Irreversible loss of hard/tooth tissue by non-bacterial means.
Attrition, Abrasion, Erosion 1778 john hunter. Abfraction 1991
likely to be multi-factoral with each form of toothwear contributing to and exacerbating other forms.
Toothwear management and prevention
identified by; MH, SH, DH. appropriate tx plan can be formulated. (T/B instruction, treat sensitivity, restorations)
mechanical loss of tooth substance by any means other than tooth-to-tooth often secondary to gingival recession.
T/B, I/D cleaning, nail biting, wind instruments, objects held between teeth, orthodontic appliances, pipe smoking/vapes, partial dentures, chewing harsh/abrasive substances, s&s differs depending on aetiology
V shaped grooves at cervical margins, rarely effects enamel- usually cementum into dentine, gingival recession is initiating factor, premolars canines and outstanding teeth are most affected, often unilateral or more severe on one side (may be sensitive), smoothing of surface irregularities, other factors may contribute: erosion.
abrasion management and prevention
DR; pt to show you how they are brushing
bass technique systematic approach,
ETB with pressure sensor and timer
soft-medium bristle toothbrush with small head and round ended filaments
change tb 3/12
not to brush for 1 hour after free sugars/acidic intake
physical wear from tooth to tooth contact
wear and tear, malocclusion, traumatic occlusion, bruxism, masseteric hypertrophy
wear facets on occlusal/incisal surface (dentine maybe visible), worn surfaces match in occlusion, reduction in cusp height, flattening of occlusal plane, shiny amalgams in area of contact, molar concaved, fractured cusps/restorations, pulp recedes-secondary dentine laid down.
Attrition management and prevention
Identify and avoid causative habit, therapy for anxiety, occlusal adjustments, night guard/splint, desensitising agents, restorative work if necessary. bruxism may cause horizontal bone loss (jiggling forces)
loss of hard tissue by a concentration of stresses causing flexion of the tooth on occlusion seperating the enamel rods.
excessive occlusal loading, bruxism, clenching, malocclusion. rapid
abfraction clinical features
dished out areas of enamel, extending to cementum in the cervical region (CEJ), may be sharp V shaped lesions, more frequent on buccal surfaces, often confused with abrasion
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