Daniel; Lippert, Frank; Zero, Domenick T.; Zunt, Susan; Eckert, George J.; Gutierrez Gossweiler, Ana; Elkington-Stauss, Dylan Jacob; Tamayo-Cabeza, Guillermo; Kelly, Adam B.; Bartels, Troy; Kita, Camille; Wewers, Elizabeth; Hara, Anderson T.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryThis study proposed using enamel surface texture and thickness for the objective detection and monitoring of erosive tooth wear (ETW), comparing them to the standard subjective Basic Erosive Wear Evaluation (BEWE). Thirty-two subjects (n = 597 teeth) were enrolled in this longitudinal observational clinical study. Enamel thickness (by cross-polarization optical coherence tomography, CP-OCT) and 3D dental microwear parameters, i.e., area-scale fractal complexity (Asfc), anisotropy (Str), and roughness (Sa) (by white-light scanning confocal profilometry), were obtained from buccal surfaces. Buccal, occlusal, and lingual surfaces were scored for BEWE and the maximum score per tooth (BEWEMax) was determined at baseline and 12 months (M12). Data outcome relationships were evaluated (alpha = 0.05). Enamel thickness decreased (p < 0.001), BEWE scores, Sa, and Str increased (p < 0.001), while Asfc did not change at M12. Baseline BEWEBuccal correlated strongly with BEWEMax (r = 0.86, p < 0.001) and moderately with BEWELingual (r = 0.42, p < 0.001), but not with enamel thickness (r = 0.03, p = 0.43). Change (Δ) in surface texture outcomes correlated poorly but significantly with ΔBEWEBuccal (r = −0.15–0.16, p < 0.001) and did not correlate with Δenamel thickness (r = 0.02–0.09, p > 0.06). Teeth with BEWE progression revealed a greater increase in ΔSa and ΔStr. These findings suggest that enamel surface roughness can potentially determine ETW severity, and CP-OCT may be relevant for clinically monitoring enamel thickness.Item Trend-analysis of dental hard-tissue conditions as function of tooth age(Elsevier, 2018-07) Algarni, Amnah A.; Ungar, Peter S.; Lippert, Frank; Martinez-Mier, E. Angeles; Eckert, George J.; González-Cabezas, Carlos; Hara, Anderson T.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjective This retrospective in-vitro study investigated tooth age effect on dental hard-tissue conditions. Methods Unidentified extracted premolars (n = 1500) were collected and their individual age was estimated (10–100 (±10) years old (yo)) using established dental forensic methods Dental caries, fluorosis and tooth wear (TW) were assessed using the International Caries Detection and Assessment System (ICDAS; 0–5 for crown and 0–2 for root), Thylstrup-Fejerskov (TFI; 0–9) and Basic Erosive Wear Examination (BEWE; 0–3) indices, respectively. Staining and color were assessed using the modified-Lobene (MLI) (0–3) and VITA shade (B1-C4) indices, respectively. Relationships between indices and age were tested using regression models. Results Starting at age ∼10yo, presence of caries increased from 35% to 90% at ∼50yo (coronal), and from 0% to 35% at ∼80yo (root). Caries severity increased from ICDAS 0.5 to 2 at ∼40yo and from ICDAS 0 to 0.5 at ∼60yo for coronal and root caries, respectively. Presence of TW increased from 25% (occlusal) and 15% (smooth-surfaces) to 100% at ∼80yo. TW severity increased from BEWE 0.5 to 2 at ∼50yo (occlusal) and ∼0.3 to 1.5 at ∼50yo (smooth-surfaces). Percentage and severity of fluorosis decreased from 70% to 10% at ∼80yo, and from TFI 1 to 0 at ∼90yo, respectively. Percentage of extrinsic staining increased from 0% to 85% at ∼80yo and its severity increased from MLI 0 to 2 at ∼70yo. Color changed from A3 to B3 at ∼50yo (crown), and from C2 to A4 at ∼85yo (root). Conclusions Aging is proportionally related to the severity of caries, TW, staining, and inversely to dental fluorosis. Teeth become darker with age