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Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods.
As teeth flex under pressure, the arrangement of teeth touching each other, known as occlusion, causes tension on one side of the tooth and compression on the other side of the tooth. This is believed to cause V-shaped depressions on the side under tension and C-shaped depressions on the side under compression.
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This theory of abfraction is disputed by somes who think that these type of enamel lesions are due to over-zealous brushing since these cervical lesions are mainly located at the premolar areas and sometimes the first molars and on the buccal side (this is exactly where people put most of the force when they brush) and because of the fact that there is a very high correlation between these lesions and patients who are very good brushers as evidenced by their good oral hygiene. Recent studies by T.C. Abrahamsen have shown that toothpaste (not the toothbrush) is abrasive enough to cause this type of damage if the patient is too aggressive in brushing the teeth in a very hard and vigorous "sawing" motion. Abrahamson suggests that the term "toothbrush abrasion" be replaced with the term "toothpaste abuse".
Lee,WC., Eakle,WS. "Possible role of tensile stress in the etiology of cervical erosive lesions of teeth". Journal of Prosthetic Dentistry (1984) Vol. 52: 374-380.
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