Cervical erosions: Morphology and restoration of cervical erosions

Abstract

Cervical dentin is covered by a thin layer of acellular-afibrillar cement which develops during the early odontogenesis. The cervical cement layer is only about 100 µm thick (Fig. 13.1) and therefore vulnerable to mechanical (i.e., toothbrushing (Wiegand and Schlueter, Monogr Oral Sci 25:215- 219, 2014)), chemical (i.e., soft drink consumption (Pinto et al., BMC Res Notes 6:67, 2013; Zimmer et al., PLoS One 10:e0129462, 2015; Shellis et al., Monogr Oral Sci 25:163-179, 2014)), and microbiological (i.e., gingival recession and plaque accumulation (Bignozzi et al., J Esthet Restor Dent 25:371-382, 2013; Pikdoken et al., J Oral Rehabil 38:95-100, 2011)) influences. The etiology of dental erosion is a multifactorial and complicated process (Lussi and Carvalho, Monogr Oral Sci 25:1-15, 2014). With increasing life expectancy and effective oral prevention, more patients retain their teeth. An increased prevalence of periodontal diseases such as gingival recession leaves the cervical cement uncovered in these patients. Repeated erosive stress challenges to cervical cement result in a loss of the cementum layer (Fig. 13.2a) and open dentin tubules which in turn may be the cause for dental hypersensitivity (West, Monogr Oral Sci 20:173-189, 2006). Another major risk factor is plaque accumulation on the eroded dentin surface which results in in-surface demineralization (Fig. 13.4) and finally in root caries lesions (Fig. 13.4). Iatrogenic cervical dentin erosions as a result of cervical root scaling during periodontal treatment are frequently occurring.