Monitoring of simulated occlusal tooth wear by objective outcome measures

Ghadeer S Alwadai; Grace Roberts; Peter S Ungar; Carlos González-Cabezas; Frank Lippert; Kim E Diefenderfer; George J Eckert; Anderson T Hara

doi:10.1016/j.jdent.2020.103467

Monitoring of simulated occlusal tooth wear by objective outcome measures

J Dent. 2020 Nov:102:103467. doi: 10.1016/j.jdent.2020.103467. Epub 2020 Sep 8.

Authors

Ghadeer S Alwadai¹, Grace Roberts², Peter S Ungar³, Carlos González-Cabezas⁴, Frank Lippert⁵, Kim E Diefenderfer⁶, George J Eckert⁷, Anderson T Hara⁸

Affiliations

¹ Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St., Indianapolis, IN, 46202, USA; Department of Restorative Dental Sciences, King Khalid University School of Dentistry, Guraiger, Abha, 61471-3263, Saudi Arabia. Electronic address: galwadai@iu.edu.
² Department of Anthropology, Old Main, 330, University of Arkansas, Fayetteville, AR, 72701, USA. Electronic address: gar003@uark.edu.
³ Department of Anthropology, Old Main, 330, University of Arkansas, Fayetteville, AR, 72701, USA. Electronic address: pungar@uark.edu.
⁴ Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, 1011 N University Ave, Ann Arbor, MI, 48109, USA. Electronic address: carlosgc@umich.edu.
⁵ Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St., Indianapolis, IN, 46202, USA. Electronic address: flippert@iu.edu.
⁶ Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St., Indianapolis, IN, 46202, USA. Electronic address: kediefen@iu.edu.
⁷ Department of Biostatistics, Indiana University School of Medicine, 410 West 10th Street, Suite 3000, Indianapolis, IN, 46202, USA. Electronic address: geckert@iu.edu.
⁸ Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St., Indianapolis, IN, 46202, USA. Electronic address: ahara@iu.edu.

PMID: 32916231
DOI: 10.1016/j.jdent.2020.103467

Abstract

Objectives: This in vitro study explored quantitative outcome measures as clinical indicators of simulated occlusal tooth wear progression.

Methods: Ten sound, extracted human premolars were selected and submitted to occlusal tooth wear simulation in 0.5-mm steps (0/0.5/1.0/1.5 mm). At each step, enamel thickness on the buccal cusp tips was evaluated using cross-polarization optical coherence tomography (CP-OCT) and micro-computed tomography (μ-CT). The occlusal surface of each premolar was also scanned at each step using a 3D digital intraoral scanner, followed by morphological characterization using standard topography attributes (Slope, Relief, RFI, OPCr). Repeated measures ANOVA assessed differences in simulated wear levels for the μ-CT and CP-OCT data as well as the topography values. Correlations were also calculated between the μ-CT/CP-OCT and topography data.

Results: Significant differences were observed for enamel thickness at each simulation wear stage, for both CP-OCT (p < 0.001) and μ-CT (p < 0.001), with good agreement between methods (intraclass correlation: 0.89). For topography analysis, as wear increased, the average Slope, RFI, and Relief values decreased, and average OPCr values increased, with more significant differences shown for Slope. Slope showed significant (p < 0.05) positive correlations with CP-OCT. OPCr showed significant negative correlations with μ-CT, and CP-OCT (p < 0.05). RFI and Relief were not correlated with either μ-CT or CP-OCT (p > 0.05).

Conclusions: Our findings suggest the potential of PS-OCT for measuring enamel thickness changes in the cusp tips of the occlusal surface. Similarly, conventional intraoral scanners can serve effectively for monitoring overall tooth wear when combined with dental topographic analyses of resultant point clouds.

Clinical significance: CP-OCT measures of enamel thickness and dental 3D topographic attributes showed potential as objective outcomes for the clinical monitoring of occlusal tooth wear. Their combination provided a comprehensive understanding of the tooth wear development process.

Keywords: Dental enamel; Occlusal; Optical coherence tomography; Tooth wear; Topography.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Dental Enamel / diagnostic imaging
Humans
Outcome Assessment, Health Care
Tomography, Optical Coherence
Tooth Attrition*
Tooth Wear* / diagnostic imaging
X-Ray Microtomography