Tuesday, July 28, 2009

Treatment for Dental Abfraction

Ask The Dentist
The Cosmetic Dentistry Center in the Houston Medical Center Dental Group offers the full range of cosmetic dentistry procedures and general dentistry practices. Every patient is treated as a genuinely unique individual with his or her own set of unique and specific needs. We like to say that no two smiles are exactly alike, so when you come to our office, you can be confident we provide your smile with a restorative or cosmetic solution that is specifically created just for you.
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What is treatment of abfraction?
What are criteria of the filling material for abfraction?

Hazem Galal Mors


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Hello – welcome to our website and practice. I see that you are familiar with the term “abfraction”, which describes the entire complex situation that leads to a tooth lesion and much of the tooth sensitivity that we see. These areas at the gumline of teeth are often sensitive, and it is a common complaint that we see. Patients will complain of cold sensitivity around the necks of their teeth. These used to be called “toothbrush abrasion”, but the cause is more complicated that that, and it is primarily the flexing of the teeth in people who clench and grind their teeth. There is a range of treatment choices for abfractive lesions, depending on the patient and the severity of the problem.


I. treatment of abfraction:

1. Minimal involvement, with a small amount of tooth structure gone from the neck of the tooth and a small amount of tooth sensitivity (usually to cold)

- no treatment is acceptable

- occlusal equilibration (bite adjustment)

-dental varnishes, topical fluoride, Sensodyne tooth paste

- protective acrylic guard



2. Moderate involvement, which is more likely to be sensitive to cold, and also has more soft tissue recession and visible loss of tooth structure

- occlusal equilibration (bite adjustment)

-dental varnishes, topical fluoride, Sensodyne tooth paste

- protective acrylic guard

- bonding material placement to cover root surface


3. Advanced involvement often has root sensitivity that is severe and irreversible

- occlusal equilibration (bite adjustment)

- protective acrylic guard

- bonding material placement to cover root surface

- crowning tooth for more advanced coverage

- root canal treatment depending on the severity


II. Filling material for abfraction: Depending on the severity of the case and doctor preference, several types of materials can be used:

1. Composite resins
2. Flowable composite resins
3. Glass ionomers


We focus our efforts in the direction of management of forces, as we believe this is the most dominant factor in this multifactorial problem. The excessive forces that cause abfractions can lead to several common problems:

1)Abfractions
2) Sensitive teeth
3) Loosening of teeth
4) Excessive wear of teeth
5) Change in alignment of teeth
6) Bone breakdown and bone loss
7) Broken or destroyed restorations
8) Non-bacterial, non-plaque related gingival recession
9) Opening of contacts

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I hope that this gives you more perspective on this complex problem. It needs more consideration than what material to use. In our opinion, it is an important problem that does not get enough attention or conversation in assessing overall dental health.



Chuck Campbell, DDS

713-795-5905

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