Epidemiological evaluation of the multifactorial aetiology of abfractions

Abstract

The purpose of this study was to determine risk indicators for the aetiology of abfractions (cervical wedge-shaped defects) on teeth using dental and medical variables obtained in a population-based sample of the cross-sectional epidemiological 'Study of Health in Pomerania' (SHIP). Medical history, dental, and sociodemographic parameters of 2707 representatively selected subjects 20-59 years of age with more than four natural teeth were checked for associations with the occurrence of abfractions using a two-level logistic regression model on a tooth and a subject level. The estimated prevalence of developing abfractions generally increased with age. The following independent variables were associated with the occurrence of abfractions: buccal recession of the gingiva, odds ratio (OR) = 6.7; occlusal wear facets of scores 1, 2 and 3, OR = 1.5, 1.9, 1.9; tilted teeth, OR = 1.4; inlays, OR = 1.6; toothbrushing behaviour, OR = 1.9 to 2.0 (two and three times a day versus once a day). First premolars had the highest estimated risk for developing abfractions, followed by the second premolars. Maxillary and mandibular teeth behaved similarly in terms of abfractions, with the exception of mandibular canines, which had a much lower estimated risk of incurring abfractions than did maxillary canines. The results of this analysis indicated that abfractions are associated with occlusal factors, like occlusal wear, inlay restorations, altered tooth position and tooth brushing behaviour. This study delivers further evidence for a multifactorial aetiology of abfractions.

Noncarious cervical lesions in occlusion service patients: occlusal aspects and risk factors

“…The research results accept the hypothesis that occlusal factors were associated with the presence of NCLs, and corroborates clinical findings in literature 15,[17][18][19][20] . However, they noted that lower tension forces in lateral movements do not prevent the progression of the lesion.…”

“…This result can be questioned, because even if tensions are lower, if they are not axial loads, the occlusal interference continue acting, promoting the progression of lesions. Occlusal interference in MI and next to nonworking area are risk factors for the development and a greater number of injuries corroborates the literature 18 . It is interesting to emphasize that the adequate anterior guidance is correlated to the absence of lesions, ie, patients without lesions have fewer interferences 17 .…”

The Prevalence, Characteristics and Risk Factors in Non-Carious Cervical Lesion: A Survey on 295 People in Guangzhou Area

“…NCCL incidence was least seen in second molar (0.3%), and the results agree with those of other studies [7,[9][10][11]. However, NCCLs lesions do not present with an equal distribution within a given individual.…”

A qualitative assessment of non‐carious cervical lesions in extracted human teeth

“…31,32 Even when such associations have been strong, occurrences of wedge-shaped NCCLs were found to be associated with both occlusal attrition and corrosion. 7 Furthermore, the finding that NCCLs occur most frequently on buccal surfaces of teeth and rarely on lingual surfaces has been attributed to variation in salivary protection against corrosion at different intra-oral sites rather than occlusal stress.…”