Craniofacial morphology, occlusal traits, and bite force in persons with advanced occlusal tooth wear

The aim of this study was to investigate the dentofacial structure, the occlusal traits, and the bite force in subjects with advanced occlusal wear. The material comprised 54 adults, 30 men (mean = 40 years, range 16 to 61) and 24 women (mean = 28 years, range 18 to 47), most of whom had a full or near-full complement of natural teeth, and the presence of occlusal wear. Craniofacial structure was studied on lateral cephalograms. Occlusal traits were examined on study casts, these serving also for an evaluation of occlusal wear to be carried out by using an ordinal scale. Bite forces were recorded at differing force levels (maximum biting, "biting as when chewing" and "light biting") and occlusal positions. Although maximum bite force and endurance time did not differ significantly between men and women, the level of bite force was high compared with other samples. The craniofacial structure of the sample was characterized by a deviation in the vertical direction, a small angle between the mandibular-palatal planes and a small gonial angle, as compared with Swedish adult norms. No significant differences were found in anteroposterior relationships between persons with advanced wear and normal standards. The results support the hypothesis that functional hyperactivity of the masticatory system imposed increased stress on the bony structures of the craniofacial complex with possible influences on its structure.