Esta es una revisión de los últimos 3 años de las así llamadas “Lesiones Cervicales no Cariosas”. (LCNC). El tema es aún bastante poco claro y debe haber una docena de etiologías posibles para este tipo de desgaste que se observa tan a menudo en la clínica. (¿Más a menudo en los últimos años…?) Hiperactividad de la mejilla, Coca Cola, limón, trauma oclusal, torsión a nivel del cuello de la pieza dentaria (abfraciones), té, azúcar, cepillo dental, otros agentes químicos… la lista es larga y las conclusiones pocas.
Dr. Jorge Garat.
J Oral Rehabil. 2008 Feb;35(2):128-34.
The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad.
Smith WA, Marchan S, Rafeek RN.
School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Trinidad, West Indies. wsmith@fms.uwi.tt
Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.
Aust Dent J. 2008 Mar;53(1):46-51.
A qualitative assessment of non-carious cervical lesions in extracted human teeth.
Nguyen C, Ranjitkar S, Kaidonis JA, Townsend GC. School of Dentistry, The University of Adelaide, Adelaide, South Australia. BACKGROUND:
Opinions vary about the causes of non-carious cervical lesions (NCCLs). They have been attributed to toothbrush abrasion, acid corrosion (commonly termed dental erosion), and abfraction. The purpose of this study was to examine the microwear details of NCCLs in a collection of extracted human teeth using scanning election microscopy (SEM). METHODS: Negative replicas of large NCCLs in 24 extracted human teeth were obtained in polyvinylsiloxane impression material (Light Body Imprint II, 3M ESPE) and viewed under SEM. RESULTS: All NCCLs extended from the cemento-enamel junction to the root surface and they displayed a variety of wedge-shaped appearances. There was evidence of both abrasion and corrosion in 18 of the 24 teeth (75.0 per cent), abrasion only in one tooth (4.2 per cent) and corrosion only in five teeth (20.8 per cent). Horizontal furrows with smooth edges and minor scratch marks, characteristic of abrasion and corrosion, were noted in 13 teeth (54.2 per cent). CONCLUSIONS: Based on microscopic assessment of a sample of extracted teeth, it appears that abrasion and corrosion are common associated aetiological factors in the formation of NCCLs.
Gerodontology. 2006 Sep;23(3):183-6
Symmetry of non-carious cervical lesions in canines and premolars.
Maseki T, Tanaka H. General Dentistry, University Hospital, The Nippon Dental University, School of Dentistry at Tokyo, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan. thinkpad720c@yahoo.co.jp
OBJECTIVES: Clinically non-carious cervical lesions (NCCLs) are frequently seen. The aim of this study was to investigate the relationship between the shape and symmetry of NCCLs, wear of cuSPS and triangular ridge, and the curvature of the tooth root. METHODS: One hundred and twenty-nine extracted human upper canine teeth and 274 extracted human upper premolar teeth with NCCLs were used in this study. The specimens were studied using photographs and three-dimensional scanning. RESULTS: Asymmetric NCCL was observed in 69.0% of the canines and 44.5% of the premolars. Wear of cusp and lingual ridges was observed in 82.9% and 93.0% of the canines, respectively. Wear of the buccal cusp and buccal triangular ridge was observed in 85.4% and 89.8% of the premolars, respectively. On the other hand, the wear of lingual cusp and lingual triangular ridge was observed in 89.1% and 93.8% of the premolars, respectively. The curvature of the root was observed in 48.1% of the canines and 43.4% of the premolars. CONCLUSIONS: There was no relationship between the symmetry of NCCLs, and the wear of cuSPS and triangular ridges for either canines or premolars. Although there was a relationship (p < 0.05) between the symmetry of NCCL and the curvature of the root in the canines, no relationship was observed between the symmetry of NCCL and the curvature of the root in the premolars.
Minerva Stomatol. 2006 Jan-Feb;55(1-2):43-57
Non carious cervical lesions. A review.
Ceruti P, Menicucci G, Mariani GD, Pittoni D, Gassino G. Department of Dentistry and Prosthodontics, University of Turin, Turin, Italy. cer_paola@yahoo.it
Non-carious cervical lesions (NCCL) are characterized by a loss of hard dental tissue near the cement-enamel-junction. Commonly, their shape is like a wedge with the apex pointing inwards. Other times, they appear as regular depressions, like a dome or a cup. Their main characteristic is the presence of hard-mineralized tissue. According to the literature, the prevalence of cervical lesions is 85%, while their incidence is about 18% among permanent teeth. NCCL are currently classified as erosion, abrasion, or abfraction. Their etiology seems to be related to different factors: hexogen and endogen acids, mechanical abrasive action, tooth flexion under axial and non-axial loads. Moreover, it seems that a fundamental role is ascribable to tooth bending phenomena due to the strength components parallel or oblique to the occlusal level, which occur during the normal function as well as during parafunctions. The frequent therapeutic failures are probably due to the same factors causing the onset of the original lesion. Several materials have been proposed to restore NCCL: amalgam (abandoned), glass-ionomer cements, compomers, and composite resins. Early failures of these restorations have often been reported in the literature, probably due to the same factors which originally caused the lesions. Further investigations are required to determine more reliable restorative therapies.
Odontology. 2005 Sep;93(1):35-40
Raman spectroscopic study of noncarious cervical lesions.
Sakoolnamarka R, Burrow MF, Prawer S, Tyas MJ. School of Dental Science, The University of Melbourne, Victoria 3010, Australia.
The surface of noncarious cervical lesions (NCCLs) consists of sclerosed dentin. This type of dentin may affect the ability of adhesive restorative materials to bond well to its surface, but little information exists on the chemical nature of this dentin surface and how it may be affected during acidic treatment. The inorganic part of normal dentin and dentin from NCCLs before and after acid conditioning with phosphoric acid or polyacrylic acid was investigated. Ten premolars with NCCLs and four human third molars (control) were used. Replicas of NCCLs were examined using scanning electron microscopy (SEM). Surfaces and longitudinal sections of four NCCLs and control dentin discs were analyzed using Raman spectroscopy. The discs and NCCLs were sectioned, and treated with 35% phosphoric acid or 20% polyacrylic acid/3% aluminum chloride, and Raman spectra obtained. The area under phosphate nu1 of the dentin spectrum was computed to obtain a ratio with the area under the second-order spectrum of a silicon phonon comparative standard. Mean phosphate nu1 and silicon phonon ratios from normal dentin and NCCLs were compared using a linear model with repeated measurements and Tukey’s pairwise tests. Mean ratios from different locations of the NCCLs were compared using one-way analysis of variance (ANOVA) and Tukey’s pairwise tests. SEM micrographs of NCCL surfaces showed variation from relatively smooth with no dentinal tubule openings to surfaces with occluded tubules. The mean phosphate nu1 and silicon phonon ratios for NCCLs were higher than those of normal dentin in all treatment groups (P < 0.05). Ratios from the untreated specimens were higher than those of the polyacrylic acid-treated specimens, and those for the phosphoric acid-treated group were the lowest (P < 0.05). The ratios obtained for the surfaces of NCCLs were higher than those halfway towards the pulp, and those adjacent to the pulp were the lowest (P < 0.05).
J Oral Rehabil. 2004 Feb;31(2):117-23
The prevalence of non-carious cervical lesions in permanent dentition.
Borcic J, Anic I, Urek MM, Ferreri S. Department of Prosthodontics, School of Dental Medicine, University of Rijeka, Rijeka, Croatia. josipa.borcic@ri.htnet.hr
A non-carious cervical lesion (NCCL) is the loss of hard dental tissue on the neck of the tooth, most frequently located on the vestibular plane. Causal agents are diverse and mutually interrelated. In the present study all vestibular NCCL were observed and recorded by the tooth wear index (TWI). The aim of the study was to determine the prevalence and severity of NCCL. For this purpose, 18555 teeth from the permanent dentition were examined in a population from the city of Rijeka, Croatia. Subjects were divided into six age groups. The teeth with most NCCL were the lower premolars, which also had the largest percentage of higher index levels, indicating the greater severity of the lesions. The most frequent index level was 1, and the prevalence and severity of the lesions increased with age.
Ann Acad Med Stetin. 2006;52(3):125-36.
Analysis of etiological factors involved in noncarious cervical lesions
Tomasik M.
PURPOSE: The etiopathology of noncarious cervical lesions (NCCL) is multifactorial and still not fully understood. Tooth wear is defined as loss of dental hard tissue by a chemical or mechanical process that does not involve bacteria. This form of tooth surface loss includes attrition, abrasion, erosion, and abfraction. Noncarious cervical lesions represent loss of tooth structure at the cementoenamel junction. The purpose of this clinical study of NCCL was to analyze the etiology in relation to age and to identify the most important risk factors associated with cervical lesions, as well as patients and teeth more susceptible to NCCL with a focus on more effective treatment of this condition. MATERIAL AND METHODS: The study group comprised 124 patients with NCCL, aged 15-75 years (mean = 44). A questionnaire was distributed addressing medical history–gastric disorders, dietary habits–consumption of acidic drinks, dental history, oral hygiene practices, and parafunctional habits. Clinical examination of tooth wear was performed on four tooth surfaces after air-drying. The distribution and severity of tooth wear was graded using the tooth wear index (TWI) calculated with a computer programme allowing for tooth characteristic to be determined for each decade of life. Depth of the cervical defect was measured with a periodontal probe. TWI was devised to reveal the extent of tooth surface wear irrespective of the cause. Raw scores were compared with the computer using predetermined threshold values which are set to distinguish between acceptable and unacceptable pathological levels of tooth wear for each decade of life and each tooth surface. Dentition status, oral hygiene, periodontal status, gingival recession, number of teeth and their mobility, oral symptoms of parafunction and relationship to lateral and protrusive tooth contact schemes was assessed and analyzed. Statistical analyses were performed with the Stata Statistical Software: release 5. The risk of NCCL formation was estimated with the logistic regression model. Results were presented as odds ratio, 95% confidence interval, and p probability. RESULTS: Tooth wear on all surfaces of the tooth, including cervical, was related to age and the ranges were 25-60%. Older patients were more likely to exhibit NCCL. Frequency, localization, and depth of noncarious cervical lesions in a given group of teeth was related to age, although NCCL was more common in premolars (mean = 85.1%). Associations between oral hygiene, consumption of acidic drinks, status of periodontium, number of teeth, their mobility and etiology of wedge-shaped defects were revealed. A relationship between lateral excursive contact of teeth, bruxism, and formation of cervical lesions was established evidencing a correlation between occlusal and cervical pathology. CONCLUSIONS: 1. Cervical lesions were most common in premolars. 2. Early detection of dental erosion is important for prevention of serious irreversible damage to dentition. 3. An understanding of the multifactorial nature of tooth wear and risk factors of erosion, abrasion, and ab-fraction is important in the patient’s diagnostic protocol and management strategy.
J Am Dent Assoc 2001 Dec;132(12):1694-701; quiz 1726-7 Related Articles, Books, LinkOut
Examining the prevalence and characteristics of abfractionlike cervical lesions in a population of U.S. veterans.
Piotrowski BT, Gillette WB, Hancock EB.
Dental Service, Veterans Affairs Medical Center, Indianapolis, USA. mbpiotr@msn.com
BACKGROUND: Abfraction is believed to be caused by biomechanical loading forces. It may be due to flexure and ultimate fatigue of tooth tissues that occur away from the point of occlusal loading. Other possible causes of cervical lesions include toothbrush abrasion and erosion. The purpose of this study was to investigate the characteristics and prevalence of abfraction-like lesions in a population of U.S. veterans. METHODS: The authors evaluated 103 teeth with noncarious cervical lesions in 32 subjects and characterized them based on the surface on which the lesion was located, history of toothbrush abrasion, size of the lesion, presence of plaque, surface texture, and presence and size of occlusal wear facets. RESULTS: Clinical examination revealed that adjacent control teeth had a significantly lower percentage of surfaces with plaque than did teeth with cervical lesions. Control teeth also had significantly less gingival recession than did affected teeth. Seventy-five percent of subjects reported a history of using a firm toothbrush, and 78.1 percent reported using a brushing technique that is known to cause toothbrush abrasion in the affected area. Affected teeth had neither significantly different occlusal wear facets nor occlusal contacts than control teeth. No significant correlations were found between cervical lesion dimensions and facet area. CONCLUSIONS: Toothbrush abrasion is strongly suspected as contributing to the formation of the majority of wedge-shaped lesions in this group of subjects. A small subset of lesions is thought to have resulted from some other phenomenon. Although the presence or contribution of occlusal stresses in the direct formation of these lesions could not be measured directly, the possibility of abfraction could not be eliminated. CLINICAL IMPLICATIONS: Because the existence of abfraction could not be ruled out in about 15 percent of the cases, teeth with noncarious, wedge-shaped lesions warrant careful occlusal evaluation, with the possible need for occlusal adjustment or bitesplint therapy to treat bruxism.
Eur J Prosthodont Restor Dent 2000 Dec;8(4):139-44 Related Articles, Books, LinkOut
A review of the biomechanics of abfraction.
Rees JS.
Division of Restorative Dentistry, University of Bristol Dental School, Lower Maudlin St., Bristol, BS1 2LY. j.s.rees@bristol.ac.uk
Loss of tooth substance in the cervical region is usually attributed to abrasion or erosion. However, the role of occlusal loading is becoming increasingly prominent. It is suggested that high occlusal loads result in large stress concentrations in the cervical region of the teeth. These stresses may be high enough to cause disruption of the bonds between the hydroxyapatite crystals, eventually resulting in the loss of cervical enamel. This article reviews the available evidence to support the thesis that occlusal loading can contribute to the process of non-carious cervical tooth loss or abfraction. It also reviews the potential interactions between occlusal loading and erosion that may contribute to non-carious cervical tooth loss.
Dent Mater 2000 Nov;16(6):412-9 Related Articles, Books, LinkOut
Strain patterns in cervical enamel of teeth subjected to occlusal loading.
Palamara D, Palamara JE, Tyas MJ, Messer HH.
School of Dental Science, University of Melbourne, 711 Elizabeth St, Melbourne, Victoria 3000, Australia.
OBJECTIVES: This study was planned to investigate the variations in strains in enamel under different patterns of occlusal loading, using three-dimensional finite element analysis (3D FEA) and strain gage measurements in extracted teeth. METHODS: A 3D FEA model of a mandibular second premolar was used to investigate effects of occlusal load on enamel surface strains, particularly in response to oblique directions of cuspal loading. Point loads of 100 N were applied axially and at 45 degrees from the vertical on the buccal or lingual incline of the buccal cusp, either in the bucco-lingual plane or at varying mesio-distal angulations (up to +/- 20 degrees). Patterns of strain observed in the FEA model were confirmed experimentally using strain gages on extracted premolars mounted in a servohydraulic testing machine. RESULTS: Strains predicted from the FEA model were in excellent agreement with the strain gage measurements. Strains were concentrated near the cementoenamel junction (CEJ) regardless of load direction. A vertical load on the buccal cusp tip resulted in compressive strains on the buccal surface but small tensile strains in lingual cervical enamel. Strains resulting from oblique loads on buccal cusp inclines were complex and asymmetric, with either tension or compression occurring in any location depending on the site and angle of loading. SIGNIFICANCE: The magnitude, direction and character of strains in cervical enamel are highly dependent on patterns of loading. The asymmetric pattern of strains in buccal cervical enamel in response to oblique occlusal forces is consistent with the common clinical picture of asymmetric non-carious cervical lesions.
J Prosthet Dent 2000 Oct;84(4):436-43 Related Articles, Books, LinkOut
Correlation of noncarious cervical lesion size and occlusal wear in a single adult over a 14-year time span.
Pintado MR, Delong R, Ko CC, Sakaguchi RL, Douglas WH.
University of Minnesota, Minneapolis, Minn., USA. pinta001@tc.umn.edu
STATEMENT OF PROBLEM: Noncarious cervical lesions are described as having a multifactorial cause, with occlusal trauma and toothbrush abrasion frequently mentioned as major factors. Finite element modeling studies have demonstrated a relocalization of occlusal stresses to the cervical area due to flexure of the crown. This may cause microcracking, especially under tensile stresses, that will lead to a loss of enamel and dentin in the cervical region. Clinical confirmation of an occlusal cause for noncarious cervical lesions has been difficult to obtain. PURPOSE: This study investigated whether occlusal wear was correlated with an increase in the size of noncarious cervical lesions. MATERIAL AND METHODS: Loss of contour at occlusal and cervical sites on 3 teeth of a single individual was measured using digital and visualization techniques at 3 time intervals over a 14-year time span. The 1983 baseline casts and 1991, 1994, and 1997 clinical impressions of a single adult patient with existing noncarious cervical lesions were replicated in epoxy. Surfaces of all replicas were digitized with a contact digitizing system. Sequential digitized surfaces were fit together and analyzed using AnSur-NT surface analysis software. Clinical losses of surface contour by volume and depth of the left mandibular first molar and first and second premolars were recorded. RESULTS: Nine measurements of cervical volume loss (range 0.9 to 11.5 mm(3)) and 9 corresponding measurements of occlusal volume loss (range 0.39 to 7.79 mm(3)) were made. The correlation between occlusal and cervical volume loss was strong (r(2)=0.98) and significant (P<.0001). CONCLUSION: For the single adult patient in this study, there was a direct correlation between occlusal wear and the growth of noncarious cervical lesions.
Quintessence Int 2000 Jul-Aug;31(7):466-73 Related Articles, Books, LinkOut
Cervical dentin hypersensitivity. Part II: Associations with abfractive lesions.
Coleman TA, Grippo JO, Kinderknecht KE.
Shaftsbury Medical Building, Box 230, Shaftsbury, Vermont 05262, USA.
OBJECTIVE: The purpose of this retrospective study was to evaluate the association between cervical dentin hypersensitivity and the presence of abfractive lesions. METHOD AND MATERIALS: Written records and study casts for 250 active-care patients, selected alphabetically, were analyzed for the clinical detection of abfractive lesions and cervical dentin hypersensitivity from 1979 until 1996. Clinical diagnosis of abfractive lesions was made according to existing literature descriptions of these hard tissue lesions. Cervical dentin hypersensitivity was diagnosed when a verified positive threshold patient response was found during tooth evaluation by the air indexing method. Patient groups I and II were formed solely on the basis of the presence or absence, respectively, of a verified positive threshold patient response of cervical dentin to air. RESULTS: A significant association was found between air-indexed cervical hypersensitivity and the presence of abfractive lesions. The primary locations for both cervical hypersensitivity and abfractive lesions were the buccal surfaces of posterior teeth. CONCLUSION: This long-term retrospective study found a positive association between cervical dentin hypersensitivity and abfractive lesions. The correlative nature of this study suggests the need for further investigation.
J Clin Periodontol 2000 Feb;27(2):99-103
Studies in vitro of abrasion by different manual toothbrush heads and a standard toothpaste.
Dyer D, Addy M, Newcombe RG
Division of Restorative Dentistry, Dental School, Bristol, UK.
BACKGROUND: Loss of dentine at the buccal cervical region of teeth has a multifactorial aetiology. However, a considerable amount of circumstantial evidence, supported by laboratory experiments, implicates toothbrushing with toothpaste as a consistent factor. Most interest has centred around the abrasivity of toothpastes, particularly since a toothbrush alone has negligible effects on dentine. The influence of filament stiffness on toothpaste abrasion was the subject of some studies, mostly at least 2 decades ago, and produced conflicting conclusions. Numerous changes to toothbrush design and construction have taken place in recent years. AIMS: The aim of this study was to measure the abrasion of a standard substrate, acrylic, by a standard toothpaste carried on modern brands of toothbrushes classified by manufacturers as hard (3 brands), medium (3 brands) and soft (6 brands). METHOD: The substrate was brushed for 20,000 strokes with at least 6 heads from each brand. Measurements of substrate loss were made at 5000 stroke increments by profilometry. RESULTS: Substrate loss for all brushes showed a pattern of abrasion which was to a first approximation linear. Overall, hard brushes caused least abrasion and soft brushes the most, with differences between groups being significant. Within-group differences between brands reached significance for soft and medium brushes but not hard brushes. CONCLUSIONS: The results could be explained by increased retention of toothpaste by smaller diameter filaments and denser tufts on soft brushes and the greater flexion of filaments increasing the area of contact with the surface. Calculations on the clinical outcome of these data in vitro indicate that toothbrushing with toothpaste alone would produce minimal damage to dentine even over many years. Differences between brushes therefore are probably of little clinical significance. Certainly, the data do not support the use of hard brushes, particularly in view of the potential detrimental effects to gingival tissues.
Int Dent J 1999 Jun;49(3):139-43
The aetiology of the non-carious cervical lesion.
Osborne-Smith KL, Burke FJ, Wilson NH Department of Restorative Dentistry, University Dental Hospital of Manchester, UK.
Erosion and abrasion have been widely reported as causes of non-carious cervical lesions (NCCL). However, more recently, tooth flexure has been implicated in the formation of these lesions generating renewed interest in the pathogenesis of the non-carious loss of cervical tooth substance. This paper considers the causes of erosion and abrasion, related to modern lifestyles, and reviews the literature concerning tooth flexure as a cause of NCCL. A description of different types of NCCL is given, as an aid to determining the aetiology, yet at the same time accepting that the causation and pathogenesis of NCCL is probably multi-factorial resulting in many different clinical presentations. Consideration is given to the indications for treatment of NCCL and to the selection of materials for restoring such defects.
Esthet Dent 1999;11(4):215-22 ,
LinkOut Potential for load-induced cervical stress concentration as a function of periodontal support.
Kuroe T, Itoh H, Caputo AA, Nakahara H Division of Advanced Prosthodontics, Biomaterials Science, and Hospital Dentistry, UCLA School of Dentistry, USA.
PURPOSE: The purpose was to determine, photoelastically, the locations of occlusal load-induced stress concentrations within a maxillary premolar as a function of degree of periodontal support. MATERIALS AND METHODS: Composite three-dimensional models of a maxillary first premolar were fabricated for quasi-three-dimensional photoelastic stress analysis. Individual materials were used to model enamel, dentin, periodontal ligament, and alveolar bone. Three levels of periodontal support reduction (0%, 20%, 25%) were simulated by varying the socket depth. Vertical loads of 10 lb were applied to: (1) tip of buccal cusp, (2) tip of lingual cusp, and (3) center of occlusal surface. The resulting stresses were monitored and recorded photographically in the field of a circular polariscope arrangement. RESULTS: Cuspal loading concentrated stress around the cervical region below the loaded cusp, being highest under buccal cusp loading. The location of the stress concentration shifted apically as periodontal support diminished. CLINICAL SIGNIFICANCE: Observed cervical stress concentration corresponded well to the common location of abfractions seen in clinical situations. Since the location of cervical stress concentration varied with occlusal conditions, occurrence of abfractions must be highly dependent upon each patient’s occlusion. Periodontal support reduction shifted the location of highest stress away from the cementoenamel junction. Therefore, abfractions are less likely to occur on periodontally compromised teeth compared to stable teeth.
J Esthet Dent 1999;11(6):332-7
LinkOut Development of noncarious cervical notch lesions in vitro.
Whitehead SA, Wilson NH, Watts DC Unit of Operative Dentistry and Endodontology, University of Manchester Dental Hospital, United Kingdom.
PURPOSE: The initiation and progression of noncarious cervical notch lesions (NCCL) continues to perplex clinicians worldwide and poses a considerable restorative challenge. The purpose of this brief communication is to report what is believed to be the first in vitro production of notch-shaped lesions in the cervical third of premolar teeth. MATERIALS AND METHODS: The lesions, were produced by axial loading of selected permanent premolar teeth in a 10% aqueous solution of sulfuric acid over a period of 5 days, followed by immersion in water for 7 days. RESULTS: Results revealed macroscopic and microscopic features similar to those observed in noncarious cervical lesions in vivo. The lesions were incidental findings while the authors were studying stress corrosion of enamel at low pH. Although much remains to be investigated regarding the etiology and pathogenesis of NCCL, axial loading and a corrosive environment may be implicated in these processes. The artificial lesions arose in clinically sound teeth, suggesting that there is no simple clinical examination to identify teeth at risk from NCCL. CLINICAL SIGNIFICANCE: The relationship between the development of NCCL and applied stress indicates that occlusal factors may play the most significant role in the initiation and progression of NCCL.
Coll Antropol 1999 Dec;23(2):651-7
The influence of tooth wear on root canal dimensions.
Keros J, Bagic I, Verzak Z, Bukovic D Jr, Staudt-Skaljac G Department of Dental Anthropology, Dental School, University of Zagreb, Croatia.
The objective was to investigate the relations between tooth wear and root canal dimensions. The experimental group comprised 100 cuspids (canines), 50 of which had advanced abrasion and 50 were without it The dimensions of root canal were investigated at the light microscope level in order to define their vestibulo-oral and mesio-distal diameters in all three thirds. In the groups of teeth without abrasion the MD diameters of root canaliculi in their cervical thirds were greater than in the teeth with advanced abrasion. In the apical third the MD diameters of canaliculi were highly variable in teeth with no signs of abrasion. In the group of teeth with abrasion the MD and VO diameter values of the cervical thirds were significantly smaller than in the group of teeth without abrasion. In the mid-thirds the values of MD diameters were highly variable in the group of teeth with abrasion, whereas the VO diameter values were much greater than in the teeth without abrasion. As regards to the apical thirds, the VO diameter values were greater than in the control teeth. The data presented herewith contribute to better knowledge about tooth wear and are highly useful in restorative and reconstructive dental procedures.
Am J Dent 1998 Feb;11(1):29-32
LinkOut Association of occlusal, periodontal, and dietary factors with the presence of non-carious cervical dental lesions.
Mayhew RB, Jessee SA, Martin RE Department of Health, Promotion and Dental Care Delivery, University of Texas Health Science Center at Houston, USA.
PURPOSE: To investigate in vivo the relationship of occlusal stress factors, periodontal health status, and acidic dietary patterns to the presence of non-carious cervical lesions (NCCL) in a convenience sample of undergraduate clinic, adult dental patients. MATERIALS AND METHODS: Forty three subjects who met the entry criteria were admitted into the study; 178 teeth exhibiting NCCL were evaluated. A dietary assessment focusing on acidic food/beverage intake was used to evaluate nutritional intake over the most recent 24-hour period. Periodontal evaluation included intraoral measurement of gingival attachment loss, assessment of tooth mobility, and radiographic interpretation of percent bone loss using the Schei ruler method. Among the occlusal factors evaluated were shape and orientation of NCCL, presence and location of wear facets, and symptoms and characteristics of centric and eccentric occlusal function. RESULTS: 95% of teeth examined exhibited functional wear facets, indicating a systematic relationship with presence of NCCL (Chi Square = 16.9, P < 0.0001); 48% displayed buccal or incisal facets; 64% were accompanied by balancing interferences in lateral excursion; 98.3% had mobility scores < or = 1; there was no significant association between mobility and facets present (Chi Square = 3.04, P = 0.21); and, no relationship with dietary patterns was found. Group function, that may evolve with age, and/or traumatic occlusion factors may be related to etiology of NCCL. Longitudinal controlled clinical trials are needed to confirm suspected etiologies and establish treatment guidelines for non-carious cervical lesions.
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