Peumans Marleen, Politano Gianfranco, Van Meerbeek Bart
Int J Esthet Dent. 2020;15(1):16-42.
Noncarious cervical lesions (NCCLs) involve the loss of hard tissue from the cervical areas of teeth through processes unrelated to caries. NCCLs are nowadays a common pathology caused by changes in lifestyle and diet. The prevalence and severity of cervical wear increase with age. It is generally accepted that the lesions are not generated by a single factor but result from a combination of factors. Among the factors proposed to be related to the formation and progression of NCCLs are biocorrosion (erosion), friction (abrasion), and possibly occlusal stress (abfraction). The clinical appearance of NCCLs can vary depending on the type and severity of the etiologic factors involved. Practitioners should follow a checklist to achieve an accurate diagnosis of the etiology of multifactorial NCCLs. The successful prevention and management of NCCLs require an understanding of the etiology and risk factors, including how these change over time in individual patients. The decision to monitor NCCLs rather than intervene should be based on the progression of the lesions and how they compromise tooth vitality, function, and esthetics. Treatment options include techniques to alleviate dentin hypersensitivity and the placement of an adhesive restoration, eventually in combination with a root coverage surgical procedure. An adhesive restoration is considered the last treatment option for NCCLs. Based on their excellent esthetic properties and good clinical performance, there is a general indication to place composite restorations for NCCLs. The clinical performance of these restorations is highly product-dependent, particularly regarding the adhesive system used. The type of composite material seems to have no significant influence on the clinical performance of NCCL restorations in clinical trials. It is much more important that the operator carries out the clinical procedure correctly. Marginal degradation is frequently seen during aging. Yearly maintenance with the eventual repolishing of the restoration margins will lengthen the lifespan of the restorations.
非龋性颈部病变（NCCLs）是指牙齿颈部硬组织通过与龋齿无关的过程发生丧失。如今，NCCLs是一种由生活方式和饮食变化引起的常见病理状况。颈部磨损的患病率和严重程度随年龄增长而增加。人们普遍认为，这些病变并非由单一因素引起，而是多种因素共同作用的结果。在与NCCLs形成和进展相关的因素中，包括生物腐蚀（侵蚀）、摩擦（磨损），以及可能的咬合应力（楔状缺损）。NCCLs的临床表现可能因所涉及病因的类型和严重程度而异。从业者应遵循一份清单，以准确诊断多因素NCCLs的病因。成功预防和处理NCCLs需要了解其病因和风险因素，包括这些因素在个体患者中如何随时间变化。决定对NCCLs进行监测而非干预应基于病变的进展情况以及它们如何损害牙齿的活力、功能和美观。治疗选择包括缓解牙本质过敏的技术以及放置粘结修复体，最终可能结合牙根覆盖手术。粘结修复被认为是NCCLs的最后一种治疗选择。基于其出色的美学特性和良好的临床性能，一般倾向于为NCCLs放置复合树脂修复体。这些修复体的临床性能高度依赖产品，特别是所使用的粘结系统。在临床试验中，复合材料的类型似乎对NCCL修复体的临床性能没有显著影响。更重要的是操作人员正确地进行临床操作。在修复体老化过程中经常会出现边缘降解。每年进行维护并最终对修复体边缘进行再抛光将延长修复体的使用寿命。
