Re: Abfraction

A person exerting lateral forces on the tooth because
of a tongue thrust (blue arrow) should be retrained to
swallow properly by a person specially trained in
myofunctional therapy or orofacial myology.
Treatment Goals continued:
A person who is a bruxer / clencher can
best be helped by an occlusal splint
A person exerting lateral forces on the tooth because
of a tongue thrust (blue arrow) should be retrained to
swallow properly by a person specially trained in
myofunctional therapy or orofacial myology.
treatment of abfraction:

1. Minimal involvement, with a small amount of tooth structure gone from the neck of the tooth and a small amount of tooth sensitivity (usually to cold)

– no treatment is acceptable

– occlusal equilibration (bite adjustment)

-dental varnishes, topical fluoride, Sensodyne tooth paste

– protective acrylic guard

2. Moderate involvement, which is more likely to be sensitive to cold, and also has more soft tissue recession and visible loss of tooth structure

– occlusal equilibration (bite adjustment)

-dental varnishes, topical fluoride, Sensodyne tooth paste

– protective acrylic guard

– bonding material placement to cover root surface

3. Advanced involvement often has root sensitivity that is severe and irreversible

– occlusal equilibration (bite adjustment)

– protective acrylic guard

– bonding material placement to cover root surface

– crowning tooth for more advanced coverage

– root canal treatment depending on the severity

II. Filling material for abfraction: Depending on the severity of the case and doctor preference, several types of materials can be used:

1. Composite resins
2. Flowable composite resins
3. Glass ionomers

We focus our efforts in the direction of management of forces, as we believe this is the most dominant factor in this multifactorial problem. The excessive forces that cause abfractions can lead to several common problems:

1)Abfractions
2) Sensitive teeth
3) Loosening of teeth
4) Excessive wear of teeth
5) Change in alignment of teeth
6) Bone breakdown and bone loss
7) Broken or destroyed restorations
8) Non-bacterial, non-plaque related gingival recession
9) Opening of contacts