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Hard Tooth Tissue Reduction

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Hard Tooth Tissue Reduction

  1. 1. HARD TOOTH TISSUE REDUCTION Prepared by: Dr. Rea Corpuz
  2. 2. Hard Tooth Tissue Reduction  (1) Attrition  (2) Abrasion  (3) Erosion  (4) Abfraction
  3. 3. Attrition  loss of tooth structure  caused by tooth-to-tooth contact during occlusion + mastication  comes from Latin verb attritum  action of rubbing against another surface
  4. 4. Attrition  some degree of attrition is physiologic  process becomes noticeable with age  pathologic  begins to affect esthetic appearance + function
  5. 5. Attrition  following factors can accelerate tooth destruction  poor- quality or absent enamel • fluorosis • environmental or hereditary enamel hypoplasia • premature contacts (edge-to-edge occlusion)
  6. 6. Attrition • intraoral abrasives • erosion • grinding habits
  7. 7. Attrition  occur both in deciduous + permanent dentition  most frequently  incisal + occlusal surface  lingual surface of anterior maxillary teeth  labial surface of anterior mandibular teeth
  8. 8. Attrition  Clinically:  Large  Flat  Smooth  Shiny Wear Facet
  9. 9. Attrition
  10. 10. Abrasion  pathologic wearing away of tooth structure  restoration secondary to mechanical action of an external agent
  11. 11. Abrasion  comes from the Latin verb abrasum  to scrape off  implies wear or partial removal through mechanical process
  12. 12. Abrasion  Etiology  toothbrushing • combines abrasive toothpaste • heavy pressure • horizontal tooth brushing stroke
  13. 13. Abrasion  Etiology  pencils  toothpicks  pipe stems  bobby pins (hair grips)  chewing tobacco  cracking nuts  biting fingernails
  14. 14. Abrasion  Clinically:  (tooth brush abrasion) horizontal cervical notches on buccal surface of exposed radicular cementum + dentin  sharply defined margins  hard smooth surface
  15. 15. Abrasion  Clinically:  (thread biting or use of pipes or bobby pins) rounded or V-shaped notches in incisal edges of anterior teeth
  16. 16. Abrasion  Clinically:  degree of lost is greatest on prominent teeth • cuspids • bicuspids • teeth adjacent to edentulous area  ocassionaly more advanced on the side of arch opposite dominant hand
  17. 17. Erosion  loss of tooth structure  caused by non bacterial chemical process  comes from Latin verb erosum  to corrode  gradual destruction of surface by chemical or electrolytic process
  18. 18. Erosion  Acidic source:  foods or drinks  involuntary regurgitation  voluntary regurgitation (eg bulimia)
  19. 19. Erosion  Clinically  facial + palatal surfaces of maxillary anterior teeth  facial + occlusal surfaces of mandibular posterior teeth  (maxillary anteriors) shallow spoon-shaped depressions in cervical portion of crown
  20. 20. Erosion  Clinically  (posterior teeth) extensive loss of occlusal surface
  21. 21. Abfraction  loss of tooth structure from occlusal stresses  create repeated tooth flexure with failure of enamel + dentin at a location away from point of loading
  22. 22. Abfraction  derived from Latin words ab + fractio  away + breaking  dentin is able to withstand greater tensile stress than enamel
  23. 23. Abfraction  when occlusal forces are applied eccentrically to a tooth  tensile stress is concentrated at cervical fulcrum  leads to flexure  produce disruption in chemical bonds of enamel crystals in cervical areas
  24. 24. Abfraction  once damaged, the cracked enamel can be lost or more easily removed by erosion or abrasion
  25. 25. Abfraction  Clinically  wedge-shaped defects limited to cervical area of teeth  deep, narrow + V-shaped
  26. 26. Abfraction  Clinically  occasionally lesions are subgingival • site typically protected from abrasion + erosion
  27. 27. Abfraction  Clinically  predominantly affects • bicuspids facial • molars surfaces  greater prevalence in those with brusixim
  28. 28. References:  Books Neville, et al: Oral and Maxillofacial Pathology 3rd Edition • (pages 61-65)

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