Etiology of Noncarious Cervical Lesions (original) (raw)
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Hitherto, noncarious cervical lesions (NCCLs) of teeth have been generally ascribed to either toothbrush-dentifrice abrasion or acid "erosion. " The last two decades have provided a plethora of new studies concerning such lesions. The most significant studies are reviewed and integrated into a practical approach to the understanding and designation of these lesions. A paradigm shift is suggested regarding use of the term "biocorrosion" to supplant "erosion" as it continues to be misused in the United States and many other countries of the world. Biocorrosion embraces the chemical, biochemical, and electrochemical degradation of tooth substance caused by endogenous and exogenous acids, proteolytic agents, as well as the piezoelectric effects only on dentin. Abfraction, representing the microstructural loss of tooth substance in areas of stress concentration, should not be used to designate all NCCLs because these lesions are commonly multifactorial in origin. Appropriate designation of a particular NCCL depends upon the interplay of the specific combination of three major mechanisms: stress, friction, and biocorrosion, unique to that individual case. Modifying factors, such as saliva, tongue action, and tooth form, composition, microstructure, mobility, and positional prominence are elucidated.
Noncarious Cervical Lesions: Correlation between Abfraction and Wear Facets in Permanent Dentition
Open Journal of Stomatology, 2015
Non-carious cervical lesions (NCCLs) are defined as the loss of dental hard tissue at the cementenamel junction. Erosion, abrasion, and attrition have been associated with this disorder. Objective: Recently, occlusal stress causing of cervical enamel cracks (abfraction) has been considered as an additional etiology for NCCLs to facilitate the erosion and abrasion mechanisms in tooth wear. Study Design: The prevalence of NNCLs and wear facets in a population with permanent dentition in absence of any clear etiological factors related to erosion and abrasion causes is evaluated. A total 295 subjects are enrolled for this study and divided into four age groups (subjects aged 15-27 years, 28-42 years, 43-57 years and 58-75 years respectively). An overall of 6629 teeth are investigated to find NCCLs and wear facets. The occlusion is analyzed in each patient. Results: An overall of 801 teeth (12%) show NCCLs and 623 of them (78%) highlight also wear facets. The higher number of teeth with NCCLs and of these with simultaneous presence also of wear facets are found on teeth of patients of group-3 (11% of all teeth examined for group and 81% respectively) and to group-4 (24.4% of all teeth examined for group and 86.5% respectively) of remaining teeth without NCCLs (5828) only 138 (2.4%) shown wear facets. Conclusion: The results of this study held the occlusal forces as the main cause of NCCLs on teeth in presence of wear facets.
Non-carious cervical lesions - can terminology influence our clinical assessment?
British Dental Journal, 2019
The introduction of abfraction into tooth wear nomenclature The most common cause of non-carious cervical lesions (NCCLs) is abrasion combined with erosion. Occlusal forces may play a role in NCCL progression but are unlikely to be an aetiological agent. Terming these lesions 'abfraction lesions' may be misleading.
Cervical abrasion injuries in current dentistry
Lesiones cervicales de abrasión en la odontología catual, 2018
Currently, dental abrasion is a frequent pathological condition, hence the importance of its study; to be specific, the cervical abrasion injury is the wear of the hard tissues of the tooth located in the neck of the tooth, produced by a constant frictional mechanical process. Clinically, at the beginning it is small horizontal groove near the cement-enamel junction; However, then the walls form a wedge with polished, glassy surfaces and tactile sensitivity. This type of lesions usually have a multi-causal origin, where the oral hygiene technique should be supervised and corrected as part of the treatment, emphasizing the type, quantity and frequency of toothpaste use, hardness of brush and the pressure exerted during dental brushing. In this way, the correct diagnosis allows the professional to identify the possible causes and the specific treatment for each case
Dental cervical lesions associated with occlusal erosion and attrition
Australian Dental Journal, 1999
Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedgeshaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedgeshaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusal and cervical pathology. Shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge-shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the sitespecificity of dental erosion than to attrition from occlusal forces. Non-carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.
Etiological Aspects of Noncarious Dental Lesions
2017
Purpose: The aim of the present study was to correlate etiological factors with noncarious cervical lesions in a group of patients from Craiova. Material and Methods: The study was conducted between November 2015 and May 2016 on 50 patients, aged 18-56 years, who addressed to the Oral Rehabilitation Clinic, from the University of Medicine and Pharmacy of Craiova. Patients were divided into two groups: the study group consists of patients who had noncarious cervical dental lesions (NCCLs) and the control group with patients who did not have noncarious cervical lesions. Each patient underwent a clinical examination and completed a questionnaire, referring to eating habits, oral hygiene, vicious habits and personal impressions about the appearance and functionality of his teeth, highlighting the factors involved in the noncarious dental lesions etiology. Results: The study group consisted of 64% women and 36% men. Noncarious cervical lesions were higher in men (72.22%) compared to wome...
Influence of abrasion in clinical manifestation of human dental erosion
Journal of Oral Rehabilitation, 2003
The influence of abrasion from oral soft tissues on softened enamel lesion remineralization and erosion development was investigated. Using orange juice, softened enamel lesions were produced on 20 human premolars assigned randomly to 10 volunteers. Sections used as control and two test slabs were cut from each tooth. One of the two slabs from each tooth had an appliance built on it, which protected the lesion from abrasion. The two slabs (with ⁄ without appliance) were bonded to the palatal surfaces of upper right and left lateral incisor teeth of the participants who chewed sugar-free gum four times daily. After 28-day intra-oral exposure, mineral loss (DZ) and lesion depth (ld) in both control and test samples were quantified using transverse microradiography, and the data was analysed by paired t-test. DZ was significantly lower in lesions with appliance (protected), but higher in lesions without appliance (unprotected) when compared with control (unexposed). Similar pattern was observed with lesion depth. In unprotected slabs the lesions were abraded resulting in eroded enamel lesions. It was concluded that erosion observed clinically is the combined effect of demineralization of the tooth surface by an erosive agent and abrasion of the demineralized surface by surrounding oral soft tissues and through food mastication. Abrasion from oral soft tissues can contribute to site-specificity of dental erosion.
THE ANATOMICAL LESIONS OF CERVICAL ABRASION AND GINGIVAL RECESSION SIDE-EFFECTS OF TOOTHBRUSHING
The increased incidence of cervical abrasion associated with gingival abrasion or recession, encouraged us to pursue the incidence, the characteristics and factors favoring the occurrence of these lesions. The clinical study evaluated 132 patients, of which 5.63% presented cervical abrasion lesions due to an inadequate toothbrushing, the association with gingival recession meeting in the rate of 4.22%. The cases were of both sexes, all from urban areas and the age between 16 and 40 years, on which we evaluated the location, shape, size and sensitivity of the lesions. The highest incidence of lesions was found in the canines and premolars, especially on the mandibular arch. Canines, because of the anatomical alveolar bone defects and buccal location, are more susceptible to gingival recession. In all cases, the abrasion lesions and gingival recession are in a more advanced stage at the quadrant where begins the initial placement of the brush, in the opposite area of the hand which holds the brush.
Non-carious lesions due to tooth surface loss: A Review
Tooth surface loss is a process that results in non-carious lesions. Several categories of tooth surface loss exist, including erosion, attrition, abrasion, and abfraction. There can be many causes of this condition, including bruxism, clenching, disease, dietary factors, habits and lifestyle, incorrect tooth brushing, abrasive dentifrices, the craniofacial complex, iatrogenic dentistry, and aging. Determining the etiology of tooth surface loss can be difficult but is possible through observation of the pattern of tooth surface loss on the teeth and is necessary for treatment planning to prevent failure. Management of this process includes prevention, tooth remineralization, and active treatment by restoring the involved teeth. Treatment can range from minimally invasive and adhesive dentistry, to full mouth rehabilitation, to restoring the lost vertical height.
Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL)
International journal of biomedical science : IJBS, 2014
To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1(st) January 2009 to 28(th) Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square χ(2) test was applied to assess association among different categorical variables. Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significan...