Physical And Chemical Injuries
Oral Pathology And Medicine
CONTRIBUTED BY DR. HIMANI
Attrition is the mechanical wearing of the inscisal or occlusal surface as a result of functional or parafunctional movements of mandible (tooth to tooth contact).
- PHYSIOLOGICAL ATTRITION:- Attrition which occurs due to normal ageing process, due to mastication.
- PATHOLOGICAL ATTRITION:- It occurs due to certain abnormalities in occlusion, chewing pattern or due to some structural defects in teeth.
- Chewing tobacco
- Abrasive dust, that cannot be avoided getting into mouth.
- Sleep apnea
- Airway issues
- Premature contact:- In case of edge to edge contact pathological attrition may also occur.
- Structral defects:- In defects like amelogenesis imperfecta and dentinogenesis imperfecta.
- SEX:- Men usually exibhit more severe attrition than women with comparable age.
- SITE:- It occurs only on occlusal, inscial and proximal surfaces of teeth.
- APPEARANCE:- The first clinical manifestation of attrition may be the appearance of small polished facet on a cusp tip or ridge or a slight flattening of incisal edge.
- CONTACT POINT:- Due to slight mobility of teeth in their socket(which is manifestation of resiliency of periodontal ligament) similar facets occur at contact points.
- COLOR OF TEETH:- When the dentin is exposed it generally becomes discoloured, i.e brown in colour.
- There is gradual reduction in cusp height and consequent flattening of occlusal inclined plane.
- There is shortening of length of dental arch, due to reduction in mesiodistal diameter of teeth
- Secondary dentin deposition occurs.
- CROWN:- smooth wearing of incisal and occlusal surfaces of involved teeth is evident by shortened crown image.
- PULP:- sclerosis of pulp chamber and canals is seen due to deposition of secondary dentin that narrows the pulp canals
- PERIODONTAL LIGAMENT:- widening of periodontal ligament space and hypercementosis
- ALVEOLAR BONE:- some loss of alveolar bone is seen.
HABIT BREAKING APPLIANCE:-
- Soft bite guard
- Occlusal interferance splint
- Stabilization splint
- Correction of malocclusion
- Stoppage of tobacco chewing habit
- Restriction of diet to non coarse food
MANAGEMENT OF SENSITIVITY AND ESTHETICS:-
- Non carious loss of tooth tissue may require treatment for sensitivity, esthetics, function and space loss in vertical dimension.
- STURDEVANT’S – Art and science of operative dentistry, a south asian edition, pg no- 295 to 297
- TEXTBOOK OF ORAL MEDICINE- Anil ghoom, 3rd edition, pg no 112 & 113
- SHAFER’S TEXTBOOK OF ORAL PATHOLOGY- 7th edition, pg no -571 & 572.