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Silva EJNL, Vianna PS, Lima CO, Barbosa AFA, Vieira VTL, Versiani MA. Exploring access cavity through non-carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors. Int Endod J 2024. [PMID: 38984709 DOI: 10.1111/iej.14123] [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: 05/14/2024] [Revised: 06/04/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
AIM To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors. METHODOLOGY Twenty recently extracted and intact mandibular incisors were initially scanned using a micro-CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge-shaped non-carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double-faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single-cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann-Whitney test or the Student's t-test, with a statistical significance level of 5%. RESULTS Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008). CONCLUSIONS CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors.
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Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Patrícia S Vianna
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Carolina O Lima
- Department of Dentistry, School of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Ana Flávia A Barbosa
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Victor T L Vieira
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Marco A Versiani
- Oral Health Center, Brazilian Military Police, Minas Gerais, Brazil
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Gupta R, Patel A, Nikhade P, Chandak M, Rajnekar R, Dugar M. Comparative Evaluation of Postoperative Sensitivity Using Three Different Tooth-Colored Restorative Materials in Non-carious Cervical Lesions: A Split-Mouth Design In Vivo Study. Cureus 2022; 14:e27861. [PMID: 36110475 PMCID: PMC9462524 DOI: 10.7759/cureus.27861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Three different tooth-colored restorative materials were evaluated and compared for postoperative sensitivity using a split-mouth design. This is a double-blinded clinical trial assessed for a one-month follow-up period in patients with non-carious cervical lesions (NCCLs). Materials and Methods A total of 60 NCCLs in 20 participants were considered in this split-mouth design study and randomly divided into three different groups: Flowable composite (n = 20), resin-modified glass ionomer cement (RMGIC) (n = 20), and Zirconomer® (n = 20). The restorations were evaluated for postoperative sensitivity at baseline (BL-day 0), three, seven, and 21 days using the Schiff cold air sensitivity scale. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) using a post hoc test for postoperative sensitivity and one-way Anova to analyze all the groups together at the time interval of three, seven, and 21 days. Results In Group 1 (flowable composites) and Group 3 (Zirconomer), a statistically significant difference in terms of reduced postoperative sensitivity was seen after three and seven days. However, a significant reduction in postoperative sensitivity was seen after three, seven, and 21 days in Group 2 (RMGIC). Conclusion In this study, RMGIC showed reduced postoperative sensitivity after restoring NCCLs compared to Zirconomer and flowable composites. Compared with flowable composites and Zirconomer, RMGIC showed better clinical performance in terms of less postoperative sensitivity after restoring NCCLs.
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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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Adhesion of Flowable Resin Composites in Simulated Wedge-Shaped Cervical Lesions: An In Vitro Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11073173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The resin composite restoration of non-carious cervical lesions (NCCLs) still faces some drawbacks mostly related to the quality of the marginal seal. This study attempts to evaluate the adhesive capacities of two flowable and two conventional hybrid resin composite restorations of NCCLs having two types of cervical margins. Our null hypothesis assumes the same adhesive behavior of different materials. The relative composition of dental–restoration structures was also measured. Thus, restored wedge-shaped cervical cavities were realized on both the buccal and oral surfaces of extracted teeth. After immersion in dye solution, sectioning of the teeth was performed. We proposed an optical microscopy method to quantify the dye penetration along the restoration–tooth interface and scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX) to evaluate the quality of the peripheral seal. The data obtained revealed an amount of dentinal microleakage for all tested materials, despite the favorable results of the restoration peripheral seal. Therefore, data from this study failed to reject the null hypothesis. The adhesion is not influenced by the position of cervical margins. The SEM revealed occasional disruptions of the adhesive interface. EDX sustains the qualitative compositions as provided by the manufacturers. Conclusions: The four experimental composites are recommended to restore NCCLs in clinic.
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Pai S, Bhat V, Patil V, Naik N, Awasthi S, Nayak N. Numerical Three-dimensional Finite Element Modeling of Cavity Shape and Optimal Material Selection by Analysis of Stress Distribution on Class V Cavities of Mandibular Premolars. J Int Soc Prev Community Dent 2020; 10:279-285. [PMID: 32802773 PMCID: PMC7402252 DOI: 10.4103/jispcd.jispcd_75_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: Adhesive restoration does not depend primarily on the configuration of the shape of the cavity. Under varying loading conditions, it is essential to know the stress concentration and load transfer mechanism for distinct cavity shapes. The aim of this study was to evaluate and compare the biomechanical characteristics of various cavity shapes, namely oval, elliptical, trapezoidal, and rectangular shapes of class V cavities on mandibular premolars restored with amalgam, glass ionomer cement, and Cention N using three-dimensional (3D) finite element analysis. Materials and Methods: A 3D prototype of a mandibular premolar was generated by Digital Imaging and Communications in Medicine (DICOM) images obtained from the cone beam computed tomography and imported to 3D modeling software tool, SpaceClaim. The four distinct load magnitudes of 100, 150, 200, and 250N were applied as a pressure load perpendicular to the lingual plane of the lingual cusp of the occlusal surface (normal load) and at 45° to same (oblique load). The stress distribution patterns and the maximum von Mises stresses were analyzed and compared. Results: The occlusal stresses were distributed from the force loading point in an approximate actinomorphic pattern, and when the force load was close to the margin, the stress was much greater. Conclusion: Ovoid cavity showed lesser stress concentration and deformation for each of the tested restorative material.
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Affiliation(s)
- Swathi Pai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal, Karnataka, India
| | - Vishal Bhat
- Department of Pharmacology, Melaka Manipal Medical College, Manipal, Karnataka, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Swetank Awasthi
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nithin Nayak
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Du JK, Wu JH, Chen PH, Ho PS, Chen KK. Influence of cavity depth and restoration of non-carious cervical root lesions on strain distribution from various loading sites. BMC Oral Health 2020; 20:98. [PMID: 32264864 PMCID: PMC7140390 DOI: 10.1186/s12903-020-01083-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background We aimed to investigate the load-induced strain variation in teeth with unrestored and resin-based composite restored non-carious cervical lesions (NCCLs). Methods Twelve extracted premolars were provided for measuring buccal-side root NCCLs. Strain gauges were fixed at four measuring sites of each tooth, two at the buccal surface and two at the lingual surface. NCCLs were prepared with occlusal margins at the cemento-enamel junction. A static 9-kg load was applied at seven occlusal loading points: buccal cusp tip (BC), inner inclination of the BC, lingual cusp tip (LC), inner inclination of the LC, center of the mesial marginal ridge or distal marginal ridge, and center of the central groove. The strain was detected at each site in teeth with NCCL depths of 0 (control), 0.5, 1.0, and 1.5 mm. Each NCCL was restored using an adhesive composite resin, and the strains were re-measured. Results The strains at the NCCL occlusal and gingival margins decreased with increasing defect depths, and the effect was significant when the depth of the defect was 1.5 mm. Loading on the buccal and lingual cusps induced prominent strain variation. The strains at all depth distribution recovered to nearly intact conditions when the NCCLs were restored. Conclusions NCCLs at 1.5 mm depth are detrimental, but they can be restored using resin composites. Clinical significance The existence of NCCLs should not be ignored. The depth of the NCCL may affect the progression of the lesion. Resin composite restoration is an appropriate method for preventing persistent NCCL deterioration.
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Affiliation(s)
- Je-Kang Du
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Ju-Hui Wu
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.,Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Ker-Kong Chen
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan. .,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
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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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Evaluation of Three Esthetic Restorative Materials Used for Carious or Noncarious Cervical Lesion Restoration. JOURNAL OF INTERDISCIPLINARY MEDICINE 2019. [DOI: 10.2478/jim-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: Cervical lesions appear on the cervical surface of the lingual or buccal side of the tooth and are classified into carious and non-carious lesions.
Aim: The present study evaluates the performance of three different types of aesthetic restorative materials, used for the restoration of carious or non-carious cervical lesions.
Materials and methods: The study comprised 195 cervical lesions in 45 patients. The restorations were carried out for non-carious cervical lesions in 34.62% of the cases, for primary carious lesions in 40.00% of the cases, and to replace a previous restoration in 25.38% of the cases. The restorations were evaluated at 2 weeks (the reference line), and then at 1 and 2 years after placement. The following have been assessed: restoration retention, color harmonization, surface texture, margin discoloration, anatomical contour, margin integrity, and the presence of secondary caries. The characteristics were registered in conformity with the modified USPHS criteria.
Results: At the one-year evaluation, we noticed the loss of 12 restorations, and after 2 years, the loss of 19 restorations. The results showed significant differences between restorative materials regarding color, margin adaptation, margin coloration, surface texture, as well as criteria regarding the anatomical contour (p <0.05).
Conclusions: The evaluation of the success of restorative material retention must consider the location of the cervical lesion. A successful treatment depends particularly on a full understanding of the factors that caused the lesions and on the method of their treatment.
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Roman A, Stratul SI, Rusu D, Boariu M, Soanca A, Balazsi R, Suciu M, Moldovan M, Bulboacă AE. Investigations on the adhesion of new composites for restoring cervical lesions using energy dispersive X-ray analysis and scanning electron microscopy. Sci Rep 2019; 9:9853. [PMID: 31285523 PMCID: PMC6614361 DOI: 10.1038/s41598-019-46340-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/25/2019] [Indexed: 11/08/2022] Open
Abstract
Restoration of noncarious cervical lesions with resin composites is one of the treatment options, but the retention of the restorations located at the crown-root junction is still a cause of clinical concern. The aim of this study was to evaluate the adhesive properties of three experimental resin composites and two commercial materials used to restore cavities prepared on extracted teeth as well as to determine the relative elemental composition of these materials. We tested the null hypothesis, which considered that the adhesive behaviours of different resin composites did not differ. The microleakage test using tracers showed that all tested materials exhibited some degree of dentinal microleakage, although they all had good dentinal adhesion. The results failed to reject the null hypothesis. The scanning electron microscopy revealed completely adapted adhesive interfaces underneath the restorations along with well-developed hybrid layers depending on the adhesive system. Energy dispersive X-ray analysis analyses showed that the restorative materials have similar chemical compositions, with some differences between the samples from the same material. The results support the implementation of experimental resins in clinical settings.
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Affiliation(s)
- Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania
| | - Stefan Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Marius Boariu
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Andrada Soanca
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania.
| | - Robert Balazsi
- Department of Psychology, Babes-Bolyai University, 7 Sindicatelor St, 400029, Cluj-Napoca, Romania
| | - Maria Suciu
- Electron Microscopy Integrated Laboratory (LIME), National Institute for Research and Development of Isotopic and Molecular Technologies, INCDTIM, 67-103 Donath St., 400293, Cluj-Napoca, Romania
- Department of Molecular Biology and Biotechnologies, Faculty of Biology and Geology, Babeş-Bolyai University, 5-7 Clinicilor St., 400006, Cluj-Napoca, Romania
| | - Mărioara Moldovan
- Raluca Ripan Institute for Research in Chemistry, Babes-Bolyai University, 30 Fântânele St., 400294, Cluj-Napoca, Romania
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, 4-6 Victor Babeș St., Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania
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Composite vs. ionomer vs. mixed restoration of wedge-shaped dental cervical lesions: Marginal quality relative to eccentric occlusal loading. J Mech Behav Biomed Mater 2019; 91:309-314. [PMID: 30616202 DOI: 10.1016/j.jmbbm.2018.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 11/21/2022]
Abstract
Dental cervical restorations may be impacted by resultants of occlusal loads that may have already contributed to the development of the lesion and should rely on materials' favorable properties to bear the stresses. The marginal quality of cervical restorations made with materials of different moduli of elasticity in essence, isolated, or in combination, was evaluated relative to eccentric occlusal loading. Cervical wedge-shaped cavities, prepared in extracted premolars, were restored with a composite resin (CR), a restorative ionomer (GIC), or the composite in combination with a lining ionomer (Mixed restoration: M). Half of the teeth in each group were subjected to eccentric occlusal loading (eol; 150 N / 106 cycles / 2.5 Hz; CReol / GICeol / Meol, n = 10), and the others were stored in 37 °C distilled water (Control: c; CRc / GICc / Mc, n = 10). A fluorescein-modified adhesive favored delimitation of formed gaps, which were evaluated by confocal laser scanning microscopy regarding their presence, location related to the cavity walls, and width and depth (µm), at a 5% significance level. From a comprehensive perspective, neither the loading nor the materials were significantly associated with the qualitative response variables or exerted any influence over the quantitative variables. More specifically, the use of the different materials was significantly associated with the frequency of gaps exclusively when loading was applied (Chi-square test, p = 0.029, CR > M > GIC). Though the marginal quality of cervical restorations may not be influenced by eccentric occlusal loading or the use of different materials, even in association in general, the unfavorable aspects of the use of the composite may be relevant, particularly in face of the existence of eccentric occlusal loads.
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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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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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Vandana KL, Deepti M, Shaimaa M, Naveen K, Rajendra D. A finite element study to determine the occurrence of abfraction and displacement due to various occlusal forces and with different alveolar bone height. J Indian Soc Periodontol 2016; 20:12-6. [PMID: 27041831 PMCID: PMC4795125 DOI: 10.4103/0972-124x.168484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Noncarious cervical lesions (NCCLs) are rarely described in the periodontal literature, perhaps because no direct link between NCCLs and periodontal lesions has been demonstrated. Aim: The aim of this study is to determine the stress and displacement produced in the tooth at different bone levels under different occlusal load using finite element model (FEM) study. Materials and Methods: Four FEMs of maxillary incisor were designed consisting of the tooth, pulp, periodontal ligament, and alveolar bone at the various level of bone height (25%, 50%, and 75%). Different occlusal load (5 kg, 15 kg, 24 kg, and 29 kg) at an angle of 50° to the long axis of the tooth was applied on the palatal surface at the level of middle third of the crown. All the models were assumed to be isotropic, linear and elastic, and the analysis was performed on a Pentium IV processor computer using the ANSYS software. Results: The maximum stress in the tooth was seen in the cervical region and to a greater extent at the apex for all models. The maximum tooth displacement for all the occlusal loads applied in this study was at the incisal edge with the minimum tooth displacement at the cervical third of the root which shifted apically with the reduction of alveolar bone support. Conclusion: The cumulative effect of increased stress and displacement at the cervical region of the tooth would result in abfraction as the age advances along with other wasting diseases.
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Affiliation(s)
| | - Mittal Deepti
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Muneer Shaimaa
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Karnath Naveen
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Desai Rajendra
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
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Pereira FA, Zeola LF, de Almeida Milito G, Reis BR, Pereira RD, Soares PV. Restorative material and loading type influence on the biomechanical behavior of wedge shaped cervical lesions. Clin Oral Investig 2015; 20:433-41. [PMID: 26159778 DOI: 10.1007/s00784-015-1523-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the influence of restorative materials used on the rehabilitation of MOD cavities and loading type, on biomechanical behavior of wedge-shaped (WS) lesions in endodontically treated maxillary premolars. The investigation was conducted by 3D finite element analysis (FEA) and strain gauge test. MATERIALS AND METHODS Six models were generated, with MOD cavities and endodontic treatment: A (MOD amalgam restoration), R (MOD composite restoration), AL (A + cervical lesion (L)), RL, ALR (A + cervical lesion restored with composite (LR)), and RLR. Each model underwent two compressive loading (100N): axial and oblique-45° angle to the long axis on the buccal cusp. The models were analyzed by von Mises criteria. For strain gauge test, 14 standardized maxillary premolars were treated according to the groups described for FEA. Two strain gauges were bonded on each sample submitted to compressive loading in a mechanical testing machine. RESULTS A presented higher stress concentration and strain values than R. Oblique loading promoted highest stress concentration and strain rates for all groups. ALR and RLR presented similar stress-strain distribution pattern when compared to A and R. CONCLUSION The interaction between MOD cavity restored with amalgam and oblique loading propitiated the highest stress concentration and strain values on cervical region and WS lesion. CLINICAL RELEVANCE The MOD cavity restored with composite resin is a better option than amalgam to improve the biomechanical behavior of wedge-shaped lesion, avoiding dental failure. In addition, the occlusal interferences must be removed, allowing homogeneous contact distribution and preventing WS lesion progression.
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Affiliation(s)
- Fabrícia Araújo Pereira
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Livia Fávaro Zeola
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Giovana de Almeida Milito
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Bruno Rodrigues Reis
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Rodrigo Dantas Pereira
- Department of Dentistry, United Universities of the North of Minas, Avenida Osmane Barbosa, 11111, Montes Claros, Minas Gerais, 39404-549, Brazil
| | - Paulo Vinícius Soares
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil.
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Fahl N. Direct-Indirect Class V Restorations: A Novel Approach for Treating Noncarious Cervical Lesions. J ESTHET RESTOR DENT 2015; 27:267-84. [DOI: 10.1111/jerd.12151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Farias DCS, Lopes GC, Baratieri LN. Two-year clinical performance of a two-step etch-and-rinse adhesive in non-carious cervical lesions. Clin Oral Investig 2015; 19:1867-74. [PMID: 25609033 DOI: 10.1007/s00784-015-1399-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 01/02/2015] [Indexed: 11/28/2022]
Affiliation(s)
- David Cardoso Sandes Farias
- School of Dentistry, Department of Operative Dentistry, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima - Trindade, room 138, 88040-900, Florianópolis, Santa Catarina, Brazil.
| | - Guilherme Carpena Lopes
- School of Dentistry, Department of Operative Dentistry, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima - Trindade, room 138, 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Luiz Narciso Baratieri
- School of Dentistry, Department of Operative Dentistry, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima - Trindade, room 138, 88040-900, Florianópolis, Santa Catarina, Brazil
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19
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Veitz-Keenan A, Spivakovsky S, Lo D, Furnari W, ElSayed H. Adhesive restorations for the treatment of dental non-carious cervical lesions. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Analia Veitz-Keenan
- New York University College of Dentistry; Oral Maxillofacial Pathology, Radiology and Medicine; 345 East 24th Street NYC 1st floor New York USA 10010
| | - Silvia Spivakovsky
- New York University College of Dentistry; Oral Maxillofacial Pathology, Radiology and Medicine; 345 East 24th Street NYC 1st floor New York USA 10010
| | - Danny Lo
- New York University College of Dentistry; Oral Maxillofacial Pathology, Radiology and Medicine; 345 East 24th Street NYC 1st floor New York USA 10010
| | - Winnie Furnari
- College of Dentistry, New York University; Dental Hygiene Program; 345 East 24th Street New York New York USA
| | - Hend ElSayed
- National Research Center (NRC); Orthodontics & Paediatric Dentistry; National Research Center. Oro-Dental division, Elbuhouth Street Giza Egypt
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20
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Oginni AO, Adeleke AA. Comparison of pattern of failure of resin composite restorations in non-carious cervical lesions with and without occlusal wear facets. J Dent 2014; 42:824-30. [DOI: 10.1016/j.jdent.2014.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/02/2014] [Accepted: 04/05/2014] [Indexed: 10/25/2022] Open
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Abstract
Abfraction (AF) is the pathological loss of tooth substance caused by biomechanical loading forces that result in flexure and failure of enamel and dentin at a location away from the loading. The theory of AF is based primarily on engineering analyses that demonstrate theoretical stress concentration at the cervical areas of the teeth. However, the theory is not yet proven and there are explanations against it. AF lesions present primarily at the cervical region of the dentition and are typically wedge-shaped, with sharp internal and external line angles. Diagnosis of AF plays a very important role in the management of patients. The aim of the present narrative review is to comprehensively discuss the historical, etiopathogenetic, clinical, and diagnostic and treatment aspects of AF.
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Affiliation(s)
- Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, India
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22
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Stress analysis of occlusal forces in canine teeth and their role in the development of non-carious cervical lesions: abfraction. Int J Dent 2012; 2012:234845. [PMID: 22919387 PMCID: PMC3419420 DOI: 10.1155/2012/234845] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Revised: 06/05/2012] [Accepted: 06/10/2012] [Indexed: 11/23/2022] Open
Abstract
Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by μCT machine (Skyscan, Belgium). These μCT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK) to create a three-dimensional finite element model. A 100 N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200 N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management.
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23
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NCCL or AAE? J Am Dent Assoc 2012; 143:556-7; author reply 557-8. [DOI: 10.14219/jada.archive.2012.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Restoration of noncarious tooth defects by dentists in The Dental Practice-Based Research Network. J Am Dent Assoc 2012; 142:1368-75. [PMID: 22130438 DOI: 10.14219/jada.archive.2011.0138] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a study to quantify the reasons for restoring noncarious tooth defects (NCTDs) by dentists in The Dental Practice-Based Research Network (DPBRN) and to assess the tooth, patient and dentist characteristics associated with those reasons. METHODS Data were collected by 178 DPBRN dentists regarding the placement of 1,301 consecutive restorations owing to NCTDs. Information gathered included the main clinical reason, other than dental caries, for restoration of previously unrestored permanent tooth surfaces; characteristics of patients who received treatment; dentists' and dental practices' characteristics; teeth and surfaces restored; and restorative materials used. RESULTS Dentists most often placed restorations to treat lesions caused by abrasion, abfraction or erosion (AAE) (46 percent) and tooth fracture (31 percent). Patients 41 years or older received restorations mainly because of AAE (P < .001). Premolars and anterior teeth were restored mostly owing to AAE; molars were restored mostly owing to tooth fracture (P < .001). Dentists used directly placed resin-based composite (RBC) largely to restore AAE lesions and fractured teeth (P < .001). CONCLUSIONS Among DPBRN practices, AAE and tooth fracture were the main reasons for restoring noncarious tooth surfaces. Pre-molars and anterior teeth of patients 41 years and older are most likely to receive restorations owing to AAE; molars are most likely to receive restorations owing to tooth fracture. Dentists restored both types of NCTDs most often with RBC.
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25
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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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26
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Andreaus U, Colloca M, Iacoviello D. Coupling image processing and stress analysis for damage identification in a human premolar tooth. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2011; 103:61-73. [PMID: 20638150 DOI: 10.1016/j.cmpb.2010.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 06/10/2010] [Accepted: 06/17/2010] [Indexed: 05/29/2023]
Abstract
Non-carious cervical lesions are characterized by the loss of dental hard tissue at the cement-enamel junction (CEJ). Exceeding stresses are therefore generated in the cervical region of the tooth that cause disruption of the bonds between the hydroxyapatite crystals, leading to crack formation and eventual loss of enamel and the underlying dentine. Damage identification was performed by image analysis techniques and allowed to quantitatively assess changes in teeth. A computerized two-step procedure was generated and applied to the first left maxillary human premolar. In the first step, dental images were digitally processed by a segmentation method in order to identify the damage. The considered morphological properties were the enamel thickness and total area, the number of fragments in which the enamel is chipped. The information retrieved by the data processing of the section images allowed to orient the stress investigation toward selected portions of the tooth. In the second step, a three-dimensional finite element model based on CT images of both the tooth and the periodontal ligament was employed to compare the changes occurring in the stress distributions in normal occlusion and malocclusion. The stress states were analyzed exclusively in the critical zones designated in the first step. The risk of failure at the CEJ and of crack initiation at the dentin-enamel junction through the quantification of first and third principal stresses, von Mises stress, and normal and tangential stresses, were also estimated.
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Affiliation(s)
- U Andreaus
- "Sapienza" University of Rome, Department of Structural and Geotechnical Engineering, Italy.
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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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28
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REIS ALESSANDRA, HIGASHI CRISTIAN, LOGUERCIO ALESSANDRODOURADO. Re-anatomization of Anterior Eroded Teeth by Stratification with Direct Composite Resin. J ESTHET RESTOR DENT 2009; 21:304-16. [DOI: 10.1111/j.1708-8240.2009.00281.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Wood ID, Kassir ASA, Brunton PA. Effect of Lateral Excursive Movements on the Progression of Abfraction Lesions. Oper Dent 2009; 34:273-9. [DOI: 10.2341/08-100] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
The results of this randomized controlled trial have direct relevance to clinical practice and provide some evidence that occlusal adjustment to prevent further progression of abfraction lesions cannot be supported currently.
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30
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Wood I, Jawad Z, Paisley C, Brunton P. Non-carious cervical tooth surface loss: a literature review. J Dent 2008; 36:759-66. [PMID: 18656296 DOI: 10.1016/j.jdent.2008.06.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Revised: 06/11/2008] [Accepted: 06/11/2008] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES As the population ages and teeth are increasingly retained for life the incidence of non-carious cervical tooth surface loss is increasing but little is understood about the aetiology and management of these lesions. The purpose of this literature review was to review and critically appraise the literature as it relates to the prevalence, aetiology and treatment of non-carious cervical tooth surface loss. SEARCH STRATEGY An electronic search, using OVID electronic bibliographic databases was performed with no restriction on the language of publication. CONCLUSIONS Despite the paucity of research into non-carious cervical tooth surface loss it was concluded that the number and size of lesions increases with age, lesions are more common on the facial aspects of teeth and the formation of lesions appears to be multi-factorial with lesion shape not being a predictor of aetiology. It was also concluded that the value of restoring these lesions, where indicated, is unclear and that occlusal adjustment to increase the retention of restorations placed to restore lesions or to halt lesion progression cannot be supported.
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Affiliation(s)
- Ian Wood
- Restorative Dentistry, Manchester University, England, United Kingdom
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31
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Celik C, Ozgünaltay G, Attar N. Clinical Evaluation of Flowable Resins in Non-carious Cervical Lesions: Two-year Results. Oper Dent 2007; 32:313-21. [PMID: 17695602 DOI: 10.2341/06-93] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Different types of flowable resin materials placed in non-carious cervical lesions demonstrated acceptable clinical performance, except for the retention rates of Dyract Flow restorations, after two years.
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Affiliation(s)
- Cigdem Celik
- Baskent University, School of Dentistry, Department of Conservative Dentistry, Ankara, Turkey.
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32
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Ballal S, Seshadri S, Nandini S, Kandaswamy D. Management of class V lesions based on the etiology. J Conserv Dent 2007. [DOI: 10.4103/0972-0707.43038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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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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Onal B, Pamir T. The two-year clinical performance of esthetic restorative materials in noncarious cervical lesions. J Am Dent Assoc 2005; 136:1547-55. [PMID: 16329418 DOI: 10.14219/jada.archive.2005.0085] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Materials used in restoration of cervical lesions include resin-modified glass ionomer cements, polyacid-modified resin-based composites and resin-based composites. In this study, the authors evaluated the clinical performance of these materials over a two-year period. METHODS Thirty patients were enrolled in this study. The authors placed in these patients 130 restorations, 24 of which were Vitremer (3M Dental Products, St. Paul, Minn.), 38 were F2000 Compomer (3M Dental Products), 46 were Dyract AP (Dentsply DeTrey, Konstanz, Germany) and 22 were Valux Plus (3M Dental Products). Enamel margins were not beveled, and no mechanical retention was placed. Two independent, calibrated examiners evaluated the restorations baseline and at one and two years after placement using modified U.S. Public Health Service criteria. RESULTS Retention rates at the end of two years were 100 percent for Vitremer, 67 percent for F2000 Compomer, 68 percent for Dyract AP and 70 percent for Valux Plus. The retention rate of Vitremer was significantly higher than that of the others (P < .05). In other categories, however, Valux Plus had the most favorable performance (P < .05). No secondary caries was detected around any restoration. CONCLUSION Vitremer, with its high retention rate, seems to be the most appropriate material for restoration of noncarious cervical lesions, though it does not have the esthetic properties of resin-based composites. All materials used in this study were in need of improvements. CLINICAL IMPLICATIONS Resin-modified glass ionomer cement, polyacid-modified resin-based composite and resin-based composite behaved differently in the restoration of noncarious cervical lesions. Therefore, clinicians should take factors such as esthetic needs and localization into account in selecting materials for such restorations.
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Affiliation(s)
- Banu Onal
- Ege University, School of Dentistry, Department of Restorative Dentistry and Endodontics, Bornova-Izmir, Turkey
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35
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de Melo FV, Belli R, Monteiro S, Vieira LCC. Esthetic noncarious Class V restorations: a case report. J ESTHET RESTOR DENT 2005; 17:275-84. [PMID: 16225790 DOI: 10.1111/j.1708-8240.2005.tb00130.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED When restoring anterior and posterior teeth affected by noncarious cervical lesions, many clinicians overlook the etiologic factors responsible for the lesions' development, resulting in frequent restorative failures. The treatment approach for noncarious cervical lesions must not be based only on restorative procedures since a variety of causative and aggravating factors are related to their formation. This article discusses a treatment protocol and techniques for the restoration of noncarious Class V lesions and presents a clinical case in which esthetic restorations are achieved. CLINICAL SIGNIFICANCE Treatment options for noncarious Class V lesions can range from simply eliminating the causative factors of the lesions and regularly monitoring their progression to specific restorative procedures. Resin composites are the best materials for restoring cervical defects owing to their bonding ability, physical properties, and esthetic potential. A straightforward technique for the successful restoration of noncarious Class V lesions is presented.
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Borcic J, Anic I, Smojver I, Catic A, Miletic I, Ribaric SP. 3D finite element model and cervical lesion formation in normal occlusion and in malocclusion. J Oral Rehabil 2005; 32:504-10. [PMID: 15975130 DOI: 10.1111/j.1365-2842.2005.01455.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to develop a three-dimensional (3D) finite element model (FEM) of the first maxillary premolar in order to compare the stress profiles in the buccal and palatal cervical regions. The 3D geometry of the tooth was reconstructed, the solid model was transferred into a finite element program where a 3D mesh was created, and the stress distribution analysis was performed. Two typical cases have been considered: the tooth under normal occlusion (case I) and the tooth under malocclusion (case II). In case I, larger compressive stresses were found in the cervical enamel and dentine. Tensile stresses were found in the fissure system, adjacent area, and at the vestibular surface of the buccal cusp. The peak values for the principal stress ranged from -259 to +2.25 MPa in the cervical areas. In the case II, larger compressive stresses were found in the palato-cervical enamel and dentine. Tensile stresses were found inside the enamel in the fissure system, adjacent area, at the vestibular surface of the buccal cusp, and in the bucco-cervical enamel. The peak values for the principal stress ranged from -501.947 MPa in palatal region to +82.4 MPa in the buccal region This study implies a role of occlusal forces in development of non-carious lesions. In the case of malocclusion, tensile stresses generated on the cervical areas were higher compared with the stresses generated in the case of normal occlusion and it is probably capable of producing non-carious cervical lesion.
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Affiliation(s)
- J Borcic
- School of Dental Medicine, University of Rijeka, Rijeka, Croatia.
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37
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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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Hallmon WW, Harrel SK. Occlusal analysis, diagnosis and management in the practice of periodontics. Periodontol 2000 2004; 34:151-64. [PMID: 14717861 DOI: 10.1046/j.0906-6713.2003.003430.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- William W Hallmon
- Department of Periodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, Texas, USA
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Terry DA, McGuire MK, McLaren E, Fulton R, Swift EJ. Perioesthetic approach to the diagnosis and treatment of carious and noncarious cervical lesions: Part I. J ESTHET RESTOR DENT 2004; 15:217-32. [PMID: 12948216 DOI: 10.1111/j.1708-8240.2003.tb00290.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several factors can contribute to the development of noncarious cervical lesions. Therefore, these lesions can be described and classified according to their primary etiology. Traditionally, most dentists have treated noncarious cervical lesions only with restorative methods, for example, composite resin restorations. However, in many cases, a periodontal or a combined restorative/periodontal approach provides a better esthetic and functional result. In part I of this two-part report, we provide a review of noncarious cervical lesions and a series of clinical case reports showing surgical techniques used and the importance of the periodontal aspect of lesion management.
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Affiliation(s)
- Douglas A Terry
- Department of Restorative Dentistry and Biomaterials, University of Texas Health Science Center at Houston, Houston, TX, USA.
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40
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Oginni AO, Olusile AO, Udoye CI. Non-carious cervical lesions in a Nigerian population: Abrasion or abfraction? Int Dent J 2003; 53:275-9. [PMID: 14560800 DOI: 10.1111/j.1875-595x.2003.tb00759.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To determine the proportion of non-carious cervical lesions (NCCL) that were either abrasion or abfraction like and to test the validity of the assumption that right-handed patients cause more abrasion on the cervical surfaces of teeth on the left side of the mouth. SETTING Ile-lfe, Southwestern Nigeria. PARTICIPANTS 106 first time patients diagnosed as having any form of NCCL. DESIGN Patients were subjected to intra-oral examination followed by the administration of a questionnaire. The cervical lesions were examined and scored using the tooth wear index designed by Smith & Knight 1984. NCCL was diagnosed as abrasion or abfraction like based on established clinical features plus positive history of possible associated aetiological factors. OUTCOME MEASURES Abrasion and abfraction like lesions. RESULTS Abrasion was the diagnosis in 630 (62.3%) of the 1,012 tooth sites with NCCL that had no associated occlusal surface wear facet. This constituted about two-thirds of the NCCL. Three hundred and eighty two (37.7%) of the NCCL occurred in association with an occlusal surface wear facet and presented the typical wedge shaped defects with sharp margins characteristic of abfraction. These abfraction like lesions constituted about one-third of the NCCL. 50.8% of abrasive NCCL in right-handed brushers were located on the left side of the mouth. CONCLUSIONS About one-third of NCCL in the present study presents an abfraction component, and two-thirds abrasion. Although, right-handed brushers had more severe lesions on the opposite side of the mouth, the difference was not statistically significant.
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Affiliation(s)
- A O Oginni
- Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
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Terry DA, McGuire MK, McLaren E, Fulton R, Swift EJ. Perioesthetic Approach to the Diagnosis and Treatment of Carious and Noncarious Cervical Lesions: Part II. J ESTHET RESTOR DENT 2003; 15:284-96. [PMID: 14620659 DOI: 10.1111/j.1708-8240.2003.tb00299.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Several classes of tooth-colored materials are available for restoring carious and noncarious cervical lesions. Included are the composite resins, which can be bonded into the cervical area to provide predictable form, function, and esthetics. Part I of this two-part report reviewed the etiology of noncarious cervical lesions and provided a series of clinical case reports showing the importance of the periodontal aspect of lesion management. In part II we present information about adhesive preparation design and esthetic restoration of the noncarious cervical lesion. CLINICAL SIGNIFICANCE When used with proper attention to preparation design and restoration placement and finishing, resin composites can be used to successfully restore form, function, and esthetics to defective cervical areas of teeth.
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Affiliation(s)
- Douglas A Terry
- Department of Restorative Dentistry and Biomaterials, University of Texas Health Science Center at Houston, Houston, TX, USA.
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Litonjua LA, Andreana S, Bush PJ, Tobias TS, Cohen RE. Noncarious cervical lesions and abfractions: a re-evaluation. J Am Dent Assoc 2003; 134:845-50. [PMID: 12892441 DOI: 10.14219/jada.archive.2003.0282] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The concept of abfraction is controversial. The authors present the fundamental basis of abfraction and review studies that describe the condition. TYPES OF STUDIES REVIEWED The authors used data on masticatory forces, enamel and dentin properties, as well as stress studies related to abfraction, for background information. They also analyzed the genesis of the abfraction theory, experimental evidence, case presentations, clinical investigations and restorative studies. RESULTS The theory of abfraction is based primarily on engineering analyses that demonstrate theoretical stress concentration at the cervical areas of teeth. While some recent stress studies support earlier findings, others have provided significant deviating information. Few controlled studies exist that demonstrate the relationship between occlusal loading and abfraction lesions. The role of occlusal loading in noncarious cervical lesions (as shown by clinical data) appears to be part of a multifactorial event that may not necessarily follow the proposed classic abfraction mechanism, and other mechanisms or factors may explain cervical restoration failure just as well. CLINICAL IMPLICATIONS There is little direct evidence supporting the theory of abfraction as the primary factor in the formation of noncarious cervical lesions. Controlled clinical trials are necessary to elucidate more fully the etiology of those lesions.
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Affiliation(s)
- Luis A Litonjua
- Department of Periodontics and Endodontics, State University of New York at Buffalo 14214-3008, USA.
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Lee HE, Lin CL, Wang CH, Cheng CH, Chang CH. Stresses at the cervical lesion of maxillary premolar--a finite element investigation. J Dent 2002; 30:283-90. [PMID: 12554108 DOI: 10.1016/s0300-5712(02)00020-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES The objective of this study was to use a three-dimensional (3-D) finite element model to investigate normal stress distribution to substantiate the tooth flexure mechanism. The study also compared the changes in the stresses by different occlusal loading sites and directions. METHODS The 3-D finite element analysis was used. A maxillary premolar was selected to construct the simulation model. The model was constructed step-by-step for convergence and validity. Seven load conditions for various load sites and different directions were simulated to the model. RESULTS The maximal principal stress and minimal principal stress distributions developed within the structures of seven load conditions were output and their stress distributions on z-plane at the vertical midline were shown. The peak tensile stress of the cervical area for various load conditions were compared and listed. CONCLUSIONS This study has shown that the presence of tensile stresses in the cervical region of a maxillary premolar by various loading sites and different directions. The results coincided with the stress-induced theory, hence sustaining it. The relationship of the affected factors of leverage to the development of cervical abfraction lesions, was explored.
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Affiliation(s)
- H E Lee
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuen 1st Road, Kaohsiung 80708, Taiwan
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Knight JS, Sneed WD. Restoration of extensive erosion areas using an indirect composite technique. JOURNAL OF ESTHETIC DENTISTRY 2001; 12:5-9. [PMID: 11323834 DOI: 10.1111/j.1708-8240.2000.tb00192.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cervical erosion defects, particularly those of extensive size that are located in an area where control of the operative field is difficult, can present a significant restorative challenge. This article describes an indirect restorative technique to solve this problem. Following tooth preparation, an indirect restoration is luted to the tooth and the margins are finished and polished. Using an indirect technique minimizes operative field isolation time and the total chairside time required to restore the tooth. Clinical cases are presented to illustrate this technique.
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Affiliation(s)
- J S Knight
- Division of Operative Dentistry, MUSC College of Dental Medicine, Charleston, South Carolina, USA
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Telles D, Pegoraro LF, Pereira JC. Prevalence of noncarious cervical lesions and their relation to occlusal aspects: a clinical study. JOURNAL OF ESTHETIC DENTISTRY 2001; 12:10-5. [PMID: 11323828 DOI: 10.1111/j.1708-8240.2000.tb00193.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to assess noncarious cervical lesions in young patients and to establish a possible relation with occlusal aspects. MATERIALS AND METHODS Forty-eight dental students (28 males; 20 females) between the ages of 16 and 24 years, were investigated to verify the presence of noncarious cervical lesions and their relation to some occlusal aspects. The assessment involved a questionnaire, clinical examinations, and model analysis. RESULTS The results indicated that the lower first molars (21.3%), the upper first molars (16.0%), the upper first premolars (12.8%), the lower first premolars (11.7%), and the lower second premolars (11.7%) were the teeth most affected by the lesions. Age was a significant factor with respect to the presence of lesions; the students with noncarious cervical lesions were older than the students who showed no lesions. Among the 79 teeth exhibiting lesions, 62 (78.5%) showed wear facets. In the group with lesions, the mean, per subject, was 15.0 teeth with wear facets, whereas in the group without lesions the mean was 10.8 teeth with wear facets per subject, suggesting that occlusal stress has some effect on lesion development.
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Affiliation(s)
- D Telles
- Department of Prosthodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil.
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Kuroe T, Itoh H, Caputo AA, Nakahara H. Potential for load-induced cervical stress concentration as a function of periodontal support. JOURNAL OF ESTHETIC DENTISTRY 2000; 11:215-22. [PMID: 10825878 DOI: 10.1111/j.1708-8240.1999.tb00401.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose was to determine, photoelastically, the locations of occlusal load-induced stress concentrations within a maxillary premolar as a function of degree of periodontal support. MATERIALS AND METHODS Composite three-dimensional models of a maxillary first premolar were fabricated for quasi-three-dimensional photoelastic stress analysis. Individual materials were used to model enamel, dentin, periodontal ligament, and alveolar bone. Three levels of periodontal support reduction (0%, 20%, 25%) were simulated by varying the socket depth. Vertical loads of 10 lb were applied to: (1) tip of buccal cusp, (2) tip of lingual cusp, and (3) center of occlusal surface. The resulting stresses were monitored and recorded photographically in the field of a circular polariscope arrangement. RESULTS Cuspal loading concentrated stress around the cervical region below the loaded cusp, being highest under buccal cusp loading. The location of the stress concentration shifted apically as periodontal support diminished. CLINICAL SIGNIFICANCE Observed cervical stress concentration corresponded well to the common location of abfractions seen in clinical situations. Since the location of cervical stress concentration varied with occlusal conditions, occurrence of abfractions must be highly dependent upon each patient's occlusion. Periodontal support reduction shifted the location of highest stress away from the cementoenamel junction. Therefore, abfractions are less likely to occur on periodontally compromised teeth compared to stable teeth.
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Affiliation(s)
- T Kuroe
- Division of Advanced Prosthodontics, Biomaterials Science, and Hospital Dentistry, UCLA School of Dentistry, USA
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Abstract
Erosion and abrasion have been widely reported as causes of non-carious cervical lesions (NCCL). However, more recently, tooth flexure has been implicated in the formation of these lesions generating renewed interest in the pathogenesis of the non-carious loss of cervical tooth substance. This paper considers the causes of erosion and abrasion, related to modern lifestyles, and reviews the literature concerning tooth flexure as a cause of NCCL. A description of different types of NCCL is given, as an aid to determining the aetiology, yet at the same time accepting that the causation and pathogenesis of NCCL is probably multi-factorial resulting in many different clinical presentations. Consideration is given to the indications for treatment of NCCL and to the selection of materials for restoring such defects.
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Affiliation(s)
- K L Osborne-Smith
- Department of Restorative Dentistry, University Dental Hospital of Manchester, UK
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Osborne-Smith KL, Burke FJ, Farlane TM, Wilson NH. Effect of restored and unrestored non-carious cervical lesions on the fracture resistance of previously restored maxillary premolar teeth. J Dent 1998; 26:427-33. [PMID: 9699433 DOI: 10.1016/s0300-5712(97)00029-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The effect of non-carious cervical lesions (NCCL) on tooth fracture resistance has not previously been investigated. The aims of this in vitro study were to examine the fracture resistance of a group of extracted maxillary premolar teeth with mesio-occlusal-distal (MOD) restorations of amalgam, and restored or unrestored simulated NCCL. METHOD Forty sound maxillary, premolar teeth were divided at random into four groups, each of 10 teeth, which were fixed crown uppermost and long axis vertical in stainless steel moulds. Groups 1,2,3 and 4 were prepared with standardized parallel-sided MOD cavities, then restored with amalgam. Groups 1, 2 and 3 were further prepared with standardized NCCL. The NCCL in Group 1 were restored using a resin-modified polyalkenoate (glass-ionomer) cement, and the NCCL in Group 2 were restored with an adhesive composite resin system. The NCCL in Group 3 were left unrestored. The specimens were loaded compressively at 1 mm min-1 using a universal testing machine. RESULTS Mean fracture loads (KN) of 1.08, 1.03, 0.98 and 1.14, respectively, were recorded for Groups 1, 2, 3 and 4. Two-way ANOVA and Scheffe's Multiple Range Test showed no statistically significant difference between the groups. CONCLUSIONS It is concluded that the presence of a standardized NCCL in an extracted maxillary premolar tooth does not reduce the fracture resistance of the tooth when loaded compressively at 1 mm min-1. The restoration of NCCL with the materials tested did not result in an increase in the fracture resistance of the previously restored premolar teeth, when loaded compressively at 1 mm min-1.
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Lyttle HA, Sidhu N, Smyth B. A study of the classification and treatment of noncarious cervical lesions by general practitioners. J Prosthet Dent 1998; 79:342-6. [PMID: 9553890 DOI: 10.1016/s0022-3913(98)70248-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE This study presented a survey to determine what general practitioners in Nova Scotia perceived to be the cause of noncarious cervical lesions, and to ascertain their most frequent method of treatment. METHODS The survey was completed by 63% of the 343 dentists polled. RESULTS Ninety-four percent classified the lesion as abrasion, and 66% rated toothbrushing as the most likely cause. Treatment methods were varied, with no clear preference. CONCLUSION The most frequently used restorative materials were GI/composites (29%) and composites (27%). The results of the survey suggest that treatment provided for noncarious cervical lesions may not be based on the correct diagnosis.
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Affiliation(s)
- H A Lyttle
- Department of Applied Oral Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Lambrechts P, Van Meerbeek B, Perdigão J, Gladys S, Braem M, Vanherle G. Restorative therapy for erosive lesions. Eur J Oral Sci 1996; 104:229-40. [PMID: 8804891 DOI: 10.1111/j.1600-0722.1996.tb00072.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
More needs to be learned about the etiology of erosion lesions before they can be accurately diagnosed, confidently treated and, more importantly, prevented. The treatment is dependent on the location and the degree of erosion. The decision to treat an erosion lesion should be based on careful consideration of the etiology and progression of the condition. Reasons for restoring noncarious enamel/dentin lesions are discussed and various therapeutic measures are provided. Preventive and restorative therapeutic measures for noncarious abrasive/ erosive lesions are proposed such as: a change of dietary or behavior patterns; application of desensitization products; intensive fluoride therapy with or without iontophoresis; brushing with desensitizing dentifrices; adhesive penetration with dentin bonding agents; glass ionomers and compomers; resin composites; composite or porcelain veneers; crown and bridge work; occlusal adjustments and nightguard fabrication if the abfraction factor coincides. The clinical durability of restorative therapy and important clinical factors related to the restoration of multifactorial defects are discussed.
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Affiliation(s)
- P Lambrechts
- BIOMAT, Department of Operative Dentistry and Dental Materials, Catholic University Leuven, Belgium
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