Abfraction lesions: etiology, diagnosis, and treatment options

Abstract

Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons.

Diagnosis attitudes and restorative practices of non-carious cervical lesions by a group of Brazilian dentists from the state of Rio de Janeiro

“…Aesthetics and sensitivity control have been described as the main indications to restore NCCLs, directly interfering materials' choice [17,18]. Although GIC and RMGIC have some specific characteristics, such as the chemical adherence to enamel and dentin, the fluoride release and consequent anti-cariogenic properties and the low annual failure rates in clinical follow-up [19,20], composite resin is first choice for the vast majority of clinicians.…”

Erosão dentária em paciente atleta: artigo de revisão

“…As lesões são mais frequentes nas regiões cervicais e vestibulares dos dentes e costumam ser mais superficiais. 19 Tabela 3. Escala ordinal utilizada para avaliar a gravidade da erosão dentária nas superfícies vestibular e lingual dos dentes anteriores superiores Grau Descrição 0 Sem mudanças visíveis, estruturas de desenvolvimento permanecem, macromorfologia intacta.…”

JVA, Mastication and Digital Occlusal Analysis in Diagnosis and Treatment of Temporomandibular Disorders

“…All these symptoms are assembled under TMJ pathology [10,[15][16][17][18][19]. In dentistry, there is no other problem that must be managed in a multidisciplinary fashion like TMJ disorders.…”

“…Nowadays, one of the most widely used diagnostic tools in the examination of the pathology of temporomandibular joints is magnetic resonance imaging (MRI) technique [4,11,15]. MRI represents the golden standard among the temporomandibular diagnostic tools [41].…”