Abstract
Objective
The term “non-carious cervical lesion” (NCCL) describes a dental hard tissue defect of unknown origin. Two very distinct variations are known: wedge-shaped and saucer-shaped lesions. Reasons for occurrence of two forms might include different contributing factors.
Methods
Forty-two teeth, 19 wedge-shaped and 23 saucer-shaped lesions, were analysed by light and confocal laser scanning microscopy (CLSM) to investigate presence of calculus and organic matter, surface structure of the lesion, borders of the lesion, and potential fractures in the dental hard tissues.
Results
One hundred percent of the wedge-shaped teeth showed evidence of additional abrasion (incisal/occlusal surface) but only 70 % of the saucer-shaped teeth. In most teeth, the edge was rounded. Tiny grooves parallel to the cemento-enamel junction (CEJ) were present in 11 % of the wedge-shaped and in 39 % of the saucer-shaped lesions. Seventy-nine percent wedge-shaped and 52 % saucer-shaped lesions had some sort of apposition. Eighty-eight percent of all teeth had dead tracts, 62 % of which were located directly next to the defect (in the lesion). In 48 %, sclerotic dentin was present right next to the defect (in the lesion). Tertiary dentin was visible in 60 %. Not a single fracture was detected.
Conclusion
Different characteristics associated with each type of cervical lesion support the theory of different aetiology or at least of differing contributions from different factors that participate in the development of NCCLs.
Clinical relevance
Only knowledge of the correct aetiology of NCCLs will allow the best treatment and prevention for such lesions.
Similar content being viewed by others
References
Eccles JD (1979) Dental erosion of nonindustrial origin. A clinical survey and classification. J Prosthet Dent 42(6):649–653
Arambawatta K, Peiris R, Nanayakkara D (2009) Morphology of the cemento-enamel junction in premolar teeth. J Oral Sci 51(4):623–627
Neuvald L, Consolaro A (2000) Cementoenamel junction: microscopic analysis and external cervical resorption. J Endod 26(9):503–508
Piotrowski BT, Gillette WB, Hancock EB (2001) Examining the prevalence and characteristics of abfractionlike cervical lesions in a population of US veterans. J Am Dent Assoc 132(12):1694–1701, quiz 1726–1697
Estafan A, Furnari PC, Goldstein G, Hittelman EL (2005) In vivo correlation of noncarious cervical lesions and occlusal wear. J Prosthet Dent 93(3):221–226
Michael JA, Townsend GC, Greenwood LF, Kaidonis JA (2009) Abfraction: separating fact from fiction. Aust Dent J 54(1):2–8
Wood I, Jawad Z, Paisley C, Brunton P (2008) Non-carious cervical tooth surface loss: a literature review. J Dent 36(10):759–766. doi:10.1016/j.jdent.2008.06.004
Takehara J, Takano T, Akhter R, Morita M (2008) Correlations of noncarious cervical lesions and occlusal factors determined by using pressure-detecting sheet. J Dent 36(10):774–779
Young A, Tenuta LM (2011) Initial erosion models. Caries Res 45(Suppl 1):33–42
Wiegand A, Attin T (2011) Design of erosion/abrasion studies—insights and rational concepts. Caries Res 45(Suppl 1):53–59
Aw TC, Lepe X, Johnson GH, Mancl L (2002) Characteristics of noncarious cervical lesions: a clinical investigation. J Am Dent Assoc 133(6):725–733
Khan F, Young WG, Shahabi S, Daley TJ (1999) Dental cervical lesions associated with occlusal erosion and attrition. Aust Dent J 44(3):176–186
Litonjua LA, Andreana S, Patra AK, Cohen RE (2004) An assessment of stress analyses in the theory of abfraction. Biomed Mater Eng 14(3):311–321
McCoy G (1982) The etiology of gingival erosion. J Oral Implantol 10(3):361–362
McCoy G (1983) On the longevity of teeth. J Oral Implantol 11(2):248–267
Grippo JO (1991) Abfractions: a new classification of hard tissue lesions of teeth. J Esthet Dent 3(1):14–19
He LH, Xu Y, Purton DG (2011) In vitro demineralisation of the cervical region of human teeth. Arch Oral Biol 56(5):512–519
Nguyen C, Ranjitkar S, Kaidonis JA, Townsend GC (2008) A qualitative assessment of non-carious cervical lesions in extracted human teeth. Aust Dent J 53(1):46–51
Hur B, Kim HC, Park JK, Versluis A (2011) Characteristics of non-carious cervical lesions—an ex vivo study using micro computed tomography. J Oral Rehabil 38(6):469–474
Rasmussen ST, Patchin RE, Scott DB, Heuer AH (1976) Fracture properties of human enamel and dentin. J Dent Res 55(1):154–164
Qin W, Song Z, Ye YY, Lin ZM (2012) Two-year clinical evaluation of composite resins in non-carious cervical lesions. Clin Oral Investig. doi:10.1007/s00784-012-0780-7
Santamaria MP, Casati MZ, Nociti FH Jr, Sallum AW, Sallum EA, Aukhil I, Wallet SM, Shaddox LM (2012) Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: microbiological and immunological results. Clin Oral Investig. doi:10.1007/s00784-012-0690-8
Burrow MF, Tyas MJ (2012) Comparison of two all-in-one adhesives bonded to non-carious cervical lesions—results at 3 years. Clin Oral Investig 16(4):1089–1094. doi:10.1007/s00784-011-0595-y
Ermis RB, Van Landuyt KL, Cardoso MV, De Munck J, Van Meerbeek B, Peumans M (2012) Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years. Clin Oral Investig 16(3):889–897. doi:10.1007/s00784-011-0565-4
Peumans M, De Munck J, Van Landuyt KL, Poitevin A, Lambrechts P, Van Meerbeek B (2012) A 13-year clinical evaluation of two three-step etch-and-rinse adhesives in non-carious class-V lesions. Clin Oral Investig 16(1):129–137. doi:10.1007/s00784-010-0481-z
Loguercio AD, Raffo J, Bassani F, Balestrini H, Santo D, do Amaral RC, Reis A (2011) 24-Month clinical evaluation in non-carious cervical lesions of a two-step etch-and-rinse adhesive applied using a rubbing motion. Clin Oral Investig 15(4):589–596. doi:10.1007/s00784-010-0408-8
Pecie R, Krejci I, Garcia-Godoy F, Bortolotto T (2011) Noncarious cervical lesions—a clinical concept based on the literature review. Part 1: prevention. Am J Dent 24(1):49–56
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Walter, C., Kress, E., Götz, H. et al. The anatomy of non-carious cervical lesions. Clin Oral Invest 18, 139–146 (2014). https://doi.org/10.1007/s00784-013-0960-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-013-0960-0