Treatment of Erosion, Abrasion & Attrition Flashcards
Tooth Wear
Ñ Tooth wear is the general term used for the surface loss of
dental hard tissues from causes other than developmental ones,
dental caries, and trauma.
Ñ Lambrechts et al. in 1989 estimated the normal vertical loss of
enamel resulting from natural wear is about – μm per year
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Classification of tooth wear
(4)
Ñ Attrition
Ñ Abrasion
Ñ Abfraction
Ñ Erosion or corrosion
Attrition as defined in GPT 9 is the
mechanical wear resulting
from mastication or parafunction, limited to contacting surfaces
of the teeth
Attrition is related to the — process
aging
Attrition
Etiology is
multifactorial and is accelerated by extrinsic factors
such as coarse diet, chewing tobacco and snuff, abrasive dust,
parafunctional habits of clenching and bruxism, traumatic
occlusion in the partially edentulous dentition, anterior open
bite, and anterior teeth in edge-to-edge relationship or crossbite.
Consequences of loss of posterior support
Supraeruption was found in –% of unopposed teeth.
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Consequences of loss of posterior support
Mean supraeruption measurement for unopposed teeth
was — mm
1.68
Consequences of loss of posterior support
Passive eruption:
After ten years of remaining
unopposed tooth, recession and root exposure occurred
without occlusal movement of the tooth as in case of
active eruption
Types of Supraeruption:
(3)
Relative wear
Periodontal growth
Active eruption
Relative wear
association with — and is
more prevalent in
increasing age
unopposed mandibular teeth
Periodontal growth
inverse association with attachment
loss. More prevalent in younger patients, in the maxilla, in
premolars, and in females
Active eruption
has an association with attachment loss.
Ó Active eruption increases, the presence of attachment
loss increases, and periodontal growth is reduced.
Ó Alters the C/R ratio, affecting the mechanical
characteristics of the tooth and its behavior under
functional loading
Abrasion as defined in GPT 9 as an
abnormal wearing away of
the tooth substance by some unusual or abnormal mechanical
process independent of mastication and occlusion.
Abrasion
Causative agent:
Foreign object or substance repeatedly
contacting the tooth surface
Abrasion
Site and pattern of the abrasive lesions:
Diagnostic as different
foreign bodies produce different patterns of abrasion
Abrasion
Example:
Overzealous horizontal tooth brushing with an
abrasive dentifrice produces a rounded or V-shaped ditch on the
facial aspects of teeth at the cemento-enamel junction
Clinical presentation of
Abrasion
Most commonly affected teeth:
Canines and premolar
Clinical presentation of
Abrasion
Causative agents:
(5)
1) Improper use of dental floss,
2) chewing tobacco;
3) Biting on hard objects such as
pens, pencils or pipe stems;
opening hair pins with teeth; and
biting fingernails.
4) Abrasion also can be produced
by the clasps of partial dentures.
5) Occupational abrasion:
5) Occupational abrasion:
(3)
a) Tailors – sever thread with their
teeth,
b) Shoemakers and upholsterers -
hold nails between their teeth,
c) Glassblowers and musicians-play
wind instruments
Abfraction is defined in GPT 9 as the
the pathologic loss of hard tooth
substance caused by biomechanical
loading forces; which is the result of
flexure and chemical fatigue
degradation of enamel and/or dentin
at some location distant from the
actual point of loading
Abfraction
Causative agent:
Stress
Abfraction
Stresses that lead to abfractions are transmitted by occlusal loading forces
such as (3)
occlusal interferences,
premature contacts, habits of bruxism
and clenching
Erosion as defined in GPT 9 as the
progressive loss of tooth substance
by chemical processes that do not involve bacterial action, producing
defects that are wedge-shaped depressions often in occlusal, facial
and cervical areas
Erosion
Causative agent:
Acids from external and internal sources
Erosion
Extrinsic factor:
(4)
1) Acidic foods such as citrus fruit, pickle, vinegar (acetic acid),
sucking lemons, fruit juice and carbonated drinks, yogurt, herbal
tea, spicy food.
2) Medicines such as effervescent and chewable vitamin C
preparations46 and hydrochloric acid for achlorhydria,
3) Occupational exposure to acid fumes (sulfuric, hydrochloric, nitric,
and tartaric acids),
4) Swimming in acidic gas-chlorinated pools.
