Editorial Type:
Article Category: Review Article
 | 
Online Publication Date: 05 Nov 2024

Restoration of Non-carious Cervical Lesions: A Brief Review for Clinicians

,
,
,
, and
Page Range: 665 – 672
DOI: 10.2341/24-081-LIT
Save
Download PDF

SUMMARY

Non-carious cervical lesions (NCCLs) become common in individuals over the age of 40 and are progressive. Those that are wedge-shaped in cross-section likely develop hazardous stress concentrations along their sharp axial extent, which can be distributed to lower, safer levels over a larger area via adhesive restoration. Restoration is indicated once a lesion progresses to a minimum restorable axial depth of at least 1.5 mm at the deepest extent, which threatens the strength of the tooth, especially a single-rooted tooth. Restorations with a glass ionomer or resin composite employing an adhesive system that is total-etch or is a self-etching primer combined with selective enamel etching are equally effective. Consequently, the restorative material can be selected based on isolation or esthetic factors.

Copyright: 2024
Figure 1.
Figure 1.

Representative wedge-shaped NCCLs on maxillary central incisor and mandibular 2nd premolar.

Figure 2.
Figure 2.

FEA model of unrestored (top) and restored (bottom) wedge-shaped NCCL under functional stresses, facial tooth surface (right). Restoration (bottom) distributes destructive forces (red, dark orange) concentration away from the apex of the lesion11 Stresses shown in the color legend are in Pascals.

Figure 3.
Figure 3.

Representative secondary carious lesion adjacent to Class V resin composite resin restoration on maxillary canine (left).

Figure 4.
Figure 4.

Representative etched enamel surfaces, H3PO4 (top), self-etching primer (middle), self-etching adhesive (bottom). Original magnification 5000×, 2500× (bottom).

Figure 5.
Figure 5.

Representative dentin bonds, total-etch adhesive (top), self-etching primer (middle), self-etching adhesive (bottom). C = resin composite; D = dentin; A = adhesive layer; H = hybrid layer. Arrows indicate an increasing quantity of residual solvent (top, middle, bottom; black) disclosed with AgNO3. Original magnification 10,000×, 4000× (top). Courtesy Franklin R. Tay.

Figure 6.
Figure 6.

Representative wedge-shaped NCCL in maxillary 1st premolar (top left), RMGI restoration (bottom left). Adjacent maxillary canine restored (bottom right) on the same date with resin composite, restorations aged two years.

Figure 7.
Figure 7.

Decision tree to assist clinicians in determining appropriate restoration technique for NCCLs.

Contributor Notes

*Corresponding author: 1120 15th Street, Augusta, GA 30912 USA; e-mail: wbrackett@augusta.edu
  • Download PDF