En face optical coherence tomography investigation of pathological dental wear

Aim and objectives. Excessive dental wear (pathological attrition and abfractions) is a frequent complication of occlusal overload. Pathological attrition results from mechanical wear during parafunction and is limited to the contacting surfaces of opposing teeth. Abfraction is the pathological loss of cervical hard tooth substance caused by biomechanical loading forces. The present study proposes the microstructural characterization of frontal teeth with pathological dental wear by en face optical coherence tomography (EFOCT). Materials and methods: 42 extracted frontal teeth were investigated using eFOCT. 35 teeth derived from patients with active eccentric bruxism (diagnosed by BiteStrip devices) and presented deep abfractions and variable degrees of occlusal pathological attrition. The other 7 frontal teeth, with a normal morphology of dental crowns, were not exposed to occlusal overload before extraction. The dental samples were investigated using a OCT device operating at 1300 nm (B-scan and C-scan mode). Results. The EFOCT investigation of frontal teeth with a normal morphology revealed a homogeneous structure of the occlusal and cervical enamel. The OCT images obtained from the occlusal overloaded frontal teeth visualized the wedge-shaped loss of cervical enamel and damage in the microstructure of the underlying dentin. The high occlusal forces produced also characteristic pattern of large cracks, which reached the occlusal tooth surface. Conclusions: EFOCT is a useful imaging method for the microstructural characterization of frontal teeth with pathological wear. It allows also the monitoring of the wear process.