Treatment of

Small NonCarious
Lesions

CERVICAL ABRASION
(Abfraction)
hard, smooth, angular notch-like or cupshaped defect at facial CEJ
sensitivity to touch varies
cause: toothbrush &/or tooth flexure

Abrasion,
Attrition,
Erosion

INDICATIONS FOR RESTORATION

deep enough to weaken tooth

approaching pulp
esthetic concern
carious
hypersensitive

iatrogenic cervical abrasion

EROSION
hard, smooth, poorly demarcated loss of
tooth structure
often very sensitive to touch & cold
cause: chemical (usually regurgitation)
treatment: eliminate cause, desensitizing
treatment, or full mouth reconstruction

the hourglass incisor

ATTRITION WITH DENTIN CUPPING

loss of tooth structure from occluding
surfaces
dentin wears in advance of enamel
creating cupping
surrounding enamel left weak & prone to
chipping
can lead to catastrophic or angular wear
patterns
cause: occlusal wear (usually bruxism)
restore deep dentin cupping with
composite resin

facets of wear

dentin
cupping

facets of wear

dentin cupping defect

with carious dentin

in contact with
opposing tooth
unable to
restore with
composite resin

dentin cupping
carious dentin
caries halo

amalgam halo

PREPARATION OF THE CERVICAL ABRASION LESION

FOR COMPOSITE RESIN

PREPARATION OF THE CERVICAL ABRASION LESION

FOR RESIN MODIFIED GLASS IONOMER

ROUGHEN
SCLEROTIC
DENTIN

ROUGHEN
SCLEROTIC
DENTIN

BEVEL
ENAMEL

NO
BEVEL

ETCH
30-45 SEC

CONDITION
DENTIN

MATERIAL OF CHOICE FOR

CERVICAL ABRASION LESIONS

ATTRITION WITH DENTIN CUPPING

WHEN ISOLATION, ACCESS, & VISIBILITY

OPTIMUM, AND MARGINS ON ENAMEL:
COMPOSITE RESIN
WHEN ISOLATION, ACCESS, & VISIBILITY
OPTIMUM, AND MARGINS ON ROOT
SURFACE:
RESIN-MODIFIED GLASS IONOMER
IF DIFFICULT ISOLATION, ACCESS, OR
VISIBILITY:
AMALGAM (REQUIRES CLASS V CAVITY
PREPARATION)

ATTRITION WITH DENTIN CUPPING

RESTORED WITH LOW PROFILE COMPOSITE RESIN

EXTRACTED TOOTH EXERCISE

NO

YES

Biohazard: use gloves, mask, and eye protection

CERVICAL ABRASION/ABFRACTION LESION

3-4
mm
2-3 mm

not simulated in this exercise

shade selection
local anesthesia (not always necessary)
isolation

get bench instructor approval before restoring

roughen sclerotic dentin

cavity conditioner (25% polyacrylic acid)

condition enamel & dentin 10 sec,

rinse 20 sec,
air dry

Fuji II LC
resin-modified glass ionomer

tap capsule on bench top to loosen powder

inside
2-step capsule activation: (1) depress
plunger on desktop,

Fuji II LC dispensing syringe

2-step capsule activation: (2) insert into

syringe and click trigger one time

capsule release button

 mix in amalgamator for 10 sec @ high speed

(rabbit)

layers no more than 2mm thick

insert capsule into syringe

pump handle 3X
s
keep nozzle in growing mass
working time 2.5 minutes

light cure 40 sec

finish as for composite resin

maintain M-D & O-G contours
do NOT abrade root surface

get instructor signature on Miscellaneous Evaluation page

discard tooth in designated container