hard tooth tissue reduction
TRANSCRIPT
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HARD TOOTH TISSUE
REDUCTION
Prepared by:Dr. Rea Corpuz
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(1) Attrition
(2) Abrasion
(3) Erosion
(4) Abfraction
Hard Tooth Tissue Reduction
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loss of tooth structure
caused by tooth-to-tooth contact during occlusion + mastication
comes from Latin verb attritum
action of rubbing against another surface
Attrition
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some degree of attrition is physiologic
process becomes noticeable with age
pathologic
begins to affect esthetic appearance + function
Attrition
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following factors can accelerate tooth destruction
poor- quality or absent enamel
• fluorosis• environmental or hereditary enamel hypoplasia• premature contacts (edge-to-edge occlusion)
Attrition
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• intraoral abrasives• erosion• grinding habits
Attrition
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occur both in deciduous + permanent dentition
most frequently
incisal + occlusal surface
lingual surface of anterior maxillary teeth
labial surface of anterior mandibular teeth
Attrition
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Clinically:
Large Flat Smooth Shiny Wear Facet
Attrition
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Attrition
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pathologic wearing away of tooth structure
restoration secondary to mechanical action of an external agent
Abrasion
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comes from the Latin verb abrasum
to scrape off implies wear or partial removal through mechanical process
Abrasion
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Etiology
toothbrushing
• combines abrasive toothpaste• heavy pressure• horizontal tooth brushing stroke
Abrasion
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Etiology
pencils toothpicks pipe stems bobby pins (hair grips) chewing tobacco cracking nuts biting fingernails
Abrasion
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Clinically:
(tooth brush abrasion) horizontal cervical notches on buccal surface of exposed radicular cementum + dentin
sharply defined margins
hard smooth surface
Abrasion
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Clinically:
(thread biting or use of pipes or bobby pins) rounded or V-shaped notches in incisal edges of anterior teeth
Abrasion
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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
Abrasion
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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
Erosion
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Acidic source:
foods or drinks involuntary regurgitation voluntary regurgitation (eg bulimia)
Erosion
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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
Erosion
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Clinically
(posterior teeth) extensive loss of occlusal surface
Erosion
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loss of tooth structure from occlusal stresses
create repeated tooth flexure with failure of enamel + dentin at a location away from point of loading
Abfraction
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derived from Latin words ab + fractio
away + breaking
dentin is able to withstand greater tensile stress than enamel
Abfraction
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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
Abfraction
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once damaged, the cracked enamel can be lost or more easily removed by erosion or abrasion
Abfraction
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Clinically
wedge-shaped defects limited to cervical area of teeth
deep, narrow + V-shaped
Abfraction
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Clinically
occasionally lesions are subgingival
• site typically protected from abrasion + erosion
Abfraction
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Clinically
predominantly affects
• bicuspids facial • molars surfaces
greater prevalence in those with brusixim
Abfraction
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References:References:
BooksBooks
Neville, et al: Oral and Maxillofacial PathologyNeville, et al: Oral and Maxillofacial Pathology 33rdrd Edition Edition
• (pages 61-65)(pages 61-65)