What are dental abfractions and what should be done about them?

Abfractions are erosive lesions found on the necks of individual teeth associated with continuing bone loss, gingival recession and erosion of tooth structure.  The cause is generally multifactorial but in part the lesion is caused and aggravated by torquing forces place on a tooth by the teeth of the opposing jaw.  This force causes bending to take place at the neck of tooth, that results in bone loss, receding gums and erosion.  Once the enamel covering of a tooth is lost for any reason the exposed dentin naturally erodes.  Tooth brushing, although necessary, can increase the rate of erosion .  One good solution for abfractions (toothbrush abrasion) is for a dentist to place  bonded composite restorations over the abfraction surfaces.  This effectively seals the abfraction and tends to limit the extent of further errosion.  The resultant restoration, not only prevents further deterioration, but also improves the appearance of the teeth.  Only minimal preparation of the abfraction defect is required, since it is only used to increase the retention of the bonding by placement of minute undercuts, that tend to keep the filling in place. 

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    Abfraction on left lateral*                       minimal prepartion of abfraction         repaired abfraction on left lateral

*Please note that the two maxillary central teeth had abfraction repairs on prior visits

Lawrence Spindel DDS 30 East 40th st. suite 604, New York, NY  10016