Biomedical Engineering Reference
In-Depth Information
Table 2.3
Descriptions of stages of occlusal surface wear
Molars
Premolars
Diagnostic criteria
1
Unworn to polished or small
facets (nondentin exposure)
Unworn to polished or
small facets (nonden-
tin exposure)
Unworn to polished or
small facets (nondentin
exposure)
2
Moderate cusp removal
(blunting)
Moderate cusp removal
(blunting)
Point or hairline of dentine
exposure
Thinly enameled teeth may
show cusp tip dentin, but
human permanent molars
show no more than one or
two pinpoint exposures
3
Full cusp removal and/or some
dentin exposure, pinpoint to
moderate
Full cusp removal and/or
moderate dentin
patches
Dentin line of distinct
thickness
4
Several large dentin exposures,
still discrete
At least one large dentin
exposure on one cusp
Moderate dentin exposure
no longer resembling
a line
5
Two dentinal areas coalesced
Two large dentin areas
(may be slight
coalesced)
Large dentin area with
enamel rim complete
6
Three dentinal areas coalesced,
or four coalesced with
enamel island
Dentinal areas coalesced,
enamel rim still
complete
Large dentin area with
enamel rim lost on one
side or very thin
enamel only
7
Dentin exposed on entire surface
Full dentin exposure, loss
of rim on at least one
side
Enamel rim lost on two
sides or small remnants
of enamel remain
Enamel rime largely intact
8
Severe loss of crown height,
breakdown of enamel rim;
crown surface takes on shape
of roots
Severe loss of crown
height, crown surface
takes on shape of roots
Complete loss of crown,
no enamel remaining;
crown surface takes on
shape of roots
Source
: From Eccles [
2
]
of occlusal wear, as indicated in Tables
2.4
and
2.5
, respectively. The advantage of
this system is that it is simple and reliable for clinical treatment.
A similar diagnostic criteria on tooth erosion was presented by Millward et al.
[
5
], given in Table
2.6
, through an investigation involving the clinical examination
of 101 children and an assessment of their dietary habits. It provided a similar
method as that proposed by Eccles [
2
]. Three kinds of tooth erosion, such as none
or mild, moderate, and severe erosion, corresponding to different criteria and differ-
ent tooth surfaces were classifi ed for the children.
To conclude, several groups have tried to provide scoring systems or a classifi ca-
tion of stages of tooth wear. Most of the classifi cations are closely related to clinical
cases and based on statistical data from patients. Each individual scoring system is
suitable for a set of particular cases. We should not really question their reliability
for universal applications. As a matter of fact, understanding the philosophy and
methodology behind each rating system is much more important for clinicians and
scientifi c researchers than questioning their reliability.
