Non-carious cervical lesions
Click on thumbnail to see 'before' and 'after'
-
Before
Patient showing multiple non-carious defects (erosions) on both upper and lower teeth. Please, note that the upper lesions are concentrated at the neck of the tooth; conversely, lower teeth lesions are vertical extended lesion covering almost the entire crown.After
Lesions were restored by using tooth-colored composite fillings. The treatment is not invasive at all because it is not required any sound tooth structure removal.
-
Fig 1
Patient presented gingival recession and root exposure on the canine tooth; the exposed root surface was covered with a white filling
Fig 2
Dr Deliperi removed the root old white filling and covered the root through a gingival plastic surgery. Once the gum healed, a new white filling was completed.
-
Fig 1
Patient presented multiple gingival recessions and root exposure; previous attempts to cover the exposed root surface with white fillings resulted in very long teeth.
Fig 2
Dr Deliperi removed the root fillings before covering the exposed root with gingival tissues.
Fig 3
Final result following Dr Deliperi's gingival plastic surgery and reconstruction of the cervical area with white fillings. A nice width-length ratio of the teeth was achieved
What is it?
Non-carious cervical lesions are notch-shaped tooth defects located at the gum-line of anterior and posterior teeth; these defects most commonly occur at the gum-line or “neck” of the tooth where the root begins.
They are the result of tooth structure loss caused by chemical erosion, abrasion, stress from biting forces, or a combination of such factors.
What’s the reason of their formation?
Erosion of the tooth is generally related to the frequent consumption of acidic foods or drinks but also can be caused by gastric reflux or frequent regurgitation. The chronic presence of acidic substances in the mouth causes the tooth mineral to be slowly dissolved, contributing to non-carious defects.
Abrasion of the tooth is related to the constant use of abrasive substances on its surface. The long-term use of abrasive toothpastes and improper tooth brushing can ultimately lead to wear of the tooth.
Finally, stress from heavy biting forces is believed to contribute to the formation of these defects as well. Heavy biting causes the tooth to flex or bend at the neck of the tooth. This repeated insult is thought to cause micro defects that can grow into cervical defects called abfractions. Patients who clench or grind their teeth at night are particularly susceptible to the formation of abfractions.
How are these lesions treated?
Non-carious cervical lesions are responsible for dentin exposure (dentin contains nerve termination); a mild to severe tooth sensitivity may occur under differing stimulus (cold and hot).
These defects are anti-aesthetic and may also weaken the tooth structure.
Initially, the cause of the defect should be determined and, if possible, treated or controlled; then, the filling of the defect is required using tooth-collared composite materials.
