アブストラクト（26巻2号：The Bulletin of Kanagawa Dental College）

The Bulletin of Kanagawa Dental College

English

Title　： A Biomechanical Approach to the Etiology and Treatment of Noncarious Dental Cervical Lesions
Subtitle　： BKDC CLINICAL AND RESEARCH TOPICS : Bioadaptives of Dental Materials
Authors　： Koji Hanaoka, Daisuke Nagao, Kuniharu Mitsui, Akira Mitsuhashi, Shinichiro Sugizaki, Toshio Teranaka
Authors（kana）　：
Organization　： Department of Operative Dentistry and Endodontics, Kanagawa Dental College
Journal　： The Bulletin of Kanagawa Dental College
Volume　： 26
Number　： 2
Page　： 103-113
Year/Month　： 1998 / 9
Article　： Report
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] The etiology of noncarious dental cervical lesions is categorized as follows: abrasions (mechanical frictional wear); erosions (chemical dissolution); abfractions (stress-induced loss). Noncarious cervical lesions may be caused by the interaction of these mechanisms multifactorially, but not just by one mechanism alone. Stress-induced theories are still controversial. Lee and Eakle's theory is a satisfactory mechanism to explain the formation of cervical defects in the enamel near the cementoenamel junction (CEJ). However, there is no proper explanation for the formation of defects in dentin and cementum. The occurrence of cleavage-type cracks in dentin resulting from the accumulation of fatigue stress in this in vitro experiment may support their stress-induced theory. Biomechanical stresses have the possibility of acting as an initial and dominant modifying contributor in producing cervical tooth substance loss and causing dentin hypersensitivity. In this destructive process, additive bioelectrical phenomenon -"streaming potential"- resulting from biomechanical stresses may promote the chemical dissolution of tooth elements. Occlusal guidance is the most significant factor in determining stress establishment in the teeth during eccentric grinding excursions, especially bruxism. Therefore, sequential guidance with canine dominance as a therapeutic occlusion has the possibility of reducing the parafunctional activity of bruxism which causes stress-induced cervical defects. Cervical restorative materials require biomechanically acceptable characteristics including the adequate fatigue durability of dentin adhesive, lower modulus of elasticity (E), higher fracture toughness (KIC). Attention should be paid to the advantages and limitations of restorative materials and the presence of sclerotic dentin in noncarious cervical cavities in order to achieve successful restoration. In addition, supplemental occlusal adjustment for abfracted teeth occasionally is needed to minimize stress concentration at the cervical area.
Practice　： Dentistry
Keywords　： biomechanics, Abfraction, Cervical lesion, Modulus of Elasticity, Fracture toughness