Dentistry: Abfraction and Occlusal Forces

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Questions and Answers

What is the main cause of abfraction?

Chemical erosion

Toothbrush abrasion

Bruxism

Abnormal occlusal interactions (correct)

What is the clinical feature of abfraction lesions?

Saucer-shaped defects

Angular defects

Sharp notch or wedge-shaped lesions (correct)

Rounded defects

Where are the maximal abfractive stresses generated?

At the incisal edge

At the dental pulp

At the cervical area (correct)

At the root apex

What is the result of tensile and compressive stresses in the cervical region?

Strain leading to microfractures in cervical enamel Signup and view all the answers

What can cause the loss of bonded Class V restorations?

Abfraction Signup and view all the answers

What is the effect of tooth flexure on dentin?

It produces changes in fluid flow and microleakage Signup and view all the answers

What is the range of intra-oral loads reported in the literature?

10 N to 431 N Signup and view all the answers

What is the functional load considered clinically normal?

70 N Signup and view all the answers

What is erosion defined as in relation to tooth surface?

The wear or loss of tooth surface by chemical action Signup and view all the answers

What is the main cause of intrinsic erosion?

Endogenous acids of gastric origin Signup and view all the answers

Which of the following is NOT a medical condition associated with intrinsic erosion?

Cervical spine disease Signup and view all the answers

What is the name of the disorder characterized by repeated episodes of binge eating and self-induced vomiting?

Bulimia nervosa Signup and view all the answers

What is the name of the disease characterized by regurgitation without nausea or abdominal contractions?

GERD (Gastro Esophageal Reflux Disease) Signup and view all the answers

What is the age range of young women most commonly affected by dental erosion due to chronic vomiting?

20-30 years Signup and view all the answers

What is the term for the syndrome consisting of repetitive, effortless regurgitation of undigested food?

Rumination Signup and view all the answers

What is the occupation most commonly associated with extrinsic erosion?

Professional wine tasters Signup and view all the answers

What is the primary goal of management for non-carious lesions?

To halt or modify the etiology of the problem Signup and view all the answers

What is a consideration for initiating restorative management of non-carious lesions?

The defect is sufficiently deep to compromise the structural integrity of the tooth Signup and view all the answers

What is the purpose of occlusal guard therapy?

To protect indirect restorations from additional loss of tooth structure Signup and view all the answers

What is a requirement for a comprehensive examination of non-carious lesions?

An occlusal analysis using articulated diagnostic models Signup and view all the answers

What is the purpose of beveling the enamel margin and roughening the internal walls in Class V tooth preparation?

To create a retention form for the restoration Signup and view all the answers

What is a type of non-carious lesion that requires restoration or protection?

Areas of significant occlusal attrition that have exposed dentin Signup and view all the answers

What is a condition that may indicate the need for occlusal guard therapy?

Sleep-related bruxism Signup and view all the answers

What is a consideration for restorative management of non-carious lesions?

The defect contributes to a periodontal problem Signup and view all the answers

Study Notes

Abfraction

Definition: Strong eccentric occlusal force resulting in microfractures at the cervical area of the tooth, causing wedge-shaped defects.
Etiology: Caused by tooth flexure in patients with abnormal occlusal interactions.
Mechanism: Tooth flexure generates lateral or axial bending, leading to tensile and compressive stresses, strain, and microfractures in cervical enamel.

Clinical Features of Abfraction

Characteristics: Sharp notch or wedge-shaped lesions, not saucer-shaped defects.
Location: Maximal abfractive stresses occur at the cervical area, thinnest region of enamel at the cementoenamel junction (CEJ).
Consequences: Loss of bonded Class V restorations, enamel loss, and pulpal inflammation.

Treatment of Abfraction, Erosion, Abrasion, and Attrition

Considerations for restorative management:
- Defect compromises structural integrity of the tooth.
- Intolerable sensitivity exists.
- Area affected by caries.
- Defect contributes to periodontal problem.
- Area involved in removable partial denture design.
- Defect depth is close to the pulp.
- Defect is actively progressing.
- Patient desires esthetic improvements.

Non-Carious Lesions and Management

Definition: Various non-carious causes of tooth loss and management strategies.
Erosion: Wear or loss of tooth surface by chemical action in the presence of demineralizing agents with low pH.

Classification of Erosion based on Etiology

Intrinsic Erosion:
- Caused by endogenous acids of gastric origin.
- Associated with:
  - Recurrent vomiting (eating disorders).
  - Medical conditions (gastrointestinal, metabolic, endocrine, neurological disorders, etc.).
  - GERD (Gastro Esophageal Reflux Disease).
  - Rumination syndrome.
Extrinsic Erosion:
- Caused by extrinsic factors.
- Associated with:
  - Occupational factors (professional wine tasters).
  - Other extrinsic etiological causes.

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Description

Learn about abfraction, a dental condition caused by strong eccentric occlusal forces, resulting in microfractures at the cervical area of the tooth. Explore the etiology and effects of intra-oral loads on teeth.