title: The association between occlusal factors and noncarious cervical lesions: a systematic review.
abstract: OBJECTIVE
  This study aimed to systematically review the scientific evidence for the association between noncarious cervical lesions (NCCL) and occlusal risk factors (ORF) [occlusal interferences in excursive movements; occlusal force; premature contacts; type of guidance; skid of centric occlusion to maximum intercuspidation] in adults.
  
  
  METHODS
  Pubmed, Web of Science, Cochrane, Lilacs, Clinical Trials, National Research Register and National Institute for Health were searched.
  
  
  METHODS
  From 1082 potentially eligible studies, 106 were selected for full text analysis. Two independent reviewers (Kappa=0.8; p<0.001) selected the studies, abstracted information and assessed quality based on standardised scales. Six cross-sectional, two case-controls and one clinical trial were included. Several occlusal variables were analysed among the studies, but there was no standardisation of the units used in the analysis of occlusal factors. The majority of studies did not find significant associations between NCCL and ORF. Three studies found associations between NCCL and some variables (occlusal contact area, right canine guidance, premature contacts in centric relation and working side) (p<0.05). The methodological quality varied across studies, and there was high heterogeneity among them.
  
  
  CONCLUSIONS
  Current scientific evidence does not support an association between ORF and NCCL. Further prospective studies with standardised methods are vital to strengthen the evidence.
  
  
  CONCLUSIONS
  Understanding the risk factors for NCCL is important to control the causes and to help the dentist choose the best approach for the patient. The evidence does not support intervention to alter some occlusal factors for the prevention or control of the progression of NCCL.
authors.affiliation: Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Adriana G
authors.initials: AG
authors.lastname: Silva
authors.forename: Carolina C
authors.initials: CC
authors.lastname: Martins
authors.forename: Lívia G
authors.initials: LG
authors.lastname: Zina
authors.forename: Allyson N
authors.initials: AN
authors.lastname: Moreira
authors.forename: Saul M
authors.initials: SM
authors.lastname: Paiva
authors.forename: Isabela A
authors.initials: IA
authors.lastname: Pordeus
authors.forename: Cláudia S
authors.initials: CS
authors.lastname: Magalhães
mesh_terms: D001732:Bite Force; D016302:Centric Relation; D003766:Dental Occlusion; D003768:Dental Occlusion, Centric; D003769:Dental Occlusion, Traumatic / Q000150:complications; D006801:Humans; D008310:Malocclusion / Q000150:complications; D012307:Risk Factors; D019237:Tooth Cervix / Q000473:pathology*; D057085:Tooth Wear / Q000209:etiology*