Regressive alteration of teeth

a multifactional
condition causing loss
of enamel and dentin,
E.g. erosion, abrasion,
abfraction, attrition
Dissolution of mineralised tooth structure occurs upon contact with acid in oral cavity.
and resorption or a
combination of these
lesions.
a slow progression with
periods of activity and
Erosion
The wear or loss of tooth surface by chemicomechanical action
Irreversible loss of dental hard tissue that does not involve bacteria
Causes:
consumption of sugary, starch, acidic foods
Bruxism, GERD , dry mouth
Clinical features:
broad, shallow, saucer-shaped defect involving enamel and dentin.
No sharp line angles ,margins of defect not well defined
Surface appears smooth and polished.

inactivity. Treatment:
Dentist may recommend dental bonding, veneers, crown
Prevention:
Chew sugar-free gum
Use fluoridated toothpaste
Rinse mouth immediately with clear water after eating or drinking acidic foods.

Abfraction
Loss of tooth surface at the cervical areas of teeth caused by tensile and
compressive forces during tooth flexure
Causes :
Loss of bonds between the hydroxyapatite crystals

REGRESSIVE Fracture of the enamel

Atypical occlusal loading

ALTERATION OF Clinical features:

Wedge-shaped defects are limited to the cervical area of the teeth
Deep, narrow V-shaped notch

THE TEETH It affects the facial surfaces of teeth

Commonly affects a single tooth with adjacent unaffected teeth

Treatment
Passive treatment
i. Monitoring
ii. Prevention - dependent on the aetiology
Active treatment
i. Restorative – for Sensitivity, Aesthetics, Function
ii. Restoration of the defects with RMGIC or composite restoration

Attrition
Mechanical wear of the incisal or occlusal surface from tooth to tooth contact
Causes :
Abrasion
i. Bruxism Pathologic wearing away of tooth substance caused by
ii. Abnormal chewing habits toothbrushing, abnormal habits
iii. Developmental defects Causes :
Clinical features: i. Exposure of dentinal tubules
i. large, flat, smooth, and shiny wear facets on occlusal surfaces ii. Irritation of odontoblastic process
ii. Gradual reduction in cusp height and flattening of the occlusal plane iii. Secondary dentin formation pulpal to primary dentin
iii. Tooth sensitivity
Clinical features:
Treatments- depend on the level of wear : i. The exposed surface appears smooth and polished
i. Mild wear: No treatment needed ii. Occurs cervical, on exposed root surfaces of teeth and sometimes in incisal
ii. Severe wear: fillings, dental crowns, braces, or mouthguards to protect against or occlusal surfaces.
grinding iii. Canines and premolars are mostly affected.
iii. Tooth sensitivity or pain needs immediate attention
Treatments:
i. veneers and crown
ii. Tooth discolouration caused by dental abrasion: teeth whitening
Prevention
i. Following proper toothbrushing guidelines
ii. Halting harmful habits such as chewing pencils or nails.
iii. Treating bruxism with a dental night guard

REFERENCES
1. Oral and maxillofacial pathology 4th edition Nevile
2. E.W. Odell - Cawson’s Essentials of Oral Pathology and Oral Medicine
3. Anil Govindrao Ghom, Shubhangi Mhaske (Jedhe) (editors) - Textbook of Oral Pathology-
Jaypee Brothers Medical Publishers (P) Ltd. (2013)
4. Y, G. (n.d.-b). What is Dental Attrition? www.goldenstatedentistry.com.
https://www.goldenstatedentistry.com/blog/what-is-dental-attrition
GROUP 3.11