Abfraction lesions: myth or reality?

UNLABELLED: Loss of tooth substance in the cervical region is usually attributed to toothbrush abrasion, erosion, or a combination of both factors. Recently the role of occlusal loading has become increasingly prominent. It is suggested that high occlusal loads cause large cervical stress concentrations, resulting in a disruption of the bonds between the hydroxyapatite crystals and the eventual loss of cervical enamel. This process has been called noncarious cervical tooth loss or abfraction. This article reviews the available evidence to support the thesis that occlusal loading can contribute to the process of abfraction. It also reviews the potential interactions between occlusal loading and erosion that may contribute to abfraction lesion formation. CLINICAL SIGNIFICANCE: It is important to recognize the potential role of occlusal loading in the loss of cervical tooth tissue so that management of the occlusion can be incorporated into a treatment plan for a patient with abfraction lesions.