Attrition
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Attrition

Physical And Chemical Injuries

Oral Pathology And Medicine

ATTRITION

CONTRIBUTED BY DR. HIMANI

DEFINATION:

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).

TYPES:

  1. PHYSIOLOGICAL ATTRITION:- Attrition which occurs due to normal ageing process, due to mastication.
  2. PATHOLOGICAL ATTRITION:- It occurs due to certain abnormalities in occlusion, chewing pattern or due to some structural defects in teeth.

ETIOLOGY:

  • Bruxism
  • Chewing tobacco
  • Abrasive dust, that cannot be avoided getting into mouth.
  • Sleep apnea
  • Airway issues
  • Stress
  • Premature contact:- In case of edge to edge contact pathological attrition may also occur.
  • Structral defects:- In defects like amelogenesis imperfecta and dentinogenesis imperfecta.

CLINICAL FEATURES:

  • 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.
  • SIGNS:-
  1. There is gradual reduction in cusp height and consequent flattening of occlusal inclined plane.
  2. There is shortening of length of dental arch, due to reduction in mesiodistal diameter of teeth
  3. Secondary dentin deposition occurs.    

RADIOGRAPHIC FEATURES:

  • 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.

 

 

MANAGEMENT:

HABIT BREAKING APPLIANCE:-

  • Soft bite guard
  • Occlusal interferance splint
  • Stabilization splint

CORRECTIVE METHOD:-

  • 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.

VIDEO LINK: 

Youtube Video Link

REFERENCES:

  1. STURDEVANT’S – Art and science of operative dentistry,  a south asian edition, pg no- 295 to 297
  2. TEXTBOOK OF ORAL MEDICINE- Anil ghoom, 3rd edition, pg no 112 & 113
  3. SHAFER’S TEXTBOOK OF ORAL PATHOLOGY- 7th edition, pg no -571 & 572.
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