On average, these subjects possessed 23 teeth. The control group consisted of 20 healthy volunteers aged 46.5 ± 6 years (eight women and 12 men), matched by body mass index (BMI), without signs of pathological tooth wear. They were asked

to participate voluntary in the study as they presented at the department to make minor prosthetic procedures relating only to a single tooth (e.g., crown or inlay). On average, the reference subjects possessed Palbociclib supplier 27 teeth. All study participants demonstrated good general somatic condition, their own teeth were free of clinical signs of dental caries or periodontal disease. Tooth Wear Index (TWI) was used to categorize the participants. The inclusion criteria for the studied patients were: the presence of widespread advanced tooth wear with multiple sites

of exposed occlusal dentin (TWI on occlusal/incisal surface ≥ 2) and a considerable decrease in the occlusal vertical dimension (more than 4 mm measured in the anterior region), no significant periodontal bone loss or decay on their own teeth, no prior prosthetic rehabilitation attempting to treat the lost vertical dimension. Furthermore, the inclusion criteria for the whole group encompassed: absence of chronic metabolic, endocrine, renal, or gastrointestinal conditions, or prolonged medication known to affect bone metabolism, learn more oral microflora, or the salivary flow rate. No history of clinically significant fractures was reported in either of the groups. Patients who underwent prosthetic rehabilitation prior to recruitment were excluded. The participants were required to be available to be recalled multiple times during the duration of the study.

Informed consent was obtained from Doxacurium chloride each participant prior to confirmation of their eligibility for the study. The protocol was approved by the Ethical Committee of the Medical University of Bialystok, Poland (approval # R-I-003/6/2006). Methods The dietary intakes of nutrients, including elements and vitamin D, were assessed with the validated 7-days food-frequency questionnaire based on the software DIETA 3, and the obtained data were compared to the national recommended daily intakes (RDIs). Both direct standardized interview-based questionnaire and medical records were utilized to accomplish medical history. Anthropometric measurements (body weight and height) were performed using electronic scale (Seca, Germany) and Harpenden stadiometer, whereas BMI was calculated using standard formula. Dental examination and clinical procedures All of the participants were clinically examined to evaluate tooth wear. Tooth wear was assessed according to the protocol of Smith and Knight [42]. The TWI was selected as an assessment measure because this method allowed to visually evaluate the level of wear.