ATTRITION OF TOOTH

Chinu Maria Cyriac IV BDS

ATTRITION
Attrition is the pathological wear away of the teeth because of tooth to tooth contact as in mastication or parafunction

Types
o Physiological attrition

o Pathological attrition

Physiological Attrition
Due to normal aging process Fairly constant & proportionate to age of the individual

Pathological Attrition
occurs due to certain abnormalities in occlusion, chewing pattern or due to some structural defects in the teeth

Tooth wear not constant

Not proportionate to age of the individual

Mild Attrition

Moderate Attrition

Severe Attrition

 Abnormal occlusion

Etiology

* DevelopmentalEg: Malocclusion & crowding of teeth *AcquiredEg: Extraction

Abnormal chewing habits

*Para functional chewing habits like Bruxism *Ch. Persistent chewing of coarse & abrasive foods like tobacco & betel nut
Occupation

* Workers exposed to abrasive dust

Structural defects

* Amelogenesis Imperfecta * Dentinogenesis Imperfecta where hardness of Enamel & Dentin is reduced=>tooth more prone to Attrition

Clinical Features

Sex More in men than in women Sites # Deciduous as well as Permanent

# Occurs on occlusal incisal & proximal surfaces of the teeth

Occlusal Attrition

Physiological Attrition OnsetBegins with *Incisal edge of incisors *Palatal cusp of Max. M & *Buccal cusp of Mand. M *Proximal surface of teeth in the contact point areas
Color of the teeth When the dentin gets exposed it generally

becomes discolored ie Brown Signs- Reduction of * Vertical tooth height -Flattening of occlusal inclined plane

* horizontal tooth width shortening of length of dental arch

Pathological Attrition Severe tooth loss Attrition of occlusal surface of the teeth leads to reduction in occlusal face height

Radiographic Features
Crown -Smooth wearing of incisal & occlusal surfaces of

involved teeth is evident by shortened crown image

Pulp - sclerosis of pulp chamber & canals is seen due to

deposition of secondary dentin which narrows the pulp canals

Periodontal ligament widening of PDL space &

hypercementosis
Alveolar bone - some loss of alveolar bone

Flattening of cusp

Narrow Pulp canal

Management
Corrective methods- Correction of Malocclusion, stoppage of tobacco chewing habit. Restriction of diet

to non coarse food

Habit breaking appliance construction of occlusal

guard to correct parafunctional habits like Bruxism

 Protection of tooth by Metal or Metal ceramic crowns where structural defects( Dentinogenesis Imperfecta or Amelogenesis Imperfecta ) exists.

Before Treatment

After Crown Placement

Reference
Text book of Oral Medicine Ghoms
Shafers