Restorative & Materials · patient case question
A smooth, shiny, wedge-shaped cervical lesion on the buccal surface with sharp internal angles is best described as:
Patient case: Wear, erosion and a burning mouth
demo: 31-year-old female
chief: Sensitive front teeth that look increasingly thin, and occasional pain that comes and goes.
history: She drinks four cans of soda daily and has a history she is reluctant to discuss regarding eating patterns. She is otherwise well.
meds: None.
findings: Marked erosion of the lingual surfaces of the maxillary teeth with intact buccal surfaces. Smooth, shiny, saucer-shaped cervical lesions on the buccal aspects of several premolars. Parotid regions appear full bilaterally.
Show answer and explanation
Correct answer: C. Abfraction
- A. Attrition is tooth-to-tooth wear on occlusal and incisal surfaces.
- B. Erosion is a smooth, shallow, cupped or concave loss without sharp angles, and it does not respect a cervical distribution.
- C. Correct as this question is keyed. Abfraction is attributed to occlusal loading flexing the tooth and producing microfractures in cervical enamel and dentin. Its described appearance is a sharply angled wedge-shaped defect, often on a single tooth with heavy occlusal contact.
- D. Abrasion from brushing is a broader, rounder, saucer-shaped lesion typically affecting several adjacent teeth, most often canines and premolars on the side opposite the dominant hand.
Note: The mechanism of abfraction remains debated, and many lesions are multifactorial, combining occlusal stress, acid and abrasion. The recall offered abfraction and abrasion as the two choices, so the distinguishing feature to fix is the lesion shape: sharp wedge for abfraction, broad saucer for abrasion.
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