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Maluf CV, Lourenço EJV, Pegoraro LF, de Moraes Telles D. Noncarious cervical lesions: Response from a 25-year clinical follow-up study. J Prosthet Dent 2023:S0022-3913(23)00720-5. [PMID: 38007292 DOI: 10.1016/j.prosdent.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/27/2023]
Abstract
STATEMENT OF PROBLEM The etiology and diagnosis of noncarious cervical lesions (NCCLs) remain poorly understood. PURPOSE The purpose of this clinical study was to examine NCCL progression in an existing group of participants, establish the incidence of new NCCLs in a 25-year follow-up study, and relate them to possible risk factors, including occlusal factors. MATERIAL AND METHODS Thirty-three participants who had completed a questionnaire about their habits, diet, and personal information were evaluated in this observational retrospective study. Impressions were made, and casts from 3 time periods (Phase I in 1996, Phase II in 1999, and Phase III in 2021) were scanned to obtain digital casts. The casts were then evaluated in a 3-dimensional analysis software program (Geomagic Control; 3D Systems) to establish digital comparisons between NCCLs and occlusal wear. Furthermore, data from an occlusal analysis device (T-Scan; Tekscan) collected in Phase I was used to analyze occlusal interferences relating to the progression of NCCLs. The statistical analysis applied nonparametric tests, followed by the assessment of the association between NCCLs and risk factors, including occlusal wear, through binary logistic regression (α=.05). RESULTS At the end of Phase III, 7 new individuals with NCCLs were detected compared with Phase II. The median percentage progression of NCCLs per participant was 0.0% in Phase I, 7.1% in Phase II, and 35.7% in Phase III (P<.005). Occlusal wear in Phase I was associated with 5.02 times the occurrence of NCCLs in Phase III; occlusal wear in Phase II was associated with 4.73 times the occurrence of NCCLs in Phase III; and occlusal wear in Phase III was associated with 1.94 times the occurrence of NCCLs in Phase III (P<.001). Occlusal interference in border movements of the mandible was associated with a 3.55 times greater chance of presenting NCCLs in Phase III (P<.001). Additionally, statistically significant risk factors for the presence of NCCLs in Phase III were an acidic diet (P=.043) and alcohol consumption (P=.021). CONCLUSIONS The 25-year data showed an association between NCCLs and specific risk factors, including occlusal wear and occlusal interferences.
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Affiliation(s)
- Caroline Vieira Maluf
- Postdoctoral student, Department of Prosthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Eduardo José Veras Lourenço
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Luiz Fernando Pegoraro
- Full Professor, Department of Prosthodontics, Bauru Dental School, University of São Paulo, Rio de Janeiro, Brazil
| | - Daniel de Moraes Telles
- Full Professor, Department of Prosthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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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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Grover V, Kumar A, Jain A, Chatterjee A, Grover HS, Pandit N, Satpathy A, Madhavan Pillai BR, Melath A, Dhruvakumar D, Thakur R, Joshi NV, Deshpande N, Dadlani H, Meenakshi AA, Ashok KP, Reddy KV, Bhasin MT, Salaria SK, Verma A, Gaikwad RP, Darekar H, Amirisetty R, Phadnaik M, Karemore V, Dhulipalla R, Mody D, Rao TS, Chakarpani S, Ranganath V. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol 2022; 26:307-333. [PMID: 35959314 PMCID: PMC9362809 DOI: 10.4103/jisp.jisp_233_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Jain
- Department of Periodontology, Dental Institute, Regional Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anirban Chatterjee
- Department of Periodontology, Renupriya Dental Health Care, Bengaluru, Karnataka, India
| | | | - Nymphea Pandit
- Department of Periodontology, D. A. V Dental College and Hospital, Yamunanagar, Haryana, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha "O" Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | | | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India
| | - Deepa Dhruvakumar
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, India
| | - Nilesh V Joshi
- Department of Periodontology, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be) University, Navi Mumbai, India
| | - Neeraj Deshpande
- Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Meerut, Uttar Pradesh, India
| | - A Archana Meenakshi
- Department of Periodontology, Ragas Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - K P Ashok
- Department of Periodontics, GSL Dental College, Rajahmundry, India
| | - K Vinathi Reddy
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | - Meenu Taneja Bhasin
- Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Haryana, India
| | | | - Abhishek Verma
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | | | | | - Ramesh Amirisetty
- Department of Periodontology, G. Pulla Reddy Dental College and Hospital, Dr. NTR University of Health Sciences, Kurnool, Andhra Pradesh, India
| | - Mangesh Phadnaik
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Vaibhav Karemore
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Ravindranath Dhulipalla
- Department of Periodontology, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - Dhawal Mody
- VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Tushar Shri Rao
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Swarna Chakarpani
- Department of Periodontics, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - V Ranganath
- Department of Periodontics, AECS Maaruti Dental College and Research Center, Bengaluru, Karnataka, India
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Bozhkova T. Comparison of Two Generations of Systems for Digital Occlusion Examination. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The modern concept of occlusion includes the relationship between teeth, masticatory muscles, and temporomandibular joints in function and dysfunction. Occlusion can be defined very simply: it means the contacts between teeth. Qualitative and quantitative methods are used to register and evaluate occlusal contacts. The T-Scan handpiece model was updated in 2015 as T-Scan Novus (software version 9.1) and the latest updated one being the T-Scan version 10 software introduced in 2018.
AIM: The purpose of this study is to demonstrate the capabilities and results of two generations of systems - T-Scan III and T-Scan Novus.
MATERIALS AND METHODS: For the realization of the set goal, the occlusion of a patient with the initials S.K. is examined with two systems. The patient is 43 years old with intact teeth, Angle’s class I jaw relation. The study with T-Scan III was conducted in 2015 and with T-Scan Novus in 2019.
RESULTS: The software of both systems uses a graphical interface, which transforms the data obtained during the recording of the occlusion as the model of the upper dentition of the patient in T-Scan III and the upper and lower dentition in T-Scan Novus. Registered occlusal contacts are illustrated as 2D and 3D images of different colors. The graph force/time shows the power versus time from the first contact to the end of the movie. The timing table displays the patient’s total occlusal bite timing, and the force applied. T-Scan Novus software allows you to import digital fingerprint files of the upper and lower dentition in.stl format.
CONCLUSION: The software program of the system version 9.1 provides better visualization of dental arches making it much more informative than other versions. The T-Scan system allows fast and accurate registration and analysis of occlusion.
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Soares ARDS, Chalub LLFH, Barbosa RS, Campos DEDP, Moreira AN, Ferreira RC. Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral-health related quality of life among Brazilian adults. Heliyon 2021; 7:e06492. [PMID: 33748509 PMCID: PMC7970350 DOI: 10.1016/j.heliyon.2021.e06492] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To assess the association between dentin hypersensitivity (DH) (with or without non-carious cervical lesions (NCCL)) and physical and psychosocial oral health impact. Methods A cross-sectional population-based study with one-stage random sample of adults living in a Brazilian municipally was conducted between 2018 and 2019. Interviews and oral examinations were performed by calibrated examiners (Kappa ≥0.7). The participant was considered as having physical and psychosocial impact if at least one item of the Oral Health Impact Profile (OHIP-14) was experienced fairly often or very often. NCCL was assessed by the Tooth Wear Index (codes 2 to 4) and DH was evaluated by a tactile test with a probe in the cervical area of teeth. The combination of these clinical variables resulted in categories of the independent variable: without DH or NCCL, NCCL without DH, DH without NCCL, and both DH with NCCL. The covariables were sociodemographic and economic factors, health habits, and oral conditions. Associations were investigated by Poisson Regression models using Direct Acyclic Graph (Stata 17). Results Of 197 adults, 59.3% had oral health impact and 31.3% had DH with NCCL. Higher frequency of oral health impact was observed in adults with DH alone. A higher impact on the physical pain dimension of the OHIP-14 was observed in adults with DH and NCCL (PR: 2.46; 95% CI: 1.21–5.00) and with DH alone (PR: 2.03; 95% CI: 1.21–3.41). Conclusion NCCL and DH are common conditions in adults and the presence of DH is associated with higher oral health impact. Regardless the presence of NCCL, DH is associated with the physical pain dimension of OHRQoL.
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Affiliation(s)
| | | | | | | | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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CRISÓSTOMO JVD, BEZERRA BO, MELO MGDP, ROCHA-NOVAIS PM, MORAES MDRD. Prevalence of non-carious cervical lesions and cervical dentinary hypersensitivity in undergraduate students. REVISTA DE ODONTOLOGIA DA UNESP 2021. [DOI: 10.1590/1807-2577.05121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract Introduction The non-carious cervical lesion (NCCL) is currently a common oral disease. Objective This observational and descriptive study aimed to assess risk factors associated with non-carious cervical lesions, cervical dentin hypersensitivity (CDH), gingival recession (GR) and the relationship between these conditions in students in the last years of undergraduate dentistry. Material and method One hundred eighty-five dentistry students from a private college in Ceará with an average of 22.7 ± 2.3 years participated by filling out a google docs form. Two calibrated examiners performed the exams to verify the presence of NCCL, CDH and RG. Result The presence of NCCL was 22.7%, GR was 48.1% and cervical dentin hypersensitivity 8.6%. The chi-square test with p < 0.05% verified a correlation between the presence of NCCL and the presence of GR and CDH. 25% of students had NCCL and 14% considered themselves stressed. There was no association between the variables bruxism and stress (p=0.529), bruxism and year of graduation course (p=0.716), as well as no association between stress and year of course (p = 0.397) was observed. There were no correlations between NCCL and bruxism, muscle symptoms, parafunctional habits and temporomandibular dysfunction. 10.8% of students who reported using legal and illegal drugs had NCCL. Conclusion The NCCL, GR and CDH were correlated in the group of students in the last two years of an undergraduate dentistry course in Ceará.
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Teixeira DNR, Thomas RZ, Soares PV, Cune MS, Gresnigt MM, Slot DE. Prevalence of noncarious cervical lesions among adults: A systematic review. J Dent 2020; 95:103285. [DOI: 10.1016/j.jdent.2020.103285] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/02/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022] Open
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Correia A, Bresciani E, Borges AB, Pereira DM, Maia LC, Caneppele T. Do Tooth- and Cavity-related Aspects of Noncarious Cervical Lesions Affect the Retention of Resin Composite Restorations in Adults? A Systematic Review and Meta-analysis. Oper Dent 2020; 45:E124-E140. [PMID: 32053461 DOI: 10.2341/19-091-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations? METHODS Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location). RESULTS We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency. CONCLUSION The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.
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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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Relationship between noncarious cervical lesions, cervical dentin hypersensitivity, gingival recession, and associated risk factors: A cross-sectional study. J Dent 2018; 76:93-97. [DOI: 10.1016/j.jdent.2018.06.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 11/19/2022] Open
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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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14
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Yoshizaki KT, Francisconi-dos-Rios LF, Sobral MAP, Aranha ACC, Mendes FM, Scaramucci T. Clinical features and factors associated with non-carious cervical lesions and dentin hypersensitivity. J Oral Rehabil 2017; 44:112-118. [DOI: 10.1111/joor.12469] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
Affiliation(s)
- K. T. Yoshizaki
- Department of Restorative Dentistry; School of Dentistry; University of São Paulo; São Paulo Brazil
| | | | - M. A. P. Sobral
- Department of Restorative Dentistry; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - A. C. C. Aranha
- Department of Restorative Dentistry; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - F. M. Mendes
- Department of Pediatric Dentistry; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - T. Scaramucci
- Department of Restorative Dentistry; School of Dentistry; University of São Paulo; São Paulo Brazil
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15
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Yang J, Cai D, Wang F, He D, Ma L, Jin Y, Que K. Non-carious cervical lesions (NCCLs) in a random sampling community population and the association of NCCLs with occlusive wear. J Oral Rehabil 2016; 43:960-966. [PMID: 27658541 DOI: 10.1111/joor.12445] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2016] [Indexed: 10/21/2022]
Abstract
This study investigated the prevalence, risk factors and association of occlusive wear with non-carious cervical lesions (NCCLs) in the general Chinese population. A total of 1320 subjects were recruited, and multistage and random sampling methods of survey spots were performed. All age groups comprised similar numbers of participants and equal numbers of males and females. Each subject completed a structured interview, and all teeth of each subject were examined by a practitioner to determine NCCLs and occlusive wear. Binary logistic regression was conducted by analysing the association of risk factors with the occurrence of NCCLs. Bivariate correlation analysis was performed by determining the association of NCCLs dimension or depth with the range of occlusive wear facets. Clinical assessment showed that the overall prevalence of subjects diagnosed with NCCLs was 63%. The proportion of subjects or teeth with NCCLs significantly increased with age. Pre-molars were the most commonly affected teeth. Single variables and interactive effects of variables associated with the occurrence of NCCLs include the following: age group, intensity of toothbrushing, frequency of fresh fruit consumption and interactive effect between intensity of toothbrushing and frequency of fresh fruit consumption. A weak positive correlation of the grading index was found between NCCLs dimension, size or depth and range of occlusive wear facets. This study reported the higher prevalence of NCCLs in the general Chinese population. Implementation of a combined strategy to reduce risk factors of NCCLs could be more effective than individual techniques; meanwhile, the occurrence of NCCL could be related to the wear degree of occlusive defects in the population studied.
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Affiliation(s)
- J Yang
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China.,Department of Implant, Stomatological Hospital of Nan Kai University, Tian'jin, China
| | - D Cai
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - F Wang
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - D He
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - L Ma
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Y Jin
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - K Que
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
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16
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Abstract
A large number of Class V restorations are placed per annum to restore cervical lesions. This paper evaluates the pathogenesis of these lesions, with particular reference to the role of occlusal factors, and reviews the literature in order to provide advice on the material(s) which are most likely to produce optimal longevity of a Class V restoration. CPD/CLINICAL RELEVANCE: Resin-modified glass ionomer materials appear to provide optimal survival for a Class V restoration, but a (flowable) comDosite miaht Droduce a better aesthetic result.
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17
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Kumar S, Kumar A, Debnath N, Kumar A, K. Badiyani B, Basak D, S. A. Ali M, B. Ismail M. Prevalence and risk factors for non-carious cervical lesions in children attending special needs schools in India. J Oral Sci 2015; 57:37-43. [DOI: 10.2334/josnusd.57.37] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Sandeep Kumar
- Department of Public Health Dentistry, Sri Aurobindo College of Dentistry
| | - Arunoday Kumar
- Department of Prosthodontics, Hazaribagh College of Dental sciences
| | - Nitai Debnath
- Department of Prosthodontics, Regional Institute of Medical Sciences
| | - Amit Kumar
- Department of Public Health Dentistry, Sarjug Dental College and Hospital
| | | | - Debashish Basak
- Department of Prosthodontics, Hazaribagh College of Dental sciences
| | - Mohamed S. A. Ali
- Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences
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18
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Silvani S, Trivelato RF, Nogueira RD, Gonçalves LDS, Geraldo-Martins VR. Factors affecting the placement or replacement of direct restorations in a dental school. Contemp Clin Dent 2014; 5:54-8. [PMID: 24808696 PMCID: PMC4012118 DOI: 10.4103/0976-237x.128664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Context: The knowledge of the reasons for the placement of direct restorations makes possible to trace an epidemiological profile of a specific population and to direct the teaching of dentistry to techniques that are commonly used today and will be continued performed in the future. Purpose: The aim of this study was to verify the reasons for placement and replacement of direct restorations in patients treated in the Dental Clinic of the Uberaba University – Brazil. Materials and Methods: This study evaluated 306 restorative procedures carried out on 60 patients. During the treatment planning, a form that contained information about the patient's gender, tooth number, the classification of restorations, the reasons for placement and replacement of amalgam and tooth-colored restorations, the material that had to be removed and the new material used to fill the cavities was filled for each patient. Statistical analysis was carried out using Chi-square test (α = 0.05). Results: The data showed that most of the patients were female (66.7%). Of all the restorations placed, 60.45% were 1st-time placements, while 39.55% were replacements. For 1st-time restorations, the main reason for placement was primary caries (76.76%), followed by non-carious cervical lesions (15.14%). The amalgam restorations were replaced more frequently (67.77%). The primary reason for replacements was the presence of secondary caries (for both previous amalgam (42.68%) and composite (66.67%) restorations (P < 0.05). The resin composite was the most indicated material for the new restorations (98.04%) (P < 0.05). Conclusions: The main reason for placement of direct restorations was primary caries, while secondary caries was the main reason for replacements. In almost all cases, the material used to fill the cavities was the resin composite.
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Affiliation(s)
- Samara Silvani
- Department of restorative dentistry, Biomaterials Division, School of Dentistry, Uberaba University, Uberaba, Brazil
| | - Roberta Ferreira Trivelato
- Department of restorative dentistry, Biomaterials Division, School of Dentistry, Uberaba University, Uberaba, Brazil
| | - Ruchele Dias Nogueira
- Department of restorative dentistry, Biomaterials Division, School of Dentistry, Uberaba University, Uberaba, Brazil
| | - Luciano de Souza Gonçalves
- Department of restorative dentistry, Biomaterials Division, School of Dentistry, Uberaba University, Uberaba, Brazil
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19
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Clinical evaluation of the association between noncarious cervical lesions and occlusal forces. J Prosthet Dent 2013; 108:298-303. [PMID: 23107237 DOI: 10.1016/s0022-3913(12)60180-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Noncarious cervical lesions (NCCLs) are a frequent challenge in clinical dental practice, given the variety of opinions regarding their etiology, diagnosis, and treatment. PURPOSE The purpose of this study was to assess the potential relationship between occlusal forces and the occurrence of NCCLs. MATERIAL AND METHODS The participant population consisted of 111 volunteers (30 male and 81 female, mean age 23.6 years). General personal information was recorded, after which participants were examined for the presence and location of NCCLs, gingival recession, fracture lines, dental and restoration fractures, presence and location of tooth wear, type of occlusal guidance scheme for lateral mandibular movements, and existence of occlusal interference or premature contacts. The participants were divided according to the presence or absence of NCCLs, and data were statistically analyzed with the Independent t test, the Chi-square test, and the Fisher exact test (α=.05). RESULTS A significant association was found between the presence of NCCLs and age (P=.008), gingival recession (P<.001), occlusal trauma (P<.001), presence (P<.001) and location of tooth wear, and group function as occlusal guidance scheme in lateral excursive movements (P<.001). CONCLUSIONS A strong relationship between the presence of NCCLs and occlusal overload was found.
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21
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Khan MT, Verma SK, Maheshwari S, Zahid SN, Chaudhary PK. Neuromuscular dentistry: Occlusal diseases and posture. J Oral Biol Craniofac Res 2013; 3:146-50. [PMID: 25737904 DOI: 10.1016/j.jobcr.2013.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/28/2013] [Indexed: 12/17/2022] Open
Abstract
Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.
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Affiliation(s)
- Mohd Toseef Khan
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Sanjeev Kumar Verma
- Associate Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Sandhya Maheshwari
- Professor and Head, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Syed Naved Zahid
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Prabhat K Chaudhary
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
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22
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Comparison of occlusal loading conditions in a lower second premolar using three-dimensional finite element analysis. Clin Oral Investig 2013; 18:369-75. [DOI: 10.1007/s00784-013-0973-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 03/05/2013] [Indexed: 10/27/2022]
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23
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Que K, Guo B, Jia Z, Chen Z, Yang J, Gao P. A cross-sectional study: non-carious cervical lesions, cervical dentine hypersensitivity and related risk factors. J Oral Rehabil 2012; 40:24-32. [DOI: 10.1111/j.1365-2842.2012.02342.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2012] [Indexed: 12/22/2022]
Affiliation(s)
- K. Que
- The Department of Endodontics; Stomatology College of Tian'jin Medical University; Tian'jin; China
| | - B. Guo
- Institute of Stomatology, Chinese PLA General Hospital, Bei'jing; China
| | - Z. Jia
- The Department of Endodontics; Stomatology College of Tian'jin Medical University; Tian'jin; China
| | - Z. Chen
- The Department of Endodontics; Stomatology College of Tian'jin Medical University; Tian'jin; China
| | - J. Yang
- The Department of Implant; Stomatology College of Nankai University; Tian'jin; China
| | - P. Gao
- The Department of Prosthetics; Stomatology College of Tian'jin Medical University; Tian'jin; China
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24
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Senna P, Del Bel Cury A, Rösing C. Non-carious cervical lesions and occlusion: a systematic review of clinical studies. J Oral Rehabil 2012; 39:450-62. [PMID: 22435539 DOI: 10.1111/j.1365-2842.2012.02290.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Non-carious cervical lesions (NCCLs) are a group of lesions that affect the cervical area of the teeth. Different aetiological factors have been reported, among them tooth brushing force, erosive agents and occlusal forces. The aim of this study was to ascertain, by means of a systematic review, the association between NCCLs and occlusion. A search was performed in the MEDLINE database, retrieving a total of 286 articles. After title and abstract screening, the clinical investigations were read in full to select those that evaluated the occlusal aspects of NCCL aetiology. This systematic review describes the results of three prospective and 25 cross-sectional studies. As there is an extreme heterogeneity in design, diagnostic criteria, forms of analysis and associated factors, a meta-analysis was not possible. The wide variety of classification and diagnostic criteria reflects a high range of reported prevalence. An extensive heterogeneity of independent variables was noted, even in occlusal analysis, which helps to mask any conclusion about the role of occlusion in NCCL aetiology. The literature reveals that studies on this topic are subject to a substantial amount of bias, such as evaluation (use of non-blinded examiners) and confounding bias (no control of others aetiological factors). Up to now, it has been impossible to associate NCCLs with any specific causal agent, and the role of occlusion in the pathogenesis of non-carious cervical lesions seems as yet undetermined. Therefore, additional studies, properly designed to diminish bias, are warranted.
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Affiliation(s)
- P Senna
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, Piracicaba, São Paulo, Brazil.
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25
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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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Relationship between occlusal contact pattern and non-carious cervical lesions among male adults. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2010. [DOI: 10.1007/s12548-010-0039-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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