Hard tissue pathology non carious tooth surface loss- Abrasion, Erosion, Attrition & Abfraction

Question 1

what is attrition what causes it what is the clinical picture what is the management?

Answer 1

attrition is tooth to tooth contact, it is caused by grinding teeth, stress and anxiety, strong muscles of mastication the clinical picture is secondary dentine protects the pulp from injury Occlusal surfaces may become concave, dentine wears more rapidly than enamel. the management if this would be a splint, reducing stress and anxiety, hypnosis.

Question 2

what is abrasion what causes it what is the clinical picture and what is the management?

Answer 2

Mechanical wearing away of tooth surface mainly caused by toothbrushing abrasion wrong bristle or brushing too hard tongue, lip piercings , may lead to gingival recession exposing dentine and cementum sensitivity, the clinical picture is usually v shaped at the ACJ may be sharp exposed dentine appears highly polished. to manage abrasion removing the cause, change tb size of teepees restorations, radiographs.

Question 3

what is erosion what causes it what is the clinical picture and what is the management?

Answer 3

caused by acidic stuff such as fruit juices or foods, the clinical picture is Lesions appear smooth, broad, shallow, highly polished, scooped-out
Thinned enamel at incisal edges can be evident
teeth may appear yellow due to loss of enamel can be caused by morning sickness, bulimia, Gastro-Oesophageal Reflux Disease (GORD) acidic juices and foods steroid inhalers. the management of this would be remove the cause, focus on dietary advice, sugar free gum to increase salivary flow, drink with straws.

Question 4

how would you measure erosion?

Answer 4

BEWE
Basic Erosive Wear Examination

Question 5

what is abfraction what causes it what is the clinical picture and what is the management?

Answer 5

‘To break away’
V/wedge shaped notches with sharp internal line angles are formed at cervical margin
Caused by flexure and breakdown of susceptible teeth at locations away from the point of loading
Resembles toothbrush abrasion however sharper angles
Remove the cause!!! (Can it be removed?)
Restoration/prevention of crown fracture
Changes to occlusion

Monitor!
Radiographs
Study models
Clinical photographs

Sensitivity Rx

‘Normal’ OH & dietary advice still must be delivered