Presence Of Non-carious Cervical Lesions Research Articles

Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis

ObjectivesHistorically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence.Materials and MethodsThe present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines.ResultsAfter the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits.ConclusionsIn summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets. Clinical relevance: Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.

Risk Factors associated with noncarious cervical lesions.

Noncarious cervical lesions (NCCLs) is the dental structure loss unrelated to caries. The aim was to investigate the possible relationship between bruxism, age, gender, daily routine and dietary habits and NCCL, and correlate with sensitivity and position in the dental arch. 245 patients aged between 18 and 40 participated in the survey, in which a questionnaire focused on parafunctional habits, erosion, abrasion, dental abfraction and acidic diet was conducted. Facial symmetry analysis, masseter hypertrophy, occlusion evaluation, and presence of wear facets and NCCL. Data were expressed as absolute and percentage frequency and were analyzed using the Fisher's Exact/Chi-square tests and a multinomial logistic regression model. NCCLs was observed in 46.6 % in the participants. Bruxism was observed in 64% of the individuals, and stress in 33%. Wear facets and acidic diets were reported in 75% and 60% of the sample, respectively. There was no significant relationship between NCCL and gender (p = 0.74), bruxism (p = 0.33), stress (p = 0.52), wear facets (p = 0.73), and acidic diets (p = 0.39). Age over 30 years was more strongly associated with NCCL (p< 0.001). Age showed a direct correlation with noncarious cervical lesions. Factors including gender and dietary and parafunctional habits, such as bruxism, were not differential regarding the presence of NCCL. Key words:Tooth wear, non-carious cervical lesions, bruxism.

The prevalence and predictive factors of dentine hypersensitivity among adults in Turkey

AimThis study sought to determine the prevalence of dentine hypersensitivity (DH) among adults in Turkey. Also, to ascertain the association between DH and both etiological predictors and demographic patient characteristics.Material methodUsing a questionnaire and thermal and evaporative tests, 259 women and 209 men in the age range of 18 to 72 were analyzed. Individually, a clinical evaluation of DH signs was conducted. The DMFT index, gingival index, and gingival bleeding were reported for each subject. The gingival recession and tooth wear of sensitive teeth were also evaluated. Pearson Chi-square test was used to compare categorical data. Logistic Regression Analysis was used to examine the risk factors of DH. Data with dependent categorical variables were compared using the McNemar-Browker test. The significance level was p < 0.05.ResultsThe average age of the population was 35.6 years. In the present study, a total of 12,048 teeth were analyzed. 1755 had thermal hypersensitivity (14.57%), while 470 experienced evaporative hypersensitivity (3.9%). The incisors were the teeth most impacted by DH, whereas the molars were the least affected. Exposure to cold air and sweet foods, gingival recession, and the presence of noncarious cervical lesions were all strongly linked to DH (Logistic regression analysis, p < 0.05). The cold stimulus increases sensitivity more than the evaporation stimulus.ConclusionSignificant risk factors for both thermal and evaporative DH include cold air, consumption of sweet food, presence of noncarious cervical lesions, and gingival recession. More epidemiological research in this area is still required to fully characterize the risk factors and implement the most effective preventive interventions.

Association of Non-carious Cervical Lesions with Oral Hygiene Aspects and Occlusal Force.

The purpose of this case-control (CT) study was to investigate the association between the presence of non-carious cervical lesions (NCCLs) with occlusal force and other potential risk factors. Thirty-nine participants with NCCLs [cases (CS)] and 39 with no NCCLs [control (CT)] attending the dental clinic of the Faculdades Integradas São Pedro (FAESA), located in Brazil, were enrolled in this study. Information was collected through anamnesis, clinical examination, and a questionnaire addressing aspects related to tooth brushing, dentifrice, and mouthwash use. In clinical examination, patients were submitted to four measurements of occlusal force in the maxillary first premolars and maxillary first molars, using a strain gauge sensor of medium intensity, the Flexiforce (Tekscan, South Boston, Massachusetts, United States of America). The sensor was calibrated for the unit of measurement in Newtons (N). Data were analyzed using a student's t-test and multiple logistic regression, e with a significance level of 5%. There was no statistically significant difference between the case and CT groups regarding the bite force in the four measured regions. Logistic regression identified sex as a factor significantly associated with NCCLs (p = 0.020). The odds ratio showed the female sex had more chance (OR = 6.082; CI = 1.332-27.765) of having NCCLs. It is concluded that females presented a higher risk factor for NCCLs than men. In contrast, there was no association of occlusal force, as well as aspects related to brushing and deleterious habits. Females have a higher risk factor for non-carious lesions than men.

Current state about root coverage using soft-tissue substitutes in the presence of noncarious cervical lesions: A literature review.

About half of the cases of gingival recession are associated with the noncarious cervical lesion (NCCL), resulting in combined defects (CDs). NCCL negatively affects the root coverage outcomes. In addition, considering the morbidity associated with graft harvesting, soft-tissue substitutes (STSs) appeared as a suitable option for connective tissue grafts for surgical root coverage. Currently, the literature addressing the therapy of CDs employing STSs is scarce. Thus, the present review aimed to update the literature and outline the future perspectives about root coverage of CDs using STSs. A detailed literature search was conducted on MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Google Scholar databases using keywords and Boolean operators. Randomized clinical trials (2) and case reports (6) were included. None of the selected studies reported any adverse effect using STSs. Based on the limited evidence available, we cannot state that STSs may benefit the periodontal clinical and patient-centered outcomes. Randomized controlled trials are needed to assess the long-term outcomes, surgical approaches, and restorative protocols.

Knowledge and Attitudes on Preventing and Treating Dentin Hypersensitivity and Its Predicting Factors: A Cross-sectional Study with Brazilian Citizens.

Most dental schools have included dentin hypersensitivity (DH) as part of their taught curriculum to educate undergraduates; however, it is possible that the public still does not recognize its symptoms and the factors that predispose to the onset of this condition. Thus, the aim of this study was to assess the knowledge of a Brazilian population regarding the prevention and treatment of DH and to identify what self-reported factors can serve as predictors of the frequency of DH. An online questionnaire investigated the demographic characteristics, oral health self-perception and attitudes, and DH prevention and treatment measures of 226 participants. Data were analyzed descriptively and by a multiple linear regression with DH frequency score as the dependent variable (α < 0.05). Total 61.1% of females (n = 138) and 38.9% of males (n = 88) (mean age: 35.1 ± 12.2 years) completed the questionnaire. The sample's mean DH frequency score (minimum 0; maximum 20) was 4.2 and classified as low, with 19.1% using desensitizing products and 22.1% reporting having noncarious cervical lesions (NCCLs). When experiencing DH episodes, 21.2% never and 30.1% rarely scheduled dental appointments. Regression analysis retrieved a significant final model (F [5,220] = 12.047; p < 0.001; R 2 = 0.215). This study identified that 36.7% and 18.6% of the sample were unaware that DH can be both prevented and treated, respectively. Moreover, the presence of NCCLs, frequency of daily toothbrushing, use of desensitizing products, presence of DH modulating factors, and the presence of parafunctional habits symptoms served as predictors of DH frequency.

Clinical Behavior of the Gingival Margin following Conservative "Coronally Dynamic" Restorations in the Presence of Non-Carious Cervical Lesions Associated with Gingival Recession: A Pilot Study.

Gingival recessions (GR) are often associated with the presence of non-carious cervical lesions (NCCL). The latter result in the disappearance of the cement–enamel junction (CEJ), with consequent difficulties both in measuring the recession itself and in performing root coverage techniques. The restoration of cervical lesions is consequently an important aspect in the treatment of GR, with the re-establishment of a “new” CEJ. This pilot study aimed to verify whether restorative therapy alone, with the execution of a restoration that mimics the convexity of the natural CEJ and thanks to a slight horizontal over-contour, can stabilize a clot in the intrasulcular site and consequently is able to change the position of the gingival margin in a coronal direction. In periodontally healthy patients, with a non-thin gingival phenotype, 10 GR-associated NCCL restorations were performed using a protocol inspired by concepts of prosthetic conditioning, with a progressively reduced convexity (“coronally dynamic restoration”) and de-epithelialization of the gingival sulcus. We observed that 70% of the treated teeth showed a reduction in crown length after 15 days (−0.267 mm), without an increase in probing depth. While considering the limitations of the sample and the need to evaluate the different parameters that can affect the result, the coronally dynamic restoration of NCCL with GR was able to influence the position of the gingival margin in a coronal direction.

The frequency of cervical dentine hypersensitivity and possible etiological factors in an urban population: A cross-sectional study

Background/Aim. Dentine hypersensitivity (DH) is a commonly encountered clinical problem characterized by short, sharp pain which arises from exposed dentine. The aim of this study was to estimate the frequency of cervical DH in adults in Pancevo, Serbia, evaluate the correlation between DH and severity of cervical tooth wear, and investigate the impact of certain etiological factors. Methods. The study included 394 subjects, who were clinically examined and interviewed about potential etiological factors using a specially designed questionnaire. The presence of cervical DH was evaluated using cold air stimulation and Schiff ordinal scale. The severity of cervical tooth wear was evaluated using the Basic Erosive Wear Examination (BEWE). Results were analyzed using ?2 tests and logistic regression at a significance level of p ? 0.05. Results. The presence of cervical DH was recorded in 32.9% of the total number of subjects. The ?2 analysis showed a significant association between clinically elicited and questionnaire-declared DH (p &lt; 0.001), but not with the presence of noncarious cervical lesions and the extent of cervical tooth wear. Cervical DH showed a positive correlation with gender (p &lt; 0.001), frequent consumption of citrus fruits (p &lt; 0.001), and energy drinks (p = 0.005). Oral hygiene and other factors were not significantly associated. Conclusion. The prevalence of cervical DH in the investigated sample was relatively high. DH was more prevalent among females and significantly associated with frequent consumption of citrus fruits and energy drinks.

Fracture Resistance of Endodontically Treated Maxillary Premolars with Non-carious Cervical Lesions Restored with Different Post Systems.

To test the hypothesis that the (i) presence of non-carious cervical lesions (NCCLs) and (ii) type of post system have no effect on the fracture resistance and pattern in endodontically treated maxillary premolars. Human maxillary first premolars (n=60) with two root canals were randomly allocated into four groups (n=15). Buccal wedge-shaped NCCLs were prepared in 45 teeth specimens. Following root canal treatment, the specimens were randomly divided into (i) composite resin core (CRC); (ii) NCCLs + composite resin core (NCCL+CRC); (iii) NCCLs+prefabricated fibre-reinforced composite post + composite resin core (NCCL+PFRC+CRC); (iv) NCCLs+custom fibre posts + composite resin core (NCCL+CFP+CRC). All specimens were subjected to thermocycling (5°C to 55°C/5000 cycles). The compressive load was applied non-axially to the palatal cusp with a universal testing machine at a crosshead speed of 0.5 mm/min at a 30° angle until fracture. Fracture patterns were examined using a loupe magnification (2.5×) under transillumination. Statistical analyses were performed using non-parametric tests and pairwise comparisons of the load-to-fracture among the groups. Chi-square test was used to analyse the fracture patterns (P=0.05). Fracture resistance of NCCL+PFRC+CRC was significantly higher than NCCL+CRC (P=0.011), while NCCL+CFP+CRC did not show any significant difference when compared to NCCL+CRC (P=0.089). No statistical difference was found between CRC, NCCL+PFRC+CRC and NCCL+CFP+CRC (P=1.000). The frequencies of favourable fracture patterns in descending orders were as follows: CRC (80%), NCCL+CFP+CRC (73%), NCCL+PFRC+CRC (60%), and NCCL+CRC (40%). Chi-square test did not show significant differences in fracture patterns among all groups (P=0.110). Restoration of the endodontically treated maxillary premolars with NCCLs, with or without post, resulted in similar fracture resistance as their counterparts without NCCLs. Placement of a prefabricated fibre-reinforced composite post exhibited greater fracture resistance to the maxillary premolars with restored NCCLs than those without a post. (EEJ-2022-06-077).

The prevalence of non-carious cervical lesions (NCCLs) with or without erosive etiological factors among adults of different ages in Tokyo.

To evaluate the prevalence of non-carious cervical lesions (NCCLs) on teeth with or without erosive etiological factors across a broad range of ages of Japanese adults. The study sample consisted of a total of 1108 subjects aged 15 to 89years in Tokyo, Japan. Two examiners evaluated NCCLs and dental erosion (DE) during a full-mouth examination. Subjects were asked to complete a self-administered daily diet, habits, and health condition questionnaire. Subjects who had frequent acid consumption or gastric reflux and at least one tooth with initial enamel wear were placed in the erosion present (EP) group, and the remainder of subjects were placed in the erosion not present (EN) group. Logistic regression analyses were carried out to identify etiological factors of NCCLs associated with DE. Overall prevalence of NCCLs was 60.2%; the prevalence increased with age. There were no statistical differences in the prevalence of NCCLs between the EP and EN groups, except for the 60-69years group. Multiple logistic regression analysis showed the frequency of consumption of carbonated soft drinks, citrus juice, and acidic fruits such as oranges; tooth brushing pressure; and bruxism were associated with the presence of NCCLs. There were no statistical differences in the prevalence of NCCLs with or without erosive etiological factors except for the 60-69years group. NCCL distribution increased with age, and erosive risk factors caused by change in dietary habits might affect the incidence of NCCLs for elders. UMIN000041982.

Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral-health related quality of life among Brazilian adults

ObjectivesTo assess the association between dentin hypersensitivity (DH) (with or without non-carious cervical lesions (NCCL)) and physical and psychosocial oral health impact. MethodsA cross-sectional population-based study with one-stage random sample of adults living in a Brazilian municipally was conducted between 2018 and 2019. Interviews and oral examinations were performed by calibrated examiners (Kappa ≥0.7). The participant was considered as having physical and psychosocial impact if at least one item of the Oral Health Impact Profile (OHIP-14) was experienced fairly often or very often. NCCL was assessed by the Tooth Wear Index (codes 2 to 4) and DH was evaluated by a tactile test with a probe in the cervical area of teeth. The combination of these clinical variables resulted in categories of the independent variable: without DH or NCCL, NCCL without DH, DH without NCCL, and both DH with NCCL. The covariables were sociodemographic and economic factors, health habits, and oral conditions. Associations were investigated by Poisson Regression models using Direct Acyclic Graph (Stata 17). ResultsOf 197 adults, 59.3% had oral health impact and 31.3% had DH with NCCL. Higher frequency of oral health impact was observed in adults with DH alone. A higher impact on the physical pain dimension of the OHIP-14 was observed in adults with DH and NCCL (PR: 2.46; 95% CI: 1.21–5.00) and with DH alone (PR: 2.03; 95% CI: 1.21–3.41). ConclusionNCCL and DH are common conditions in adults and the presence of DH is associated with higher oral health impact. Regardless the presence of NCCL, DH is associated with the physical pain dimension of OHRQoL.

Association between anxiety and the presence of non-carious dental cervical lesions

Objetivo: este estudo tem como objetivo avaliar a associação entre ansiedade, hábitos alimentares, parafuncionais, condições sistêmicas, hábitos de higiene oral em associação com a ansiedade de pacientes com lesões cervicais dentárias não cariosas (LCNCs) em uma população. Material e Métodos: por meio de um estudo quantitativo, observacional, 100 pacientes, obtidos por cálculo do tamanho da amostra, com presença de LCNCs, foram avaliados por exame clínico e cálculo amostral; entre 20 e 58 anos, com idade média de 37 anos. Os dados foram coletados por meio de um questionário elaborado por um pesquisador previamente calibrado, referente à avaliação médica, odontológica, de histórico social e de ansiedade. Após a obtenção dos dados, eles foram tabulados e submetidos à análise estatística pelo teste binomial exato de Fisher de duas proporções, adotando um nível de significância de 5%. Resultados: o consumo de bebida gaseificada (81,6%), frutas cítricas (76,3%), frequência de escovação dentária igual ou superior a três vezes ao dia (100%) e abrasividade do creme dental (100%) foram significativamente associados à presença de NCCL (p = 0,0001). Doença do refluxo gastrointestinal, xerostomia, bulimia e anorexia demonstraram associação negativa com o NCCL (p=1,000). A ansiedade não mostrou relação direta com a NCCL na população estudada (36,8%). Conclusão: assim, pode-se concluir que não houve associação direta entre a presença de lesões cervicais não cariosas e a ansiedade

The Influence of Cementoenamel Restorations in the Treatment of Multiple Gingival Recession Defects Associated with Noncarious Cervical Lesions: A Prospective Study.

The aim of this present prospective study was to evaluate the outcomes of the multiple coronally advanced flap (MCAF) with a site-specific application of connective tissue graft (CTG) for the treatment of multiple gingival recession defects with or without the presence of noncarious cervical lesions (NCCLs). Analysis of periodontal conditions was performed in order to determine if the cementoenamel junction (CEJ) restorations could affect adequate plaque control as well as maintenance over time. A total of 93 gingival recessions were treated, 61% of which presented a NCCL restored with composite resin positioned 1 mm apical to the position of the anatomical CEJ. The surgical treatment involved MCAF+CTG for 54 sites and MCAF alone for 39 sites. At 12 months, complete root coverage (CRC) and periodontal parameters of restored and nonrestored teeth were assessed, and the differences between the two groups were not significant. It can be concluded that the proposed treatment modality does not produce a negative effect on periodontal condition and amount of CRC, thus resulting in a satisfactory esthetic result.

The Role of Occlusal Factors in the Presence of Noncarious Cervical Lesions in Young People: A Case-Control Study.

The aim of this retrospective case-control study was to evaluate the influence of different occlusal characteristics and self-referred bruxism in the presence of noncarious cervical lesions (NCCLs). The participants were 280 students (140 cases and 140 controls), with an average age of 24.5 years, from six schools of dentistry in Spain. Clinical examination was carried out to record the NCCLs and the static and dynamic occlusal characteristics. The side of mastication and bruxism was collected by questionnaire. Data variables were analyzed by means of univariate and multivariate logistic regression. Odds ratios and the respective 95% confidence intervals were calculated ( p<0.05). The presence of NCCLs was significantly more likely in subjects with protrusive interferences (odds ratio [OR]=1.82); with lateral interferences, especially on the nonworking side (OR= 1.77); or who were self-reported bruxists (OR=1.72). In the multivariate analysis, protrusive interferences, bruxism, age, and the presence of attrition were risk factors for the development of NCCLs. These factors resulted in a model with an area under the receiver-operating characteristic curve of 0.667 and a positive predictive value of 61.43%. There was no significant relationship between most occlusal factors and the presence of NCCLs. Only bruxism, protrusive interferences, age, and occlusal wear were risk factors. The predictive model was not sufficiently explanatory. Occlusal factors alone do not appear to be sufficient to explain the presence of NCCLs.

Non-carious cervical lesions and risk factors: A case-control study.

To evaluate whether the presence of non-carious cervical lesions (NCCLs) was related to the considered risk factors and to show the corresponding odds ratio in a predictive model. The sample was 280 dentistry students. In an initial clinical examination, 140 cases were selected that presented one or more teeth with non-carious cervical wear. For each case, a similar sex and age control without any tooth with non-carious cervical lesions was selected. An occlusal examination and periodontal probing were performed in all cases and controls by skilled dentists. All the subjects answered a questionnaire referring to factors of brushing, bruxism, preferred chewing side, consumption of extrinsic acids and the presence of intrinsic acids. Data were analysed by means of univariate and multivariate logistic regression. Of all the study variables, only the protrusion interferences, interferences on the non-working side, the brushing force, CPITN value and the consumption of salads increase the risk of NCCLs in the univariate regression. The best predictive model was formed by the combination of CPITN variables >1, the consumption of acidic salads, self-reported bruxism, brushing force and attrition. However, it only correctly classifies 68.75% of subjects. This study supports the multifactorial aetiology of NCCLs, the combination of several factors being necessary to explain their presence. The risk factors that make up the predictive model are not sufficient to explain the appearance of NCCLs. Dentists should take into account all these risk factors in prevention, diagnosis and treatment.

Epidemiological investigation of non-carious cervical lesions and possible etiological factors

BackgroundEpidemiological studies of non-carious cervical lesions (NCCLs) are being conducted in all geographical regions, which is completely justified, considering the high frequency of these lesions and possible consequences. Data obtained from such studies are of great importance because, beside describing the extent and degree of lesions, they can also point to specific etiological factors. The purpose of this study was to analyze the frequency and distribution of NCCLs among the patients of Faculty of Dentistry in Pancevo, Serbia, and to investigate the impact of certain etiological factors on the frequency of NCCLs.Material and MethodsThe study included 394 patients, who were clinically examined for the presence of NCCLs and interviewed about potential etiological factors using specially designed questionnaire. Saliva samples were analyzed for 30 patients with multiple NCCLs (≥3) and 30 patients without signs of cervical lesions and restorations. Subject – level logistic regression was used to analyze the association of potential etiological factors and presence of NCCLs and Wilcoxon test for the quantity and quality of saliva.ResultsNCCLs were diagnosed at 68.5% from total number of respondents, 15% from all present teeth were affected. The highest prevalence was recorded on premolars. Presence of lesions significantly increased with age. Frequent consumption of citrus fruit was associated with the presence of NCCLs. Significantly lower frequency of NCCLs was recorded among subjects who frequently chew gums. Significantly lower pH values of unstimulated and stimulated saliva were recorded in the group of patients with multiple NCCLs compared to control group.ConclusionsThis study showed high frequency of NCCLs among subjects of different age. Premolars were the most frequently affected. Age, frequent consumption of citrus fruit and lower salivary pH value were associated with an increased occurrence of NCCLs. Chewing gums habit was associated with an decreased occurrence of NCCLs. Key words:NCCL, abrasion, erosion, abfraction, saliva.

Prevalence of Non-Carious Cervical Lesions and Their Relation to Parafunctional Habits: Original Study

The non-carious cervical lesions (NCCL) constitute a group of great complexity in the practice of dental clinic, mainly when it regards the identification of etiologic agent and treatment. In the present study, 69 dentistry academic students, with ages from 20 to 32 years, were evaluated with the aim of identify the prevalence of NCCL and your correlation with para-functional habits (alfa=0.05). NCCL were observed in 79.7% of the total group; worn facets in 89.2%; alba line in 86.5%; fesfoneada tongue in 90.5%; report of clenching of teeth in 58.0%; teeth grinding in 20.3%; biting the lip in 30.4%; biting the cheek or tongue in 23.2% and biting objects in 14.5%. No correlation between the presence of NCCL and investigated parafunctional habits were observed (Coef. Pi). However, the correlation between the increase of depth and breadth NCCL were confirmed with following factors: presence of alba line, fesfoneada tongue, biting the lip habit, biting the cheek or tongue. Besides, there was correlation between the increase of NCCL extension and the habit of biting some object (Coef. Contingency C). Based on this, the conclusion is that the NCCL prevalence was high in the investigated population, and the presence of parafunctional habits did not affect it occurrence. However, there is a strong association between the increase of NCCL depth and breadth and the presence of parafuncional habits.

Prevalence and risk factors for non-carious cervical lesions in children attending special needs schools in India.

We assessed the prevalence and risk factors for development of non-carious cervical lesions (NCCLs) in children attending special needs schools in India. The participants were 395 children aged 12-15 years with disabilities in learning, communication, physical function, and/or development. A questionnaire was designed in order to collect information on sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for NCCLs. The chi-square test, bivariate analysis, and logistic regression analysis were used to analyze the data. Presence of NCCLs was associated with use of toothpowder or other materials for teeth cleaning, use of harder toothbrushes, use of a horizontal scrub technique for toothbrushing, consumption of a vegetarian diet, and greater consumption of lemon. The overall prevalence of NCCLs was 22.7%. Most lesions involved minimal loss of contour or defects <1 mm in depth. The prevalence of non-carious cervical lesions was slightly higher than the global average. Effective policies should be developed for oral health care among children attending special needs schools.

Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL)

Objective: To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). Methodology: It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1st January 2009 to 28th Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square X2 test was applied to assess association among different categorical variables. Result: Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value &lt;0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Conclusion: Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant.

Clinical evaluation of the association between noncarious cervical lesions and occlusal forces

Noncarious cervical lesions (NCCLs) are a frequent challenge in clinical dental practice, given the variety of opinions regarding their etiology, diagnosis, and treatment. The purpose of this study was to assess the potential relationship between occlusal forces and the occurrence of NCCLs. The participant population consisted of 111 volunteers (30 male and 81 female, mean age 23.6 years). General personal information was recorded, after which participants were examined for the presence and location of NCCLs, gingival recession, fracture lines, dental and restoration fractures, presence and location of tooth wear, type of occlusal guidance scheme for lateral mandibular movements, and existence of occlusal interference or premature contacts. The participants were divided according to the presence or absence of NCCLs, and data were statistically analyzed with the Independent t test, the Chi-square test, and the Fisher exact test (α=.05). A significant association was found between the presence of NCCLs and age (P=.008), gingival recession (P<.001), occlusal trauma (P<.001), presence (P<.001) and location of tooth wear, and group function as occlusal guidance scheme in lateral excursive movements (P<.001). A strong relationship between the presence of NCCLs and occlusal overload was found.