Studying Dentine Erosion In Vivo- An SEM Case Study

Studying dentine erosion requires direct evaluation of eroded dentine surfaces using different methods, one of which is the scanning electron microscope (SEM). In the literature, scarce if no in vivoexperiments have studied the original morphology of eroded dentine surfaces in patients with tooth wear.

Objective:

This clinical study sought to evaluate in vivothe appearance of eroded dentine surfaces from patients diagnosed with tooth wear. In theory; this could lead to better understanding of treatment regimens; i. e.  the need of dentine surface physical or chemical treatments prior to the placement of composite restorations.

Method:

1-      A 20 years old male diagnosed with sever tooth wear was recruited for this study.

2-      Ethical approval was gained to use redundant silicone dental impressions recorded as part of routine dental care at Dundee Dental Hospital. Silicone impressions (would otherwise be thrown away after producing study casts) were used to link SEM ultra-structural data to the clinical diagnosis by an indirect-replica technique to copy natural dentine surface topography.

3-      Replicas were evaluated with a Hitachi S-7400 SEM.

Result:

Eroded dentine on the occlusal surfaces of upper molars, premolars, and canines were covered with a smear layer which was deposited in a wavy undulated pattern over some surfaces. Interestingly, the incisal edge of the upper left incisor showed patent dentinal tubules at low magnification (X500) in contrast to the smear layer covered dentine on other teeth surfaces.

Conclusion:

Redundant dental silicone impressions showed high accuracy in reproducing fine dentine details despite being previously poured with dental stone. On a limited sample size, the morphology of eroded dentine in vivo is far different from lab-eroded dentine. Open dentinal tubules were only evident on the incisal edge of an upper incisor.