Abfraction

Loss of tooth structure from flexural forces

Abfraction is a theoretical concept in dentistry that describes the loss of tooth structure, particularly at the cervical areas of teeth, due to biomechanical loading forces. These forces cause flexure and ultimately lead to the breaking away of hard tissue. Abfraction is considered one of the non-carious cervical lesions (NCCLs), which also include abrasion and erosion.

Mechanism

Abfraction is believed to occur when occlusal forces, such as those from bruxism or malocclusion, create stress concentrations at the cervical areas of teeth. These stresses lead to microfractures in the enamel and dentin, eventually resulting in the loss of tooth structure. The lesions are typically wedge-shaped and occur at the gum line.

Clinical Presentation

Abfraction lesions are characterized by their distinct shape and location. They are usually:

• Wedge-shaped
• Located at the cervical area of the tooth, near the gum line
• Found on the buccal or facial surfaces of teeth

These lesions can be sensitive to thermal stimuli and may lead to dentin hypersensitivity.

Diagnosis

Diagnosing abfraction involves a thorough clinical examination and consideration of the patient's dental history. Dentists look for the characteristic shape and location of the lesions and assess the patient's occlusion and habits such as bruxism. Differential diagnosis is important to distinguish abfraction from other NCCLs like abrasion and erosion.

Treatment

Treatment of abfraction lesions focuses on managing the underlying causes and restoring the lost tooth structure. Approaches may include:

• Occlusal adjustment to reduce excessive forces
• Use of night guards to prevent bruxism
• Restorative procedures, such as composite resin fillings, to restore the tooth's shape and function

Prevention

Preventive measures for abfraction involve addressing the factors that contribute to excessive occlusal forces. This can include:

• Regular dental check-ups to monitor occlusion
• Use of protective appliances like night guards
• Stress management techniques to reduce bruxism

Related pages

• Tooth wear
• Bruxism
• Dental erosion
• Dental abrasion

Gallery

• 
  Abfraction lesion on a tooth
• 
  Example of dental abrasion
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  Close-up of an abfraction lesion