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Varna Medical Forum

The V-shaped defects on hard tooth tissues - a contemporary view

Vesela Hristova, Slavcho Dimitrov, Mayya Koleva, Maya Doychinova


Wedge defects represent loss of dental tissue in the cervical region of the tooth close to the enamel-cement border, without the presence of carious process i.e. in the absence of micro-organisms. The typical outlook is the shape of a wedge, that happens after the loss of hard dental tissues- gingival and coronal wall meet at a right angle, with the tip pointing towards the tooth pulp. They have a specific etiology, pathogenesis and clinical features. The disease affects mostly the vestibular surface of teeth, most often of the first premolars. The evolution of this pathology leads to the destruction of the tooth crown, pulpopathosis and periodontitis. The esthetic is disturbed. Issues associated with the spur-shaped defects are multipule and adequate treatment is essential for the arrest of the pathological processes.


: клиновидни дефекти; абфракция; оклузално налягане; V-shaped defects; abfraction; occlusal pressure;

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Болгарь А. Клиновидньие дефектьи зубов. Етиология. Патогенез. Клиника. Методьи лечения. 2013

Ботушанов П., Владимиров С., Иванова З. Кариесология и оперативно зъболечение. Пловдив: Автоспектър; 2000: 116-125

Bartlett DW, Shah P. A critical review of non-carious cervical lesions and the role of abfraction erosion, and abrasion. J Dent Res 2006 ;85 :306-12.

Bernhardt O., Gesch D. , Schwahn C., Mack F., Meyer G., John U., Kocher T. Epidemiological evaluation of the multifactorial aetiology of abfractions . Journal of Oral Rehabilitation Jan.2006

Chen KK, Miyake K, Terashita M. Cervical strains induced by occlusal loading. Journal of Dental Research 1999; 78:474.

Daley TJ , Harbrow DJ, Kahler B., Young WG. The cervical wedge-shapes lesion in teeth : a light and electron microscopic study. Australian Dental Journal 2009 ; 54 : 2212-219

Dzakovich J., DDS, and Oslak R., DDS. In vitro reproduction of noncarious cervical lesions. J Prosthet Dent 2008 ; 100 :1-10

Estefan A ., DDS, Furnari P., DDS, Goldstein G., DDS, and Hittelman E. EdD. In vivo correlation of noncarious cervical lesions and occlusal wear. J Prosthet Dent 2005 ;93 :221-6

Gibbs. C.H., Mahan, P.E., Lundeen, H.C., Brehnan, K., Walsh, E.K., Holbrook, W.B., 1981. Occlusal forces during chewing and swallowing as measured by sound transmission. J. Prosthet. Dent. 46, 443-449.

Goel VK, Khera SC, Ralston JL, Chang KH. Stresses at the dentino-enamel junction of human teeth-a finite element investigation. Journal of Prosthetic Dentistry 1991; 66:451-9.

Grippo JO. Abfractions: a new classification of hard tissue lesions of teeth. J Esthet Dent 1991; 3:14-9.

Grippo JO, Simring M, Schreiner S. Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions. J Am Dent Assoc 2004;135(8):1109-18

Karan K., Yao X., Xu C., Wang Y. Chemical profile of the dentin substrate in non-carious cervical lesions . Dental materials 25(2009) 1205-1212

Lee WC, Eakle WS. Possible role of tensile sress in the etiology of cervical erosive lesions of teeth. J Prosthet Dent 1984; 52:374-80.

Michael JA, Townsend GC, Greenwood LF, Kaidonis JA. Abfraction : separating fact from fiction. Australian Dental Journal 2009; 54 :2-8

Michael JA, Townsend GC, Kaidonis JA. Non-carious cervical lesions : a scanning electron microscopic study. Australian Dental Journal 2010 ; 55 :138-142

Michael JA, Townsend GC, Kaidonis JA. Non-carious cervical lesions on permanent anterior teeth : a new morphological classification. Australian Dental Journal 2010; 55-134-137

Nguyen C., Ranjitkar S. , Kaidonis JA., Townsend GC. A qualitative assessment of non-carious cervical lesions in extracted human teeth. Australian Dental Journal 2008; 53 :46-51

Nohl FS, McCabe JF, Walls AWG. Effect of load angle on strains induced in maxillary premolars in vitro. Journal of Dental Research 1999 ; 78 :1059.

Oginni A.O., Adeleke A.A.Comparison of pattern of failure of resin composite restorations in non-carious cervical lesions with and without wear facets. Journal of dentistry 42( 2014) 824-830

Oginni AO, Olusile AO, Udoye CI. Noncarious cervical lesions in a Nigerian population: abrasion or abfraction? International Dental Journal 2003;53:275-9.

Okeson JP. Causes of functional disturbances in the masticatory system. In: Okeson JP, ED. Management of temporomandibular disorders and occlusion. 5th end. St. Louis:Mosby, 2003:149-189.

Ommerborn M., Dr med dent, Schneider C., PhD, Giraki M., Schafer R., PhD , Singh P., DDS, MScD, Franz M., MD, and Raab W., Dr med dent. In vivo evaluation of noncarious cervical lesions in sleep bruxism subjects. J Prosthet Dent 2007 ;98 :150-158

Orbak R, Sezer U, Dilsiz A, Cicek Y, Orbak Z. The relationship between teething and handedness. Int J Neurosci 2007;117:401-8.

Orbak R, Tezel A, Canakci V, Tan U. Rightand left-handed dentists using right- and leftsided dental chair in treatment of calculus. Int J Neurosci 2002;112:15-30.

Osborne-Smith KL, Burke FJT, Wilson NHF. The aetiology of the non-carious cervical lesion. Int Dent J 1999;49:139-143.

Owen BM, Gallien GS. Non-carious dental abfraction lesions in an aging population. Compendium of Continung Education in Dentistry 1995;16:552. 554,557,558.

Palamara J.E.A., Palamara D., Messer H.H. , Tyas M.J. Tooth morphology and characteristics of non-carious cervical lesions. Journal of dentistry march 2006; 185-194

Piquero K, Sakurai K. A clinical diagnosis of diurnal (non-sleep) bruxism in denture wearers. J Oral Rehabil 2000;27:473-82

Santamaria MP, da Silva Feitosa D , Casati MZ, et al : Randomized controlled clinical trial evaluating connective tissue graft plus resin- modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesion :2-year follow-up. J Periodontal 84 :e1-e8,2013

Takehara J., Takano T., Akhter R. , Morita M. Correlations of noncarious cervical lesions and occlusal factors determined by using pressure-detecting sheet. Journal of dentistry 36(2008) 774-779

Tanaka M, Naito M, Yokota M, Kohno M. Finite element amalysis of the possible mechanism of cervical lesion formation by occlusal force. J Oral Rehabil 2003;30:60-67.

Tsiggos N., DDS, PhD, Tortopidis D., DDS, PhD, Hatzikyriakos A., DDS, PhD, and Menexes G., BA, PhD. Association between self-reported bruxism activity and occurrence of dental atrition, abfraction, and occlusal pits on natural teeth. J Prosthet Dent 2008;100:41-46

Tuncer D., Yazici AR, Ozgunaltay G., Dayangac B. Clinical evaluation of different adchesives used in the restoration of noncarious cervical lesions: 24-month result. Australian Dental A ssociacion 2013

Wood I., Jawad Z., Paisley C., Brunton P. Non-carious cervical tooth surface loss : A literature review. Journal of dentistry 36(2008)759-766

Wood ID, Kassir AS, Brunton PA. Effect of lateral excursive movements on the progression of abfraction lesions. Operative Dentistry 2009;34(3):273-9.



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