Clinical Implications of Regressive Alterations of Teeth and their Management

Regressive changes are a group of retrogressive changes of teeth which occur due to nonbacterial causes resulting in wear and tear of tooth structures with impairment of function. Studies1-12 on the mechanism of stress concentration in cervical areas concluded that occlusal loading forces result in tooth flexures which lead to mechanical microfractures and loss of tooth structure in the cervical areas. This loss was termed them as abfraction. Few investigators6-8,10 have concluded that the cause of non carious cervical lesions (NCCLs) could be acid in areas of stress concentration which results in either static or cyclic stress corrosion. Although, tooth wear to a certain extent is accepted as a part of the normal aging process, problems associated with tooth wear are of concern. A dental survey on middle-aged adults showed an increase in the rate of tooth wear with age on the cervical, occlusal and incisal surfaces and studies on young adults reported that prevalence of tooth wear was in the range of 6 to 45%.13,14 The regressive changes of prosthetic concern involve attrition, abrasion, erosion, abfraction and resorption. Diagnosis and management of these regressive alterations of teeth is essential for long-term functionality of the stomatognathic system as well as for the comfort of the patient.