Clinical presentation of two phenotypes of tooth wear patients

To assess the clinical presentation of wear lesions in two phenotypes of tooth wear (TW) patients based on distribution and morphological features of wear.

103 patients (mean age = 43.1 years) were divided into two groups based on cluster analysis; cluster A (61 patients) and cluster B (42 patients). The distribution of wear lesions, scores of presence or absence of 10 defined morphological TW criteria and number of teeth fulfilling each criteria were compared between groups. Intra- and inter-examiner reliability of the 10 TW criteria was determined by Cohen's kappa and intraclass correlation coefficient.

While cluster A had more wear in maxillary anterior teeth and mandibular molars compared with the same opposing tooth groups (p < 0.001, p < 0.007 respectively), there were no differences for cluster B. Cluster A was characterized by higher prevalence of 4 chemical morphological criteria and the highest number of teeth affected by one chemical criteria, whereas cluster B had a higher prevalence of one mechanical criteria and higher number of teeth affected by an additional mechanical criteria. Both intra- and inter-examiner values for the defined TW criteria were fair to excellent.

The results may indicate a more chemical background for TW in cluster A and mechanical background in cluster B. Furthermore, clinicians may use certain clinical features of TW to distinguish between individuals who belong to a specific TW cluster with a presumed chemical or mechanical etiology. These preliminary findings need to be confirmed in future studies.