Operative I: Non-Carious Lesions PDF - Kasr Al Einy, 2025

Kasr Al Einy Pre-clinical Operative I non-carious lesions Dr_M.Bedawi 2025 non-carious lesions...

Kasr Al Einy Pre-clinical Operative I non-carious lesions Dr_M.Bedawi 2025 non-carious lesions 1 non-carious lesions - lesions ẁ leads to tooth destruction are mainly categorized into carious & non-carious lesions. - it is essential to understand the etiology & symptoms of these lesions, to establish a comprehensive operative ttt for each case. - non-carious lesions are lesions with non-microbial origin ẁ cause defects in tooth structures. tooth wear  attrition - it is a mechanical wear of teeth resulting from direct frictional forces bet. natural contacting teeth. - it is a physiological & age-dependant process.  attrition can be accelerated & will be more aggressive by pathological parafunctional forces as bruxism & clenching. attrition may lead to : 1. flattening of occluding surfaces “incisal Or occlusal surfaces” “wear facet formation ”. 2. enamel is worn off with dentin exposure. 3. loss of vertical dimensions of teeth. 4. flat proximal contour & decreased mesio-distal dimension of teeth. 5. patient is suffering from hypersensitivity & bad appearance. 6. deficient masticatory abilities & check biting. 7. caries.  abrasion - it is a mechanical loss of tooth structure resulting from a direct friction bet. teeth & foreign objects.  mechanical loss of tooth structure due to friction bet. contacting teeth in presence of an abrasive medium. - it is a pathological & age-dependent process. * types : tooth brush abrasion → the most common example. - improper brushing tech. causes localized cervical lesions on the labial & buccal surface of teeth. - it is characterized by being linear in outline "following the path of brush bristles" & the tooth surface is smooth & polished.  the pt has very good oral hygiene. pipe-smoking depression abrasion occurring at the corner of the arch. 2025 Kasr Dr_M.Bedawi non-carious lesions 2 oral habits as chewing tobacco & tooth-picks ẁ cause proximal abrasion. professional habits such as cutting sewing threads Or holding pens & nails with incisors can create specific localized forms of abrasion. iatrogenic abrasion  abrasion of natural teeth with opposing porcelain teeth.  erosion - it is a chemo-mechanical loss of tooth structure mainly due to acids in absence of M.Os. - it is a pathologic & age-dependent process. * etiology of erosion : 1- extrinsic factors : a- environmental factors → mainly involve exposure to environmental acid fumes ---such as---< battery factory workers “exposed to sulfuric acids”, research laboratory workers & acidic water of swimming pools due to inadequate maintenance. b- dietary factors → high intake of acidic food & drinks ---such as---< lemon juice and sucking, grapefruit juice, acidic candies & acidic carbonated beverages. c- medications → low pH medications are potential causes for teeth erosion ---such as---< increased use of vitamin C “L-ascorbic acid” & chewable tablets of acetylsalicylic acid “aspirin”.  bad oral hygiene is a potential cause for teeth erosion. 2- intrinsic factors : - it is caused by gastric acid reaching oral cavity & the teeth ---such as---< frequent vomiting Or gastro esophageal reflux Or disorders of upper alimentary “peptic ulcer” Or certain psycho-somatic disorder as stress induced psychosomatic vomiting, anorexia and bulimia nervosa. * clinical picture : - erosive lesions are glazed crescent-shaped Or dished cervical lesions occurring predominantly on the facial surfaces. - it is characterized by having no demarcation smooth peripheries from the adjacent tooth surface.  lesions associated with frequent regurgitation, occur on the lingual, incisal & occlusal surfaces.  abfraction - it is a wedge-shaped defect occurs at the neck of the teeth resulting from unbalanced traumatic occlusal mastication forces Or parafunctional heavy forces ẁ expose one tooth Or several teeth to strong lateral tensile stresses during occlusion & mastication ẁ make cervical micro-fractures. - the micro-fractures propagate with time, perpendicular to the long axis of the stresses until cervical enamel & then dentin break-away. 2025 Kasr Dr_M.Bedawi non-carious lesions 3  the resulting wedge-shaped defects have sharp ends. - abfraction usually occur in concomitant with preexisting erosion Or abrasion. N.B) abrasion, erosion & abfraction are common causes for non-carious cervical lesions. Enamel hypo-calcification - it is a defect in enamel due to improper enamel matrix mineralization due to injury to ameloblasts, despite well formation of the matrix. - the affected enamel areas willn`t be defective & appear as chalky white areas. - the defect could vary from isolated pits to widespread linear defects Or even patches. Enamel hypoplasia - it is a defect in enamel due to improper matrix formation caused by injury to ameloblasts. - this leads to defective areas in enamel. - it is usually seen on anterior teeth & first molars in the form of pitted-and-grooved areas with opaque white Or brownish color of enamel. dental fluorosis - due to fluoride over-consumption during tooth formation which causes enamel appearance changes starting white patches to sever mottled brown teeth. - it mainly affects permanent teeth. - its clinical severity depends on how much, how long did the pt ingest fluoride & when ? discoloration - it is a deviation from the normal tooth shade & color. - it is not a destructive lesion. - it affects the individual both socially & psychologically. * etiology : a- extrinsic → due to surface staining with food, drinks, smoking & certain drugs. - can be removed by proper cleaning & polishing of teeth. b- intrinsic → created from pathological changes inside teeth tissues as a result of : - enamel hypoplasia Or enamel hypo-calcification. - tetracycline staining in pregnant females during stages of tooth formation. - pigmentation of non-vital tooth following pulpal necrosis ẁ cause dark black discoloration. 2025 Kasr Dr_M.Bedawi non-carious lesions 4 fracture - it is a loss of tooth structure as a result of traumatic injuries from a blow Or sudden biting on a hard substance. * clinical picture : - simple fracture of enamel (chipping). - fracture of enamel and dentin with or without pulp involvement. - total loss of crown structures. - fracture of tooth root. - total avulsion of the tooth. malformation - it is a deviation from normal shape Or size of the tooth. - it is usually of hereditary origin. - deviation in the size → in the form of micro-dontia Or macro-dontia. - deviation in the shape → the most common type is peg-shaped lateral incisor tooth. - peg-shaped lateral → the lateral is noticeably smaller in size than surrounding ones, with pointed incisal edges. Dr_Mohammed Bedawi 2025 Kasr Dr_M.Bedawi