title: Factors influencing the progression of noncarious cervical lesions: A 5-year prospective clinical evaluation.
abstract: BACKGROUND
  The etiology (chemical, friction, abfraction) of noncarious cervical lesion (NCCL) progression is poorly understood.
  
  
  OBJECTIVE
  The purpose of this 5-year prospective clinical trial was to measure the relationship between NCCLs and various etiologic factors.
  
  
  METHODS
  After review board approval, 29 participants with NCCLs were enrolled. Polyvinyl siloxane impressions were made of each NCCL, and casts were poured at baseline, 1, 2, and 5 years. The casts were scanned with a noncontact profilometer, and 1-, 2-, and 5-year scans were superimposed over baseline scans to measure volumetric change in NCCLs. T-scan and Fujifilm Prescale films were used to record relative and absolute occlusal forces on teeth with NCCLs at the 5-year recall. Participant diet, medical condition, toothbrushing, and adverse oral habit questionnaires were given at the 5-year recall. Occlusal analysis was completed on mounted casts to determine the presence of wear facets and group function. Volumetric lesion progression from 1 to 5 years was correlated to absolute and relative occlusal force using mixed model analysis. The Kruskall-Wallis and Mann-Whitney analyses compared lesion progression with diet, medical condition, toothbrushing, adverse oral habits, wear facets, and group function.
  
  
  RESULTS
  The NCCL progression rate over 5 years was 1.50 ±0.92 mm(3)/yr. The rate of progression of NCCLs was related to mean occlusal stress (P=.011) and relative occlusal force (P=.032) in maximum intercuspation position. No difference was seen in NCCL progression between participants with any other factors.
  
  
  CONCLUSIONS
  Heavy occlusal forces play a significant role in the progression of NCCLs.
authors.affiliation: Research Assistant, Division of Biomaterials, UAB School of Dentistry, Birmingham, Ala. Electronic address: ksawlani@uab.edu.
authors.forename: Kanchan
authors.initials: K
authors.lastname: Sawlani
authors.affiliation: Assistant Professor, Division of Biomaterials, UAB School of Dentistry, Birmingham, Ala.
authors.forename: Nathaniel C
authors.initials: NC
authors.lastname: Lawson
authors.affiliation: Professor and Director, Division of Biomaterials, UAB School of Dentistry, Birmingham, Ala.
authors.forename: John O
authors.initials: JO
authors.lastname: Burgess
authors.affiliation: Professor, Division of Biomaterials, UAB School of Dentistry, Birmingham, Ala.
authors.forename: Jack E
authors.initials: JE
authors.lastname: Lemons
authors.affiliation: Professor and Director, Graduate Prosthodontics, UAB School of Dentistry, Birmingham, Ala.
authors.forename: Keith E
authors.initials: KE
authors.lastname: Kinderknecht
authors.affiliation: Associate Professor, Division of Prosthodontics, UAB School of Dentistry, Birmingham, Ala.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Givan
authors.affiliation: Associate Professor, Division of Prosthodontics, UAB School of Dentistry, Birmingham, Ala.
authors.forename: Lance
authors.initials: L
authors.lastname: Ramp
mesh_terms: D003766:Dental Occlusion; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D019237:Tooth Cervix / Q000473:pathology*; D014077:Tooth Erosion / Q000209:etiology* / Q000473:pathology; D014099:Toothbrushing / Q000009:adverse effects