Mayhew R B, Jessee S A, Martin R E
Department of Health, Promotion and Dental Care Delivery, University of Texas Health Science Center at Houston, USA.
Am J Dent. 1998 Feb;11(1):29-32.
To investigate in vivo the relationship of occlusal stress factors, periodontal health status, and acidic dietary patterns to the presence of non-carious cervical lesions (NCCL) in a convenience sample of undergraduate clinic, adult dental patients.
Forty three subjects who met the entry criteria were admitted into the study; 178 teeth exhibiting NCCL were evaluated. A dietary assessment focusing on acidic food/beverage intake was used to evaluate nutritional intake over the most recent 24-hour period. Periodontal evaluation included intraoral measurement of gingival attachment loss, assessment of tooth mobility, and radiographic interpretation of percent bone loss using the Schei ruler method. Among the occlusal factors evaluated were shape and orientation of NCCL, presence and location of wear facets, and symptoms and characteristics of centric and eccentric occlusal function.
95% of teeth examined exhibited functional wear facets, indicating a systematic relationship with presence of NCCL (Chi Square = 16.9, P < 0.0001); 48% displayed buccal or incisal facets; 64% were accompanied by balancing interferences in lateral excursion; 98.3% had mobility scores < or = 1; there was no significant association between mobility and facets present (Chi Square = 3.04, P = 0.21); and, no relationship with dietary patterns was found. Group function, that may evolve with age, and/or traumatic occlusion factors may be related to etiology of NCCL. Longitudinal controlled clinical trials are needed to confirm suspected etiologies and establish treatment guidelines for non-carious cervical lesions.
在本科临床成人牙科患者的便利样本中，对咬合应力因素、牙周健康状况和酸性饮食模式与非龋性颈部病变（NCCL）的存在之间的关系进行体内研究。
43名符合入选标准的受试者被纳入研究；对178颗出现NCCL的牙齿进行了评估。一项侧重于酸性食物/饮料摄入的饮食评估用于评估最近24小时内的营养摄入情况。牙周评估包括口腔内牙龈附着丧失的测量、牙齿松动度评估以及使用Schei标尺法对骨丧失百分比进行影像学解读。在评估的咬合因素中，包括NCCL的形状和方向、磨损小平面的存在和位置以及正中及非正中咬合功能的症状和特征。
95%的检查牙齿出现功能性磨损小平面，表明与NCCL的存在存在系统性关系（卡方检验=16.9，P<0.0001）；48%显示颊侧或切端小平面；64%在侧方运动时有平衡干扰；98.3%的牙齿松动度评分≤1；松动度与存在的小平面之间无显著关联（卡方检验=3.04，P=0.21）；并且未发现与饮食模式有关。可能随年龄发展的组功能和/或创伤性咬合因素可能与NCCL的病因有关。需要进行纵向对照临床试验以确认可疑病因并建立非龋性颈部病变的治疗指南。
