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Questions and Answers
What aspect is crucial for the management of NCCLs according to patient needs?
Which factor is NOT mentioned as a reason for treating NCCLs?
What is recommended to enhance the bonding area during the treatment of NCCLs?
Why should composite be preferred over GIC for NCCL treatment?
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What is a significant factor contributing to NCCLs according to the provided information?
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Which of the following is primarily responsible for causing noncarious cervical lesions (NCCLs)?
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What is considered a secondary cause of noncarious cervical lesions?
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Which of the following factors is NOT an intrinsic factor associated with NCCLs?
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Which management strategy is suggested for addressing noncarious cervical lesions?
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Which dietary habit is associated with a higher risk of developing NCCLs?
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What is emphasized as essential for preventing noncarious cervical lesions?
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What role does patient education play concerning NCCLs?
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Which of the following is NOT mentioned as a method of diagnosing NCCLs?
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What does the term 'Non-Carious Cervical Lesion' (NCCL) refer to?
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Which of the following is NOT a cause of Non-Carious Cervical Lesions?
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Which shape of NCCL progresses primarily in height?
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What type of tooth wear is caused by friction or scraping?
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What characterizes the erosion of tooth structure in NCCLs?
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What type of defects are considered 'Stress-Induced lesions'?
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How may tensile stress affect cervical lesions?
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What is a common feature of Non-Carious Cervical Lesions?
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Study Notes
Introduction to NCCLs
- Non-carious cervical lesions (NCCLs) are tooth structure loss at the cemento-enamel junction (CEJ) without bacterial involvement.
- NCCLs appear as shallow or deep depressions or wedge-shaped defects at the gum line.
- They can affect both the front and back surfaces of teeth.
Causes of NCCLs
- Tooth wear, a major cause of NCCLs, involves mechanical wear (abrasion and attrition) and chemical wear (erosion).
- NCCLs can have rounded (saucer-like), V-shaped (wedge-like), or mixed defects.
- Rounded shapes progress more in height, while V-shaped progress in height and depth.
Classification
- Erosion: Dissolution of hard tissue by acidic substances.
- Abrasion: Mechanical removal of material from a surface by friction or scraping.
- Abfraction: Stress concentration causing C-shaped, V-shaped, or mixed lesions.
- Dental Wear: Another term for abfraction, often appearing as a wedge or depressions.
Main Cause?
- Research suggests tensile and compressive stresses play a primary role in causing NCCLs, while abrasion and erosion play secondary roles.
- The exact mechanism of NCCLs is not fully understood and is likely multifactorial.
- There is limited direct evidence to support abfraction as the primary cause.
- Biodental engineering factors and stress corrosion have been introduced as newer terms describing tooth wear.
Etiological factors
- Intrinsic: Parafunctions, vitamin C deficiency, aspirin tablets, powders, Ecstasy, acidic food and drinks, gastrointestinal reflux (GERD), bulimia, and bruxism.
- Extrinsic: Acidic food (erosion), reduced saliva flow, drugs altering saliva buffering power, dental floss, toothbrushes, poorly washed vegetables, immune system disease.
Diagnosis
- Diagnosis involves a thorough clinical and radiographic assessment.
- Dentists look for signs of tooth wear, sensitivity, and the presence of occlusal forces.
Management Strategies
- Management includes restorative options (e.g., fillings or crowns) and preventive measures.
- Addressing underlying causes is crucial to prevent recurrence.
Preventive Measures
- Preventive measures include using a soft-bristled toothbrush, minimizing acidic food intake, and regular dental check-ups.
Role of Patient Education
- Educating patients about NCCLs is essential.
- Understanding the causes, consequences, and management strategies enables proactive oral health maintenance.
Case Studies
- Case studies highlight the variety of NCCLs and their management strategies.
- They demonstrate the importance of individualized treatment plans.
When to treat
- Fast lesion progression
- Negative impact on quality of life
- High sensitivity
- Poor aesthetics
- Food and plaque collection
- Deep enough to compromise tooth strength
How to treat
- NCCLs have sclerotic dentin walls, hypermineralized intertubular dentin, and occluded tubules.
- Bonding strength is lower to NCCL dentin compared to regular dentin.
- Roughening the dentin surface or preparing a fine groove leads to better long-term restoration survival.
- Beveling of the enamel is recommended for better bonding area, etching substrate, and aesthetics.
- Composite restorations are preferred over glass ionomer cement (GIC).
Conclusion
- NCCLs have a multifactorial etiology including occlusal factors, clenching, mental health, oral hygiene, nutrition, and habits.
- Understanding and addressing the contributing factors is crucial, as even the best restorative approach may fail if destruction continues.
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Description
Explore non-carious cervical lesions (NCCLs) and their impact on tooth structure. This quiz covers the causes of NCCLs, including mechanical and chemical wear, as well as their classification into erosion, abrasion, and abfraction. Test your knowledge on this important dental topic.
