Long-Term In Vivo Evaluation of Occlusal Tooth Wear Progression Utilising 3D Analysis: A 25-Year Retrospective Study

This clinical study aimed to analyze occlusal tooth wear progression in a group of participants over a 25-year follow-up period.

Thirty-three participants were assessed in this observational retrospective study. Impressions were taken, and casts from three phases were scanned to generate digital models: Phase I in 1996, Phase II in 1999, and Phase III in 2021. These casts were then analyzed using a 3-dimensional (3D) software program (Geomagic Control; 3D Systems) to establish digital comparisons of tooth wear. The Basic Erosive Wear Examination (BEWE) index was used for qualitative 3D analysis, while superimposed image analysis was utilised for quantitative 3D evaluation of tooth wear. A standardised questionnaire assessed behavioural and clinical factors. Statistical analysis was performed using the Friedman test on occlusal wear (p = 0.05).

Occlusal tooth wear increased significantly over time, with median wear affecting 42.9% of teeth in Phase I, 60.7% in Phase II, and 85.7% in Phase III (p < 0.05). Lower first molars were the most affected teeth. BEWE scores also showed a significant increase across phases, indicating moderate tooth wear and a need for treatment. Nonparametric analysis identified behavioural and clinical factors associated with higher BEWE scores, revealing a statistically significant difference between the three phases (p < 0.05).

Over 25 years, occlusal tooth wear significantly progressed, especially in lower first molars, with contributing factors including lifestyle and health conditions; 3D digital analysis proved to be a precise and reliable method for long-term assessment.