All ETDs from UAB

Advisory Committee Chair

John O Burgess

Advisory Committee Members

Daniel A Givan

Keith E Kinderknecht

Amjad Javed

Jack E Lemons

Mark S Litaker

Document Type

Thesis

Date of Award

2014

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Non-carious cervical lesions (NCCLs) have a non-bacterial origin and produce a loss of tooth structure at the cemento-enamel junction. A review of the literature reveals that these lesions may have a multifactorial etiology (chemical, abrasion, abfraction). The role of heavy biting forces in the pathogenesis of NCCLs is yet to be firmly established. Treatment and preventive measures for NCCLs can be improved if the etiology can be clearly identified and treated.Objective: This prospective clinical trial measured the volume loss (increase in size) of NCCLs and the occlusal biting forces applied to these teeth; diet and tooth brushing analysis, followed by a comprehensive mounted cast occlusal analysis to determine which factors were significant in the progression of these lesions. Materials and Methods: Patients with non-carious cervical lesions were screened and consent obtained. Digital images and poly vinyl siloxane impressions (Aquasil Ultra/Dentsply, USA) were made, casts poured (Fujirock Type IV Die & model stone/ GC America). To measure the NCCL depth and volume, casts were scanned using Proscan 2000 Non Contact Profilometer, and the scans were superimposed over the baseline scans with the Proform software to measure the change in NCCLs over a five-year period. T-scan and Fujifilm Prescale films (analyzed by Topaq Occlusal Analysis System) were used to record the relative and absolute biting forces on teeth with NCCL. Lesion progression from baseline to five years was correlated to absolute occlusal force using regression analysis and KS test for normality. One way ANOVA compared lesion progression with toothbrushing techinique and presence of adverse oral habits like nail biting; while Mann-Whitney test was used to correlate NCCL progression with the diet score. Results: Rate of progression is related to mean bite force (p=0.01), presence of adverse oral habits (p=0.02) and consumption of a more acidic diet (p=0.04); but not associated significantly with occlusal wear facets, group function or toothbrushing technique. Conclusions: Within the limitations of this study, it may be concluded that heavy biting forces, erosive diet and adverse oral habits play a significant role in the progression of NCCLs over time.

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