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Dioguardi M, Spirito F, Lo Muzio E, Sovereto D, Ballini A, Alovisi M, Toto GA, Lo Muzio L, Di Cosola M. Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis. BMC Oral Health 2024; 24:370. [PMID: 38519922 PMCID: PMC10958943 DOI: 10.1186/s12903-024-04154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/17/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES Historically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence. MATERIALS AND METHODS The present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines. RESULTS After the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits. CONCLUSIONS In summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets. CLINICAL RELEVANCE Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy.
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
| | - Eleonora Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
| | - Andrea Ballini
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, 10127, Italy
| | - Giusi Antonia Toto
- Department of Humanities, Letters, Cultural Heritage, Educational Sciences, University of Foggia, Foggia, 71122, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia, 71122, Italy
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Kruzic JJ, Hoffman M, Arsecularatne JA. Fatigue and wear of human tooth enamel: A review. J Mech Behav Biomed Mater 2023; 138:105574. [PMID: 36473402 DOI: 10.1016/j.jmbbm.2022.105574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
Human tooth enamel must withstand the cyclic contact forces, wear, and corrosion processes involved with typical oral functions. Furthermore, unlike other human tissues, dental enamel does not have a significant capacity for healing or self-repair and thus the longevity of natural teeth in the oral environment depends to a large degree on the fatigue and wear properties of enamel. The purpose of this review is to provide an overview of our understanding of the fatigue and wear mechanisms of human enamel and how they relate to in vivo observations of tooth damage in the complex oral environment. A key finding of this review is that fatigue and wear processes are closely related. For example, the presence of abrasive wear particles significantly lowers the forces needed to initiate contact fatigue cracking while subsurface fatigue crack propagation drives key delamination wear mechanisms during attrition or attrition-corrosion of enamel. Furthermore, this review seeks to bring a materials science and mechanical engineering perspective to fatigue and wear phenomena. In this regard, we see developing a mechanistic description of fatigue and wear, and understanding the interconnectivity of the processes, as essential for successfully modelling enamel fatigue and wear damage and developing strategies and treatments to improve the longevity of our natural teeth. Furthermore, we anticipate that this review will stimulate ideas for extending the lifetime of the natural tooth structure and will help highlight where our understanding is too limited and where additional research into fatigue and wear of human tooth enamel is warranted.
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Affiliation(s)
- Jamie J Kruzic
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia.
| | - Mark Hoffman
- School of Engineering, University of Newcastle, Callaghan NSW 2308, Australia; School of Materials Science and Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia
| | - Joseph A Arsecularatne
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia
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Goodacre CJ, Eugene Roberts W, Munoz CA. Noncarious cervical lesions: Morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration. J Prosthodont 2023; 32:e1-e18. [PMID: 35920595 DOI: 10.1111/jopr.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To synthesize the literature regarding noncarious cervical lesions (NCCLs) and propose clinical guidelines when lesion restoration is indicated. MATERIAL AND METHODS A PubMed search was performed related to NCCL morphology, progression, prevalence, etiology, pathophysiology, and restoration. RESULTS NCCLs form as either rounded (saucerlike) depressions with smooth, featureless surfaces that progress mainly in height or as V-shaped indentations that increase in both height and depth. Prevalence ranges from less than 10% to over 90% and increases with age. Common locations are the facial surfaces of maxillary premolars. They have a multifactorial etiology due to personal habits such as excessive horizontal toothbrushing and consumption of acidic foods and drinks. Occlusal factors have been identified as contributing to the prevalence of NCCLs in some studies, whereas other studies indicate there is no relationship. The concept of abfraction has been proposed whereby mechanical stress from occlusal loading plays a role in the development and progression of NCCLs with publications supporting the concept and others indicating it lacks the required clinical documentation. Regardless of the development mechanism, demineralization occurs and they are one of the most common demineralization diseases in the body. Treatment should be managed conservatively through preventive intervention with restorative treatment delayed until it becomes necessary due to factors such as lesion progression, impact on patient's quality of life, sensitivity, poor esthetics, and food collection may necessitate restoration. Composite resins are commonly used to restore NCCLs although other materials such as glass ionomer and resin-modified glass ionomer are also used. Sclerotic dentin does not etch like normal dentin and therefore it has been recommended to texture the dentin surface with a fine rotary diamond instrument to improve restoration retention. Some clinicians use mechanical retention to increase retention. Beveling of enamel is used to increase the bonding area and retention as well as enhance the esthetic result by gradually creating a color change between the restoration and tooth. Both multistep and single-step adhesives have been used. Dentin etching should be increased to 30 seconds due to the sclerotic dentin with the adhesive agent applied using a light scrubbing motion for 20 seconds but without excessive force that induces substantial bending of a disposable applicator. Both flowable and sculptable composite resins have been successfully used with some clinicians applying and polymerizing a layer of flowable composite resin and then adding an external layer of sculptable composite resin to provide enhanced resistance to wear. When caries is present, silver diamine fluoride has been used to arrest the caries rather than restore the lesion. CONCLUSIONS Noncarious cervical lesions (NCCLs) form as smooth saucerlike depressions or as V-shaped notches. Prevalence values as high as 90% and as low as 10% have been reported due to habits such as excessive toothbrushing and an acidic diet. Occlusal factors have been proposed as contributing to their presence but it remains controversial. Publications have both supported and challenged the concept of abfraction. They are one of the most common demineralization diseases in the body. Conservative treatment through prevention is recommended with restorative treatment delayed as long as possible. When treatment is needed, composite resins are commonly used with proposed restorative guidelines including texturing the sclerotic dentin, beveling the enamel, potential use of mechanical retention, 30 seconds of acid etching, and use of either multistep or single-step adhesives in conjunction with a light scrubbing motion for 20 seconds without excessive force placed on disposable applicators.
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Affiliation(s)
- Charles J Goodacre
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, California
| | - W Eugene Roberts
- Adjunct Professor Mechanical Engineering, Indiana University & Purdue University, Indianapolis, Indiana
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Yazdani N, Ashrafi H, Özcan M, Nekoueimehr N, Kholdi M, Farzad A. Mechanical and Thermal Stress Analysis of Cervical Resin Composite Restorations Containing Different Ratios of Zinc Oxide Nanoparticles: A 3D Finite Element Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5504. [PMID: 36013640 PMCID: PMC9412397 DOI: 10.3390/ma15165504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Due to an increase in prevalence of cervical lesions, it is important to use appropriate restorative materials to reduce the incidence of secondary lesions. Owing to having antibacterial properties, cervical composite restorations containing different ratios of Zinc Oxide nanoparticles (ZnO NPs) have been analyzed using the Finite Element method to determine the optimal incorporation ratio from mechanical and thermal perspectives. A numerical simulation is conducted for a mandibular first premolar with a cervical lesion (1.5 × 2 × 3 mm3) restored with composites containing 0 to 5% wt. ZnO NPs. Subsequently, the samples are exposed to different thermo-mechanical boundary conditions, and stress distributions at different margins are examined. The accumulated stress in the restoration part increases for the 1% wt. sample, whereas the higher percentage of ZnO NPs leads to the reduction of stress values. In terms of different loading conditions, the least and most stress values in the restoration part are observed in central loading and lingually oblique force, respectively. The change in the surface temperature is inversely correlated with the ratio of ZnO NPs. In conclusion, the composite containing 5% wt. ZnO NPs showed the most proper thermo-mechanical behavior among all samples.
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Affiliation(s)
- Negar Yazdani
- Faculty of Dentistry, Kashan University of Medical Sciences, Kashan 8715988141, Iran
| | - Hossein Ashrafi
- Department of Applied Design, Faculty of Mechanical Engineering, University of Kashan, Kashan 8731753153, Iran
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zürich, CH-8032 Zürich, Switzerland
| | - Negin Nekoueimehr
- Faculty of Dentistry, Kashan University of Medical Sciences, Kashan 8715988141, Iran
| | - Mohsen Kholdi
- Department of Solid Mechanic, Faculty of Mechanical Engineering, University of Kashan, Kashan 8731753153, Iran
| | - Azin Farzad
- Faculty of Dentistry, Kashan University of Medical Sciences, Kashan 8715988141, Iran
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Ordóñez-Aguilera JF, Landmayer K, Shimokawa CAK, Liberatti GA, de Freitas AZ, Turbino ML, Honório HM, Francisconi-dos-Rios LF. Role of non-carious cervical lesions multicausality in the behavior of respective restorations. J Mech Behav Biomed Mater 2022; 131:105232. [DOI: 10.1016/j.jmbbm.2022.105232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022]
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Nascimento BL, Vieira AR, Bezamat M, Ignácio SA, Souza EM. Occlusal problems, mental health issues and non-carious cervical lesions. Odontology 2021; 110:349-355. [PMID: 34568988 DOI: 10.1007/s10266-021-00658-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022]
Abstract
Non-carious cervical lesions (NCCLs) are characterized by a loss of hard dental tissue near the cement-enamel junction with multifactorial etiology. The aim of this study was to demonstrate that occlusal factors as attrition, malocclusion, and bruxism, and mental disorders as depression, stress, and anxiety are involved in the etiology of NCCLs. Salivary samples and clinical data of 340 individuals selected from 6,112 participants were obtained from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository project. The affected group was formed by individuals with NCCL (34 females, 34 males, mean age 55.34 years). In addition, the comparison group was formed by individuals without NCCL (136 females, 136 males, mean age 55.14 years). Eleven single-nucleotide polymorphisms (SNPs) previously associated with mental disorders were genotyped and tested for association with NCCLs. When all occlusal factors were combined there was found a significant association with NCCL (p = 0.000001/adjusted OR 4.38, 95% CI 2.50-7.69). Attrition (OR 3.56, 95% CI 2.00-6.32) and malocclusion (OR 5.09, 95% CI 1.65-15.68) as separate variables showed statistically significant associations with NCCL. There was a significant difference in stress history between the two groups (OR 2.17, 95% CI 1.08-4.39). No associations between NCCLs and the SNPs selected were found. However, when the occlusal factors were analyzed as covariates, associations were found between bruxism and seven of the selected SNPs. Our results suggest that occlusal factors might be associated with NCCLs.
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Affiliation(s)
- Bruna L Nascimento
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania , USA
| | - Mariana Bezamat
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania , USA
| | - Sergio A Ignácio
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Evelise M Souza
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil.
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Haralur SB, Alqahtani AS, AlMazni MS, Alqahtani MK. Association of Non-Carious Cervical Lesions with Oral Hygiene Habits and Dynamic Occlusal Parameters. Diagnostics (Basel) 2019; 9:diagnostics9020043. [PMID: 31013807 PMCID: PMC6627150 DOI: 10.3390/diagnostics9020043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022] Open
Abstract
Dentists routinely encounter non-carious cervical lesions (NCCLs) in daily clinical practices. The dental literature is contradictory regarding the occlusal etiology of NCCLs. NCCL is defined as the loss of dental structure at the cemento-enamel junction, with no association of bacteria. The aim of this study was to evaluate the association of dynamic occlusal factors and dental hygiene practices with NCCLs. In total, 100 participants were selected by the random stratified sampling method, 50 each for control and NCCL groups. Information regarding oral hygiene practices, including frequency, duration, force, and technique of brushing, was recorded. Dynamic occlusal parameters like initial contact, occlusion time (OT), disocclusion time (DT), and center of force were recorded with T-scan analysis. The obtained data were analyzed with Pearson's correlation and binary logistic regression. We found that 68% of participants in the NCCL group and 31% in the control group utilized the horizontal brushing technique; 46% of NCCL group participants used hard brush against 7% of participants in the control group. The mean OT was 0.727 and 0.516 s for NCCL and control groups, respectively. The OT and left and right lateral DT were strongly related to NCCL, with r-values of 0.661, 0.642, and 0.534, respectively, with p ≤ 0.001. Using a hard toothbrush was found to be associated with NCCL. The NCCL group had extended mean occlusion time and disocclusion time in all eccentric mandibular movements.
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Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
| | | | - Mohammed Shaya AlMazni
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
| | - Mohammad Khalid Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
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Zuza A, Racic M, Ivkovic N, Krunic J, Stojanovic N, Bozovic D, Bankovic-Lazarevic D, Vujaskovic M. Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina. Int Dent J 2019; 69:281-288. [PMID: 30730056 DOI: 10.1111/idj.12462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments. AIMS The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors. METHODS A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs. RESULTS Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%). CONCLUSION The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.
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Affiliation(s)
- Aleksandra Zuza
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Maja Racic
- Department of Primary Health Care and Public Health, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Nedeljka Ivkovic
- Department of Oral Rehabilitation, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Jelena Krunic
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Nikola Stojanovic
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Djordje Bozovic
- Department of Oral Rehabilitation, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Dusica Bankovic-Lazarevic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia.,Faculty of Dentistry Pančevo, Pančevo, Serbia
| | - Mirjana Vujaskovic
- Department of Restaurative Dentistry and Endodontics, Faculty of Dentistry Belgrade, University of Belgrade, Belgrade, Serbia
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Alvarez-Arenal A, Alvarez-Menendez L, Gonzalez-Gonzalez I, Jiménez-Castellanos E, Garcia-Gonzalez M, deLlanos-Lanchares H. The Role of Occlusal Factors in the Presence of Noncarious Cervical Lesions in Young People: A Case-Control Study. Oper Dent 2019; 44:E12-E22. [DOI: 10.2341/18-028-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
SUMMARY
Objective:
The aim of this retrospective case-control study was to evaluate the influence of different occlusal characteristics and self-referred bruxism in the presence of noncarious cervical lesions (NCCLs).
Methods and Materials:
The participants were 280 students (140 cases and 140 controls), with an average age of 24.5 years, from six schools of dentistry in Spain. Clinical examination was carried out to record the NCCLs and the static and dynamic occlusal characteristics. The side of mastication and bruxism was collected by questionnaire. Data variables were analyzed by means of univariate and multivariate logistic regression. Odds ratios and the respective 95% confidence intervals were calculated (p<0.05).
Results:
The presence of NCCLs was significantly more likely in subjects with protrusive interferences (odds ratio [OR]=1.82); with lateral interferences, especially on the nonworking side (OR= 1.77); or who were self-reported bruxists (OR=1.72). In the multivariate analysis, protrusive interferences, bruxism, age, and the presence of attrition were risk factors for the development of NCCLs. These factors resulted in a model with an area under the receiver-operating characteristic curve of 0.667 and a positive predictive value of 61.43%.
Conclusions:
There was no significant relationship between most occlusal factors and the presence of NCCLs. Only bruxism, protrusive interferences, age, and occlusal wear were risk factors. The predictive model was not sufficiently explanatory. Occlusal factors alone do not appear to be sufficient to explain the presence of NCCLs.
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Affiliation(s)
- A Alvarez-Arenal
- Angel Alvarez-Arenal, MD, DDS, PhD, professor and chairman, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
| | - L Alvarez-Menendez
- Leticia Alvarez-Menendez, MD, PhD, collaborator, Lucus Augusti Hospital, Lugo, Spain
| | - I Gonzalez-Gonzalez
- Ignacio Gonzalez-Gonzalez, MD, DDS, PhD, associate professor, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
| | - E Jiménez-Castellanos
- Emilio Jiménez-Castellanos, MD, DDS, PhD, professor, Department of Prosthodontics, School of Dentistry, University of Seville, Seville, Spain
| | - M Garcia-Gonzalez
- Marta Garcia-Gonzalez, DDS, collaborator, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
| | - H deLlanos-Lanchares
- Hector deLlanos-Lanchares, DDS, PhD, associate professor, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
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Alvarez-Arenal A, Alvarez-Menendez L, Gonzalez-Gonzalez I, Alvarez-Riesgo JA, Brizuela-Velasco A, deLlanos-Lanchares H. Non-carious cervical lesions and risk factors: A case-control study. J Oral Rehabil 2018; 46:65-75. [PMID: 30252966 DOI: 10.1111/joor.12721] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether the presence of non-carious cervical lesions (NCCLs) was related to the considered risk factors and to show the corresponding odds ratio in a predictive model. METHODS The sample was 280 dentistry students. In an initial clinical examination, 140 cases were selected that presented one or more teeth with non-carious cervical wear. For each case, a similar sex and age control without any tooth with non-carious cervical lesions was selected. An occlusal examination and periodontal probing were performed in all cases and controls by skilled dentists. All the subjects answered a questionnaire referring to factors of brushing, bruxism, preferred chewing side, consumption of extrinsic acids and the presence of intrinsic acids. Data were analysed by means of univariate and multivariate logistic regression. RESULTS Of all the study variables, only the protrusion interferences, interferences on the non-working side, the brushing force, CPITN value and the consumption of salads increase the risk of NCCLs in the univariate regression. The best predictive model was formed by the combination of CPITN variables >1, the consumption of acidic salads, self-reported bruxism, brushing force and attrition. However, it only correctly classifies 68.75% of subjects. CONCLUSIONS This study supports the multifactorial aetiology of NCCLs, the combination of several factors being necessary to explain their presence. The risk factors that make up the predictive model are not sufficient to explain the appearance of NCCLs. Dentists should take into account all these risk factors in prevention, diagnosis and treatment.
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Affiliation(s)
- Angel Alvarez-Arenal
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
| | | | - Ignacio Gonzalez-Gonzalez
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
| | | | | | - Hector deLlanos-Lanchares
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain
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Fan J, Caton JG. Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations. J Periodontol 2018; 89 Suppl 1:S214-S222. [DOI: 10.1002/jper.16-0581] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Jingyuan Fan
- Department of Periodontics; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Jack G. Caton
- Department of Periodontics; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
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Fan J, Caton JG. Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S199-S206. [DOI: 10.1111/jcpe.12949] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Jingyuan Fan
- Department of Periodontics; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Jack G. Caton
- Department of Periodontics; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
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Friedman Rubin P, Eli I, Greenbaum T, Shapira K, Emodi-Perelman A, Winocur E. Potential orofacial hazards of resistance training: A controlled comparative study . Cranio 2017; 37:45-52. [PMID: 28876194 DOI: 10.1080/08869634.2017.1370566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the effect of resistance training (RT) regarding potential hazard for dental wear, tooth abfractions, temporomandibular joint disc displacement, limitation in mouth opening, and existence of cervical spine disorders. The initial study hypothesis was that extensive resistance trainees (ExRT) would suffer from the above-mentioned symptoms more often than recreational trainees (RcT). METHODS A controlled comparative study among male gym members via questionnaires and a clinical examination. RESULTS ExRT had a higher prevalence of teeth indentations on the tongue (26% vs. 2% p < 0.001) and a higher prevalence of tooth abfractions than RcT (28% vs. 4% p < 0.005). ExRT exhibited a higher prevalence of cervical movement limitations (p < 0.05) and inadequate posture (p < 0.001). CONCLUSION RT by itself may not be a risk factor for disc displacement. Nevertheless, it may act as a potential risk factor for irreversible hard tooth tissue damage and contribute to neck postural and mobility impairments.
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Affiliation(s)
- Pessia Friedman Rubin
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Ilana Eli
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Tzvi Greenbaum
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Keren Shapira
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Alona Emodi-Perelman
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Ephraim Winocur
- a Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine , Tel Aviv University , Tel Aviv , Israel
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15
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Abdalla R, Mitchell RJ, Ren YF. Non-carious cervical lesions imaged by focus variation microscopy. J Dent 2017; 63:14-20. [DOI: 10.1016/j.jdent.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/22/2017] [Accepted: 05/02/2017] [Indexed: 12/27/2022] Open
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Abstract
Dental abrasion is most commonly seen at the cervical necks of teeth, but can occur in any area, even inter-dentally from vigorous and incorrect use of dental floss. Acid erosion has been implicated in the initiation and progress of the cervical lesion, while tooth-brush abrasion has long been held as the prime cause of cervical abrasion. Identification of the risk factors is clearly important in order to modify any habits and provide appropriate advice.
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17
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Carlo B, Barabanti N, Piccinelli G, Faus-Matoses V, Cerutti A. Microbiological characterization and effect of resin composites in cervical lesions. J Clin Exp Dent 2017; 9:e40-e45. [PMID: 28149461 PMCID: PMC5268102 DOI: 10.4317/jced.52978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/02/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Non carious cervical lesions associated to muscle hyperfunctions are increasing. Microhybrid resin composites are used to restore cervical abfractions. The purpose of this study was to investigate if resin composites modify tooth plaque, inducing an increment of cariogenic microflora and evaluate their effect, in vivo and in vitro, against S. mutans. MATERIAL AND METHODS Eight abfractions were restored with two microhybrid resin composites (Venus, Heraeus-Kulzer® and Esthet-X, Dentsply®), after gnatological therapy, in three patients with muscle hyperfunctions. For each abfraction three samples of plaque were taken from the cervical perimeter: before the restoration, one week and three months after restoration. The samples were evaluated both by traditional microbiological methods and by Polymerase Chain Reaction (PCR). In vitro, disk-shaped specimens of the two composites were prepared to estimate the effects against pre-cultured S. mutans, after incubation at 37°C for 24h and assessed by a turbidimetric technique. RESULTS In vivo no differences were found in plaque growth, for all samples, before and after restoration with both composites; in vitro, instead, a significant reduction of S. mutans growth was found between specimens of two composites (Mann-Whitney U-test p>0,06). CONCLUSIONS In this study a relevant consideration was elicited: composite materials, in vivo, do not modify plaque composition of non carious cervical lesions to a potential cariogenic plaque. Key words:Abfraction, restoration, S. mutans, composite, class V.
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Affiliation(s)
- Bonfanti Carlo
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Nicola Barabanti
- Tutor, Department of Restorative Dentistry, University of Brescia, Italy
| | - Giorgio Piccinelli
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Vicente Faus-Matoses
- DDS, MSc. Master of Restorative Dentristy and Endodontics, Department of Stomatology, Medicine and Dental School, Valencia University, Spain
| | - Antonio Cerutti
- Professor, Department of Restorative Dentistry, University of Brescia, Italy
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Factors influencing the progression of noncarious cervical lesions: A 5-year prospective clinical evaluation. J Prosthet Dent 2016; 115:571-7. [PMID: 26774320 DOI: 10.1016/j.prosdent.2015.10.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 12/24/2022]
Abstract
STATEMENT OF PROBLEM The etiology (chemical, friction, abfraction) of noncarious cervical lesion (NCCL) progression is poorly understood. PURPOSE The purpose of this 5-year prospective clinical trial was to measure the relationship between NCCLs and various etiologic factors. MATERIAL AND METHODS After review board approval, 29 participants with NCCLs were enrolled. Polyvinyl siloxane impressions were made of each NCCL, and casts were poured at baseline, 1, 2, and 5 years. The casts were scanned with a noncontact profilometer, and 1-, 2-, and 5-year scans were superimposed over baseline scans to measure volumetric change in NCCLs. T-scan and Fujifilm Prescale films were used to record relative and absolute occlusal forces on teeth with NCCLs at the 5-year recall. Participant diet, medical condition, toothbrushing, and adverse oral habit questionnaires were given at the 5-year recall. Occlusal analysis was completed on mounted casts to determine the presence of wear facets and group function. Volumetric lesion progression from 1 to 5 years was correlated to absolute and relative occlusal force using mixed model analysis. The Kruskall-Wallis and Mann-Whitney analyses compared lesion progression with diet, medical condition, toothbrushing, adverse oral habits, wear facets, and group function. RESULTS The NCCL progression rate over 5 years was 1.50 ±0.92 mm(3)/yr. The rate of progression of NCCLs was related to mean occlusal stress (P=.011) and relative occlusal force (P=.032) in maximum intercuspation position. No difference was seen in NCCL progression between participants with any other factors. CONCLUSION Heavy occlusal forces play a significant role in the progression of NCCLs.
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Munari LS, Cornacchia TPM, Moreira AN, Gonçalves JB, De Las Casas EB, Magalhães CS. Stress distribution in a premolar 3D model with anisotropic and isotropic enamel. Med Biol Eng Comput 2015; 53:751-8. [PMID: 25850984 DOI: 10.1007/s11517-015-1289-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 03/26/2015] [Indexed: 11/30/2022]
Abstract
The aim of this study was to compare the areas of stress concentration in a three-dimensional (3D) premolar tooth model with anisotropic or isotropic enamel using the finite element method. A computed tomography was imported to an image processing program to create the tooth model which was exported to a 3D modeling program. The mechanical properties and loading conditions were prescribed in Abaqus. In order to evaluate stresses, axial and oblique loads were applied simulating realistic conditions. Compression stress was observed on the side of load application, and tensile stress was observed on the opposite side. Tensile stress was concentrated mainly in the cervical region and in the alveolar insertion bone. Although stress concentration analyses of the isotropic 3D models produced similar stress distribution results when compared to the anisotropic models, tensile stress values shown by anisotropic models were smaller than the isotropic models. Oblique loads resulted in higher values of tensile stresses, which concentrate mainly in the cervical area of the tooth and in the alveolar bone insertion. Anisotropic properties must be utilized in enamel stress evaluation in non-carious cervical lesions.
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Affiliation(s)
- Laís S Munari
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, CEP 31270-901, Belo Horizonte, MG, Brazil,
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20
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Stress amplifications in dental non-carious cervical lesions. J Biomech 2014; 47:410-6. [DOI: 10.1016/j.jbiomech.2013.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 10/29/2013] [Accepted: 11/06/2013] [Indexed: 01/06/2023]
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21
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Prosthodontic rehabilitation of the patient with severely worn dentition: a case report. Case Rep Dent 2012; 2012:961826. [PMID: 22830062 PMCID: PMC3399352 DOI: 10.1155/2012/961826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/21/2012] [Indexed: 11/17/2022] Open
Abstract
The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This paper describes the full mouth rehabilitation of a 63-year-old bruxer man with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account.
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22
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GRIPPO JOHNO, SIMRING MARVIN, COLEMAN THOMASA. Abfraction, Abrasion, Biocorrosion, and the Enigma of Noncarious Cervical Lesions: A 20-Year Perspective. J ESTHET RESTOR DENT 2011; 24:10-23. [DOI: 10.1111/j.1708-8240.2011.00487.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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23
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Moslehifard E, Nikzad S, Geraminpanah F, Mahboub F. Full-Mouth Rehabilitation of a Patient with Severely Worn Dentition and Uneven Occlusal Plane: A Clinical Report. J Prosthodont 2011; 21:56-64. [DOI: 10.1111/j.1532-849x.2011.00765.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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24
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Pikdöken L, Akca E, Gürbüzer B, Aydil B, Taşdelen B. Cervical wear and occlusal wear from a periodontal perspective. J Oral Rehabil 2011; 38:95-100. [PMID: 20678102 DOI: 10.1111/j.1365-2842.2010.02137.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate whether cervical wear was associated with occlusal wear and clinical periodontal parameters in relatively older adults. A total of 30 patients, with multiple non-carious cervical lesions (NCCLs) and without a disease or condition that could cause heavy tooth wear, were included in the study. The periodontal parameters including plaque index, probing pocket depth, gingival recession (GR) and tooth mobility were obtained from 641 teeth of which 475 (74·1%) displayed NCCLs. The levels of cervical wear and occlusal wear were determined according to a tooth wear index. Premolars were more likely to develop cervical wear than canines, molars and incisors. Cervical wear was significantly associated with less plaque accumulation and the presence of shallow pockets. The teeth with advanced GR and without increased mobility were 2·583 and 1·715 times more likely to develop deeper cervical lesions, respectively. Age and the level of occlusal wear were not linked to the bucco-lingual depth of cervical wear. In conclusion, the significant association of advanced cervical wear with the relatively healthy periodontal status suggested the role of abrasion and its possible combined action with erosion in the aetiology of NCCLs. The rate of GR and the lack of tooth mobility could constitute predisposing factors for the progression of cervical wear because the exposed root surfaces could be more susceptible to abrasion and/or erosion, and the non-mobile teeth resisting strongly against frictional forces, thus abrasive effects, could possibly develop cervical wear.
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Affiliation(s)
- L Pikdöken
- Department of Dentistry, Section of Periodontology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
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25
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Relationship between handedness and toothbrush-related cervical dental abrasion in left- and right-handed individuals. J Dent Sci 2010. [DOI: 10.1016/j.jds.2010.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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RITTER ANDRÉV, GRIPPO JOHNO, COLEMAN THOMASA, MORGAN MICHÈLEE. Prevalence of Carious and Non-carious Cervical Lesions in Archaeological Populations from North America and Europe. J ESTHET RESTOR DENT 2009; 21:324-34. [DOI: 10.1111/j.1708-8240.2009.00285.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Shah P, Razavi S, Bartlett DW. The Prevalence of Cervical Tooth Wear in Patients with Bruxism and Other Causes of Wear. J Prosthodont 2009; 18:450-4. [DOI: 10.1111/j.1532-849x.2009.00456.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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28
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Michael JA, Townsend GC, Greenwood LF, Kaidonis JA. Abfraction: separating fact from fiction. Aust Dent J 2009; 54:2-8. [DOI: 10.1111/j.1834-7819.2008.01080.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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29
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Mahboub F, Fard EM, Geramipanah F, Hajimiragha H. Prosthodontic rehabilitation of a bruxer patient with severely worn dentition: a clinical case report. J Dent Res Dent Clin Dent Prospects 2009; 3:28-31. [PMID: 23230478 PMCID: PMC3517200 DOI: 10.5681/joddd.2009.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Accepted: 01/28/2009] [Indexed: 11/30/2022] Open
Abstract
The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This article describes the full mouth rehabilitation of a 54-year-old bruxer woman with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account.
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Affiliation(s)
- Farhang Mahboub
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Iran
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30
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Correlations of noncarious cervical lesions and occlusal factors determined by using pressure-detecting sheet. J Dent 2008; 36:774-9. [DOI: 10.1016/j.jdent.2008.05.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/13/2008] [Accepted: 05/16/2008] [Indexed: 11/24/2022] Open
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31
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Park JK, Hur B, Kim SK. Stress distribution of Class V composite resin restorations: A three-dimensional finite element study. ACTA ACUST UNITED AC 2008. [DOI: 10.5395/jkacd.2008.33.1.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jeong-Kil Park
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Busan, Korea
| | - Bock Hur
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Busan, Korea
| | - Sung-Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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32
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Staninec M, Kim P, Marshall GW, Ritchie RO, Marshall SJ. Fatigue of dentin-composite interfaces with four-point bend. Dent Mater 2007; 24:799-803. [PMID: 17996931 DOI: 10.1016/j.dental.2007.09.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Revised: 09/06/2007] [Accepted: 09/29/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective was to determine the fracture and cyclic fatigue properties of composite-dentin beams bonded with a self-etching adhesive in four-point bend. METHODS Beams of rectangular cross-section were shaped to a size of approximately 0.87mmx0.87mmx10mm and placed in a four-point bending apparatus, with the loading points 1.8 and 7.2mm apart, with the interface centered between the inner rollers. Cyclical loading was performed in Hanks' Balanced Salt Solution at 25 degrees C, with forces between 54% and 99% of the bending strength of the bonded beams. RESULTS Solid dentin and solid composite beams [n=6] had bending strengths of 164.4 and 164.6MPa, respectively, under monotonically increasing loads. Bonded beams [n=6] had strengths of 90.6MPa. No significant difference was found between solid composite and solid dentin beams, the bonded beams were different (ANOVA, p<0.0001) With long-term cycling, stresses below 49MPa were tolerated for 10(6) cycles, but with increasing stress up to 90MPa, beams failed earlier, demonstrating that subcritical fatigue cycling will eventually cause failure. SIGNIFICANCE Fatigue may be a significant mechanism of dentin-composite bond degradation.
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Affiliation(s)
- Michal Staninec
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA 94143, USA.
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33
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Ichim I, Schmidlin PR, Kieser JA, Swain MV. Mechanical evaluation of cervical glass-ionomer restorations: 3D finite element study. J Dent 2007; 35:28-35. [PMID: 16782259 DOI: 10.1016/j.jdent.2006.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Revised: 03/23/2006] [Accepted: 04/03/2006] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this paper was to investigate the influence of lesion shape and depth as well as the direction of occlusal loading on the mechanical response of cervical GIC restorations. METHODS A finite element model of a lower first premolar was created. Both wedged and rounded lesions were then modelled with incremental depth after which the tooth was loaded at different angles. First principal stress (tension) was employed as an indicator of material failure, by contrasting our calculated stresses with the ultimate tensile strength of the GIC and known values of bond strength between material and tooth substrate. RESULTS Obliquely loaded teeth exhibited significantly higher tensile stress in the cervical region of the restoration. For forces inclined at angles of 30 degrees and higher to the vertical tooth axis, the tensile stresses in the cervical margin of the restoration exceeded the ultimate material and bond strength. In contrast, lesion shape and depth have only a minor influence on tensile stress development. CONCLUSIONS Lesion depth and shape are not of primary concern from a mechanical perspective for a restorative treatment decision. By contrast, occlusal diagnosis and subsequent re-adjustments of tooth contacts do form a critical part of the treatment of non-carious cervical lesions (NCCLs).
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Affiliation(s)
- I Ichim
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Bartlett DW, Shah P. A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion. J Dent Res 2006; 85:306-12. [PMID: 16567549 DOI: 10.1177/154405910608500405] [Citation(s) in RCA: 191] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.
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Affiliation(s)
- D W Bartlett
- Department of Prosthodontics, Guy's Tower, St. Thomas' Street, London Bridge, London SE1 9RT, UK.
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35
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Pegoraro LF, Scolaro JM, Conti PC, Telles D, Pegoraro TA. Noncarious cervical lesions in adults: prevalence and occlusal aspects. J Am Dent Assoc 2006; 136:1694-700. [PMID: 16383052 DOI: 10.14219/jada.archive.2005.0113] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The factors that induce the formation of noncarious lesions are not understood fully, particularly those that are related to occlusal aspects. The authors conducted a study to evaluate the prevalence of noncarious cervical lesions in adults and their association with occlusal aspects. METHODS The authors examined 70 people (35 men and 35 women) aged 25 to 45 years to determine the presence and type of noncarious cervical lesions, wear facets, tooth contacts in maximal intercuspal position, and lateral and protrusive movements. The assessment involved a questionnaire and clinical examination. RESULTS Among the teeth the authors evaluated, 17.23 percent had cervical lesions, 80.28 percent of which had wear facets (P < .01). The authors found a significant difference between the prevalence of noncarious lesions and the presence of wear facets (P = .0484). CONCLUSIONS The authors found that cervical lesions were related significantly to wear facets. These findings strengthen evidence for the role of occlusal forces as an etiologic factor for noncarious lesions. CLINICAL IMPLICATIONS The presence of wear facets should be considered in the treatment of noncarious cervical lesions.
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36
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Estafan A, Furnari PC, Goldstein G, Hittelman EL. In vivo correlation of noncarious cervical lesions and occlusal wear. J Prosthet Dent 2005; 93:221-6. [PMID: 15775922 DOI: 10.1016/j.prosdent.2004.12.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STATEMENT OF PROBLEM The etiology of noncarious cervical lesions is not well understood. An understanding of the etiology helps the clinician determine appropriate treatment and management strategies. Purpose This study evaluated the relationship between noncarious cervical lesions and occlusal (or incisal) wear. MATERIAL AND METHODS Casts (n = 299) made from dental students were articulated in a semi-adjustable articulator and evaluated. Data included the presence and contour of noncarious cervical lesions (NCLs) and the presence, location, and severity of any occlusal/incisal wear facets. Also included were Angle's classification, occlusal guidance patterns, midline, presence of tori, tooth restoration, reverse articulation (crossbite), open occlusal relationship, and posterior excursive contacts where present. Following a calibration procedure, 2 evaluators made independent observations on the casts. The first evaluator recorded for each tooth in each subject: presence and severity of NCLs, presence and extent of occlusal/proximal restorations, and presence of reverse articulation and open occlusal relationship. Following the first evaluation red rope wax was placed at the cervical margins of each tooth for the purpose of blinding the second evaluator from NCL observations. The second evaluator recorded severity and location of occlusal/incisal wear, presence or absence of posterior excursive contacts, Angle's classification, occlusal guidance pattern, any midline discrepancy, and presence or absence of tori. The Spearman correlation coefficient and chi 2 tests were used to analyze the data (alpha=.05). RESULTS There was no relationship between noncarious cervical lesions and occlusal/incisal wear. There was also no correlation between NCLs and other parameters examined. CONCLUSIONS Under the conditions of this study, noncarious cervical lesions are not related to occlusal wear.
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Affiliation(s)
- Ashraf Estafan
- Advanced Education Program in Prosthodontics, New York University College of Dentistry, New York, NY 11050, USA.
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