Skip to main content

The anatomy of non-carious cervical lesions

Abstract

Objective

The term “non-carious cervical lesion” (NCCL) describes a dental hard tissue defect of unknown origin. Two very distinct variations are known: wedge-shaped and saucer-shaped lesions. Reasons for occurrence of two forms might include different contributing factors.

Methods

Forty-two teeth, 19 wedge-shaped and 23 saucer-shaped lesions, were analysed by light and confocal laser scanning microscopy (CLSM) to investigate presence of calculus and organic matter, surface structure of the lesion, borders of the lesion, and potential fractures in the dental hard tissues.

Results

One hundred percent of the wedge-shaped teeth showed evidence of additional abrasion (incisal/occlusal surface) but only 70 % of the saucer-shaped teeth. In most teeth, the edge was rounded. Tiny grooves parallel to the cemento-enamel junction (CEJ) were present in 11 % of the wedge-shaped and in 39 % of the saucer-shaped lesions. Seventy-nine percent wedge-shaped and 52 % saucer-shaped lesions had some sort of apposition. Eighty-eight percent of all teeth had dead tracts, 62 % of which were located directly next to the defect (in the lesion). In 48 %, sclerotic dentin was present right next to the defect (in the lesion). Tertiary dentin was visible in 60 %. Not a single fracture was detected.

Conclusion

Different characteristics associated with each type of cervical lesion support the theory of different aetiology or at least of differing contributions from different factors that participate in the development of NCCLs.

Clinical relevance

Only knowledge of the correct aetiology of NCCLs will allow the best treatment and prevention for such lesions.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

References

  1. Eccles JD (1979) Dental erosion of nonindustrial origin. A clinical survey and classification. J Prosthet Dent 42(6):649–653

    PubMed  Article  Google Scholar 

  2. Arambawatta K, Peiris R, Nanayakkara D (2009) Morphology of the cemento-enamel junction in premolar teeth. J Oral Sci 51(4):623–627

    PubMed  Article  Google Scholar 

  3. Neuvald L, Consolaro A (2000) Cementoenamel junction: microscopic analysis and external cervical resorption. J Endod 26(9):503–508

    PubMed  Article  Google Scholar 

  4. Piotrowski BT, Gillette WB, Hancock EB (2001) Examining the prevalence and characteristics of abfractionlike cervical lesions in a population of US veterans. J Am Dent Assoc 132(12):1694–1701, quiz 1726–1697

    PubMed  Google Scholar 

  5. Estafan A, Furnari PC, Goldstein G, Hittelman EL (2005) In vivo correlation of noncarious cervical lesions and occlusal wear. J Prosthet Dent 93(3):221–226

    PubMed  Article  Google Scholar 

  6. Michael JA, Townsend GC, Greenwood LF, Kaidonis JA (2009) Abfraction: separating fact from fiction. Aust Dent J 54(1):2–8

    PubMed  Article  Google Scholar 

  7. Wood I, Jawad Z, Paisley C, Brunton P (2008) Non-carious cervical tooth surface loss: a literature review. J Dent 36(10):759–766. doi:10.1016/j.jdent.2008.06.004

    PubMed  Article  Google Scholar 

  8. Takehara J, Takano T, Akhter R, Morita M (2008) Correlations of noncarious cervical lesions and occlusal factors determined by using pressure-detecting sheet. J Dent 36(10):774–779

    PubMed  Article  Google Scholar 

  9. Young A, Tenuta LM (2011) Initial erosion models. Caries Res 45(Suppl 1):33–42

    PubMed  Article  Google Scholar 

  10. Wiegand A, Attin T (2011) Design of erosion/abrasion studies—insights and rational concepts. Caries Res 45(Suppl 1):53–59

    PubMed  Article  Google Scholar 

  11. Aw TC, Lepe X, Johnson GH, Mancl L (2002) Characteristics of noncarious cervical lesions: a clinical investigation. J Am Dent Assoc 133(6):725–733

    PubMed  Google Scholar 

  12. Khan F, Young WG, Shahabi S, Daley TJ (1999) Dental cervical lesions associated with occlusal erosion and attrition. Aust Dent J 44(3):176–186

    PubMed  Article  Google Scholar 

  13. Litonjua LA, Andreana S, Patra AK, Cohen RE (2004) An assessment of stress analyses in the theory of abfraction. Biomed Mater Eng 14(3):311–321

    PubMed  Google Scholar 

  14. McCoy G (1982) The etiology of gingival erosion. J Oral Implantol 10(3):361–362

    PubMed  Google Scholar 

  15. McCoy G (1983) On the longevity of teeth. J Oral Implantol 11(2):248–267

    PubMed  Google Scholar 

  16. Grippo JO (1991) Abfractions: a new classification of hard tissue lesions of teeth. J Esthet Dent 3(1):14–19

    PubMed  Article  Google Scholar 

  17. He LH, Xu Y, Purton DG (2011) In vitro demineralisation of the cervical region of human teeth. Arch Oral Biol 56(5):512–519

    PubMed  Article  Google Scholar 

  18. Nguyen C, Ranjitkar S, Kaidonis JA, Townsend GC (2008) A qualitative assessment of non-carious cervical lesions in extracted human teeth. Aust Dent J 53(1):46–51

    PubMed  Article  Google Scholar 

  19. Hur B, Kim HC, Park JK, Versluis A (2011) Characteristics of non-carious cervical lesions—an ex vivo study using micro computed tomography. J Oral Rehabil 38(6):469–474

    PubMed  Article  Google Scholar 

  20. Rasmussen ST, Patchin RE, Scott DB, Heuer AH (1976) Fracture properties of human enamel and dentin. J Dent Res 55(1):154–164

    PubMed  Article  Google Scholar 

  21. Qin W, Song Z, Ye YY, Lin ZM (2012) Two-year clinical evaluation of composite resins in non-carious cervical lesions. Clin Oral Investig. doi:10.1007/s00784-012-0780-7

  22. Santamaria MP, Casati MZ, Nociti FH Jr, Sallum AW, Sallum EA, Aukhil I, Wallet SM, Shaddox LM (2012) Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: microbiological and immunological results. Clin Oral Investig. doi:10.1007/s00784-012-0690-8

  23. Burrow MF, Tyas MJ (2012) Comparison of two all-in-one adhesives bonded to non-carious cervical lesions—results at 3 years. Clin Oral Investig 16(4):1089–1094. doi:10.1007/s00784-011-0595-y

    PubMed  Article  Google Scholar 

  24. Ermis RB, Van Landuyt KL, Cardoso MV, De Munck J, Van Meerbeek B, Peumans M (2012) Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years. Clin Oral Investig 16(3):889–897. doi:10.1007/s00784-011-0565-4

    PubMed  Article  Google Scholar 

  25. Peumans M, De Munck J, Van Landuyt KL, Poitevin A, Lambrechts P, Van Meerbeek B (2012) A 13-year clinical evaluation of two three-step etch-and-rinse adhesives in non-carious class-V lesions. Clin Oral Investig 16(1):129–137. doi:10.1007/s00784-010-0481-z

    PubMed  Article  Google Scholar 

  26. Loguercio AD, Raffo J, Bassani F, Balestrini H, Santo D, do Amaral RC, Reis A (2011) 24-Month clinical evaluation in non-carious cervical lesions of a two-step etch-and-rinse adhesive applied using a rubbing motion. Clin Oral Investig 15(4):589–596. doi:10.1007/s00784-010-0408-8

    PubMed  Article  Google Scholar 

  27. Pecie R, Krejci I, Garcia-Godoy F, Bortolotto T (2011) Noncarious cervical lesions—a clinical concept based on the literature review. Part 1: prevention. Am J Dent 24(1):49–56

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Walter.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Walter, C., Kress, E., Götz, H. et al. The anatomy of non-carious cervical lesions. Clin Oral Invest 18, 139–146 (2014). https://doi.org/10.1007/s00784-013-0960-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-013-0960-0

Keywords

  • Non-carious cervical lesion
  • Abrasion
  • Abfraction
  • Erosion
  • Occlusal wear