Wedged cervical lesions produced by toothbrushing.
OBJECTIVE
To compare the morphology of experimentally induced cervical toothbrush abrasion lesions to teeth demonstrating non-carious cervical lesions in vivo.


METHODS
Eighteen premolars extracted for orthodontic reasons were each subjected to 80 hours (1.4 million strokes) of horizontal brushing in a custom fabricated toothbrushing machine. Toothpaste slurry was applied continuously and specimens were subjected to 300 gms of toothbrushing force. Denture base resin was used to simulate gingival recession of 1 mm and a sulcus width of 0.1 mm. Cervical abrasions were analyzed by optical and scanning electron microscopy and classified as either V-shape/wedged vs. U-shape/rounded lesions. When lesions exhibited both shapes, they were classified as mixed. Shapes of experimentally induced lesions then were compared to naturally occurring ones found on extracted premolars. RESULTSts: Experimentally induced toothbrush abrasion duplicated the classical clinical shapes. Half (9/18) of the experimentally induced toothbrush abrasions exhibited wedged lesions, 28% (5/18) showed a mixed wedged/rounded lesion, and 22% (4/18) showed rounded lesions. Serial photography showed progression of the morphology of the lesions. Toothbrush abrasion apparently begins apical to the cemento-enamel junction, progresses to dentin, and then undermines enamel with loss of the original cemento-enamel junction. Wedged lesions may appear with the apex oriented coronal or apical, or may be symmetrical.
Dept. of Periodontics and Endodontics, State University of New York at Buffalo, 250 Squire Hall, 3435 Main St., Buffalo, NY 14214-3008, USA. laldmd@yahoo.com
Luis A
LA
Litonjua
Sebastiano
S
Andreana
Peter J
PJ
Bush
Thomas S
TS
Tobias
Robert E
RE
Cohen
D001641:Bicuspid / Q000473:pathology; D003743:Dental Enamel / Q000473:pathology; D003804:Dentin / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D008855:Microscopy, Electron, Scanning; D014072:Tooth Abrasion / Q000145:classification / Q000209:etiology* / Q000473:pathology; D019237:Tooth Cervix / Q000473:pathology*; D014099:Toothbrushing / Q000009:adverse effects* / Q000295:instrumentation; D014100:Toothpastes / Q000008:administration & dosage
D014100:Toothpastes