Abstract
Management of non-carious cervical lesions (NCCLs) still is a challenge in clinical practice. The diagnosis is the key to treat these lesions successfully. Aim/Case report: Therefore, the aim of this case report is to describe the diagnosis and treatment of generalized abfraction lesions associated to abrasion lesions of a 43 years old patient and to discuss considerations about the technique and materials to be used appropriately. After the diagnosis, a treatment plan with preventive and restorative approach was elaborated. The occlusal adjustment was performed to distribute the contact points and the patient was instructed in relation to tooth brushing habits. It was also recommended that the patient use a dentifrice with potassium nitrate for the control of sensitivity. For lesions over 1mm deep, the restorative treatment was performed using the self-etching adhesive system and nanohybrid composite by the stratification technique. Unsatisfactory restorations have been replaced. Occlusal splint was done and the patient was instructed to use the device every day overnight. One year after treatment, follow-up was performed. The appearance of new NCCLs was not observed. There was no progression of lesions smaller than 1 mm. There was no loss of restorations. All restorations were fully satisfactory and the patient reported absence of dentin hypersensitivity. Conclusion: The treatment performed besides being aesthetically satisfactory after 1 year resulted in the control of the disease, preventing the appearance of new lesions and guaranteeing a better quality of life to the patient.References
Walter C, Kress E, Götz H, Taylor K, Willershausen I, Zampelis A. The anatomy of non-carious cervical lesions. Clin Oral Investig. 2014 Jan;18(1):139-46. doi: 10.1007/s00784-013-0960-0.
Szesz A, Perreiras S, Martini E, Reis A, Loguercio A. Effect of flowable composites on the clinical performance of non-carious cervical lesions: a systematic review and meta-analysis. J Dent. 2017 Oct;65:11-21. doi: 10.1016/j.jdent.2017.07.007.
Maggio B, Guibert RG, Mason SC, Karwal R, Rees GD, Kelly S, et al. Evaluation of mouthrinse and dentifrice regimens in an in situ erosion remineralisation model. J Dent. 2010 Nov;38 Suppl 3:S37-44. doi: 10.1016/S0300-5712(11)70007-0.
Litonjua L, Andreana S, Cohen R. Toothbrush abrasions and noncarious cervical lesions: evolving concepts. Compend Contin Educ Dent. 2005 Nov;26(11):767-76.
Shellis R, Addy M. The interactions between attrition, abrasion and erosion in tooth wear. Monogr Oral Sci. 2014;25:32-45. doi: 10.1159/000359936.
Vasudeva G, Bogra P. The effect of occlusal restoration and loading on the development of abfraction lesions: a finite element study. J Conserv Dent. 2008 Jul;11(3):117-20. doi: 10.4103/0972-0707.45250.
Grippo JO, Simring M, Schreiner S. Attrition, abrasion, corrosion and abfraction revisited. J Am Dent Assoc. 2004 Aug;135(8):1109-18; quiz 1163-5.
Grippo JO, Simring M, Coleman TA. Abfraction, abrasion, biocorrosion, and the enigma of noncarious cervical lesions: A 20-year perspective. J Esthet Restor Dent. 2012 Feb;24(1):10-23. doi: 10.1111/j.1708-8240.2011.00487.x.
Spranger H. Investigation into the genesis of angular lesions at the cervical region of teeth. Quintessence Int. 1995 Feb;26(2):149-54.
Lee WC, Eakle WS. Stress-induced cervical lesions: review of advances in the past 10 years. J Prosthet Dent. 1996 May;75(5):487-94.
Bartlett DW, Shah P. A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion. J Dent Res. 2006 Apr;85(4):306-12.
Aw TC, Lepe X, Johnson GH, Mancl L. Characteristics of noncarious cervical lesions: a clinical investigation. J Am Dent Assoc. 2002 Jun;133(6):725-33.
Yang S, Lee H. A combined approach to non-carious cervical lesions associated with gingival recession. Restor Dent Endod. 2016 Aug;41(3):218-24. doi: 10.5395/rde.2016.41.3.218.
Moraschini V, Costa LS, Santos GO. Effectiveness for dentin hypersensitivity treatment of non-carious cervical lesions: a meta-analysis. Clin Oral Investig. 2018 Mar;22(2):617-631. doi: 10.1007/s00784-017-2330-9.
Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: etiology, diagnosis, and treatment options. Clin Cosmet Investig Dent. 2016 May 3;8:79-87. doi: 10.2147/CCIDE.S63465.
Sarode G, Sarode S. Abfraction: a review. J Oral Maxillofac Pathol. 2013 May;17(2):222-7. doi: 10.4103/0973-029X.119788.
Heymann HO. Examining tooth flexure effects on cervical restorations: a two-year clinical study. J Am Dent Assoc. 1991 May;122(5):41-7.
Estafan A, Bartlett D, Goldstein G. A survey of management strategies for noncarious cervical lesions. Int J Prosthodont. 2014 Jan-Feb;27(1):87-90. doi: 10.11607/ijp.3585.
Antonelli JR, Hottel TL, Garcia-godoy F. Abfraction lesions--where do they come from? A review of the literature. J Tenn Dent Assoc. 2013 Spring-Summer;93(1):14-21.
Leal NMS, Silva JL, Benigno MIM, Bemerguy EA, Meira JBC, Ballester RY. How mechanical stresses modulate enamel demineralization in non-carious cervical lesions? J Mech Behav Biomed Mater. 2017 Feb;66:50-57. doi: 10.1016/j.jmbbm.2016.11.003.
Pereira AG, Teixeira DNR, Soares MPCM, Gonzaga RCQ, Fernandes-Neto AJ, Soares PV. Periodontal and Restorative Treatment of gingival recession associated with non-carious cervical lesions: case study. J Int Acad Periodontol. 2016 Jan 14;18(1):16-22.
Jaeggi T, Lussi A. Toothbrush abrasion of erosively altered enamel after intraoral exposure to saliva: an in situ study. Caries Res. 1999 Nov-Dec;33(6):455-61.
Ichim IP, Schmidlin PR, Li Q, Kieser JA, Swain MV. Restoration of non-carious cervical lesions. Part II. Restorative material selection to minimise fracture. Dent Mater. 2007 Dec;23(12):1562-9.
Yoshizaki KT, Francisconi-dos-Rios LF, Sobral MAP, Aranha ACC, Mendes FM, Scaramucci T. Clinical features and factors associated with non-carious cervical lesions and dentin hypersensitivity. J Oral Rehabil. 2017 Feb;44(2):112-118. doi: 10.1111/joor.12469.
Freitas S da S, Sousa LLA, Moita Neto JM, Mendes RF, Prado Junior RR. Dentin hypersensitivity treatment of non-carious cervical lesions - a single-blind, split-mouth study. Braz Oral Res. 2015;29:45. doi: 10.1590/1807-3107BOR-2015.vol29.0045.
Külünk Ş, Saraç D, Külünk T, Karakaş Ö. The effects of different desensitizing agents on the shear bond strength of adhesive resin cement to dentin. J Esthet Restor Dent. 2011 Dec;23(6):380-7. doi: 10.1111/j.1708-8240.2011.00415.x.
Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No carious cervical lesions: abfraction. J Int Oral Health. 2013 Oct;5(5):143-6.
Tuncer D, Yazici AR, Özgünaltay G, Dayangac B. Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results. Aust Dent J. 2013 Mar;58(1):94-100. doi: 10.1111/adj.12028.
Loguercio AD, Luque-Martinez IV, Fuentes S, Reis A, Muñoz MA. Effect of dentin roughness on the adhesive performance in non-carious cervical lesions: a double-blind randomized clinical trial. J Dent. 2018 Feb;69:60-69. doi: 10.1016/j.jdent.2017.09.011.
Van Dijken JW V. A prospective 8-year evaluation of a mild two-step self-etching adhesive and a heavily filled two-step etch-and-rinse system in non-carious cervical lesions. Dent Mater. 2010 Sep;26(9):940-6. doi: 10.1016/j.dental.2010.05.009.
Srirekha A, Bashetty K. A comparative analysis of restorative materials used in abfraction lesions in tooth with and without occlusal restoration: Three-dimensional finite element analysis. J Conserv Dent. 2013 Mar;16(2):157-61. doi: 10.4103/0972-0707.108200.
Cieplik F, Scholz KJ, Tabenski I, May S, Hiller KA, Schmalz G, et al. Flowable composites for restoration of non-carious cervical lesions: results after five years. Dent Mater. 2017 Dec;33(12):e428-e437. doi: 10.1016/j.dental.2017.09.012.
Tsiggos N, Tortopidis D, Hatzikyriakos A, Menexes G. Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth. J Prosthet Dent. 2008 Jul;100(1):41-6. doi: 10.1016/S0022-3913(08)60135-3.
Carvalho RM, Manso AP, Geraldeli S, Tay FR, Pashley DH. Durability of bonds and clinical success of adhesive restorations. Dent Mater. 2012 Jan;28(1):72-86. doi: 10.1016/j.dental.2011.09.011.
The Brazilian Journal of Oral Sciences uses the Creative Commons license (CC), thus preserving the integrity of the articles in an open access environment.