Tooth Wear Flashcards
what are the two broad types of toothwear
normal
pathological
normal tooth wear
normal physiological process that increases with age
associated with normal function
Values of normal varies but estimated at 20 um per annum
pathological tooth wear
when tooth wear puts remaining tooth structure at risk or pulpal health is compromised
Or rate of toothwear is in excess of what is expected at that age
tooth wear resulting in masticatory or aesthetic deficit can also be considered pathological
what are the 4(3) causes of tooth wear
attrition
abrasion
erosion
(abfraction)
definition of attrition
the physiological wearing away of tooth structure as a result of tooth to tooth contact
definition of abrasion
the physical wear of tooth substance through an abnormal mechanical process independent of occlusion
It involves a foreign object repeatedly contacting the tooth
definition of erosion
the loss of tooth surface by a chemical process that does not involve bacterial action
definition of abfraction
the loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth
describe the appearance of attritive lesions
found on the occlusal and incisal contacting surfaces
early appearance is polished facet on cusp or slight flattening of incisal edge
progression sees reduction in cusp height, flattening of occlusal planes and incisors and canines can see shortening of clinical crown
how can you distinguish between attritive and erosive lesions - in some patients
attritive - restorations wear at same rate as tooth surface, so flat surfaces seen
erosive - restorations aren’t affected
where is the most common site of abrasive lesions and why
labial/buccal and cervical regions of canine and premolar teeth due to excessive force when toothbrushing
describe the appearance of an erosive lesion
early - loss of enamelsurface detail making it become flat and smooth
typically lesions are bilateral and concave
later - dentine exposure, cupping of occlusal and incisal surfaces, base of lesion not in contact with opposing tooth
why is staining rare on erosive lesions
acid strips the surface and therefore the stains
name 2 patient groups where palatal erosion may be found
bulimic
alcoholics
describe the theory of abfraction
forces to a tooth result in flexure and failing of enamel and dentine at a location away from the loading (cervical regions).
Results in disruption of the ordered crystalline structure of enamel and dentine by cyclic fatigue
Results in cracks in tooth substance leading to tooth substance ‘chipping’ out
