Rees J S, Jagger D C
Division of Restorative Dentistry, Department of Oral and Dental Science, University of Bristol Dental School, Bristol, England.
J Esthet Restor Dent. 2003;15(5):263-71. doi: 10.1111/j.1708-8240.2003.tb00297.x.
Loss of tooth substance in the cervical region is usually attributed to toothbrush abrasion, erosion, or a combination of both factors. Recently the role of occlusal loading has become increasingly prominent. It is suggested that high occlusal loads cause large cervical stress concentrations, resulting in a disruption of the bonds between the hydroxyapatite crystals and the eventual loss of cervical enamel. This process has been called noncarious cervical tooth loss or abfraction. This article reviews the available evidence to support the thesis that occlusal loading can contribute to the process of abfraction. It also reviews the potential interactions between occlusal loading and erosion that may contribute to abfraction lesion formation.
It is important to recognize the potential role of occlusal loading in the loss of cervical tooth tissue so that management of the occlusion can be incorporated into a treatment plan for a patient with abfraction lesions.
颈部牙体组织丧失通常归因于牙刷磨损、侵蚀或这两种因素的综合作用。近来,咬合负荷的作用日益显著。有人提出,高咬合负荷会导致颈部应力高度集中,致使羟基磷灰石晶体间的结合遭到破坏,最终造成颈部牙釉质丧失。这一过程被称为非龋性颈部牙体丧失或楔状缺损。本文回顾了现有证据,以支持咬合负荷可促成楔状缺损过程这一论点。还回顾了咬合负荷与侵蚀之间可能导致楔状缺损病变形成的潜在相互作用。
认识到咬合负荷在颈部牙体组织丧失中的潜在作用很重要,这样在为患有楔状缺损病变的患者制定治疗方案时,就可以将咬合调整纳入其中。