Noncarious Cervical Lesions: Correlation between Abfraction and Wear Facets in Permanent Dentition

Abstract

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.

Study of the morphological structure of enamel and correlation of its chemical composition with dentin in intact teeth and with a cervical pathology

“…Increased occlusal stress on the teeth is diagnosed in the form of wear facets which were detected in 78% of examined patients with non-carious cervical lesions according to some data [23]. The detection of occlusal wear facets and micro-fractures on the teeth with wedge-shaped defects confirms occlusal stress as the main etiological factor and as the root cause of this form of pathology [23] in some cases. The presence of abrasion of hard dental tissues increases the likelihood of the appearance of deeper cracks on the vestibular surface of the enamel [15].…”

Features of Dentine Chemical Composition of Intact Teeth and Teeth With Wedge-Shaped Defects

“…The results of such studies are very important for identifying new etiological factors taking into account the patient's individual characteristics that are responsible for different degrees of the loss of dental hard tissue and the development of combined forms of damage [4,6]. The progression of this pathology negatively affects the tooth structural integrity [6], pulp viability [6,7] and it also leads to aesthetic problems [2,6,7], dental plaque retention [6,7], the development of hyperesthesia [5][6][7].…”

“…The most likely causes of NCCL development are abrasion (61.60%), erosion (26.08%), abfraction (12.32%) [1] or any combination of them [2,6]. The frequency of this pathology increases with age [3][4][5][6] and the number of retained teeth [6] that indicates the long-term component in their formation associated with occlusive stress [1,3,5] which initially develops in enamel cracks [6,7]. The presence of microcracks leads to disruption of chemical bonds between hydroxyappatite crystals, subsequent penetration of water and other molecules making a tooth more vulnerable to dissolution, chemical erosion or abrasive factors [7].…”

“…The frequency of this pathology increases with age [3][4][5][6] and the number of retained teeth [6] that indicates the long-term component in their formation associated with occlusive stress [1,3,5] which initially develops in enamel cracks [6,7]. The presence of microcracks leads to disruption of chemical bonds between hydroxyappatite crystals, subsequent penetration of water and other molecules making a tooth more vulnerable to dissolution, chemical erosion or abrasive factors [7]. It is the cervical region where there are wedge-shaped defects with sharp angles converging in the region where the greatest loading is generated [6,8].…”

“…It is the cervical region where there are wedge-shaped defects with sharp angles converging in the region where the greatest loading is generated [6,8]. According to the findings significant occlusal force on teeth is diagnosed by the presence of wear facets that were determined in 78% of examined patients with NCCL [7]. The presence of occlusal wear facets and microcracks in teeth with wedge-shaped defects confirms occlusal stress as the main etiological factor, and in some cases it's the root cause of the development of this NCCL form [7].…”