Lesiones Abfractivas. Relación Causa-Efecto
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2015-06
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Universidad de Guayaquil. Facultad Piloto de Odontología
Resumen
Las lesiones no cariosas del cuello dentario (LCNC) son consideradas defectos frecuentes caracterizados por una marcha insidiosa y una etiología controversial. En un principio su origen fue atribuido a lesiones de erosión ácida, endógena o exógena, y a lesiones mecánico-abrasivas por cepillado exagerado o abusivo. En la década de los ochenta con el objetivo de dar solución a las discrepancias respecto a su origen, surge la Teoría Flexural. Esta propone como etiología primaria de las lesiones de cuña a las fuerzas oclusales parafuncionales. Las mismas concentrando estrés tensional en el cuello del diente provocarían la microfractura cristalina del tejido duro en esa zona crítica: lesiones por abfracción. Experiencias posteriores han hecho surgir nuevos postulados y han aparecido corrientes que reubican a las fuerzas oclusales en un papel menos relevante, quizás como cofactor de las otras dos causales. Estas a su vez actuarían asociadas sinérgicamente en el amplio contexto de la pérdida de tejido dentario por causas no cariosas o traumáticas, estudiadas como pérdida de superficie dentaria (PSD). Por otro lado, evidencias antropológicas señalan que las lesiones típicas de cuello serían una afección de las poblaciones modernas y ligadas al estilo de vida occidental. Hasta el momento y de acuerdo a lo dicho, la etiología de las LCNC y particularmente de los defectos en cuña todavía está en discusión.
The non carious cervical lesions (NCCL) are considered frequent defects, characterized by an insidious unfolding, and controversial aetiology. At first its genesis was attributed to acid erosion (exogenous or endogenous), and also associated to a mechanical-abrasive brushing, or abusive brushing. At the eighties decade, with the intention to solve the disagreements about the origin of this lesions, appears the Flexural Theory, to offer a primary aetiology of the wedge-shaped defects, whereas the oclusal parafunctional loads, concentred the stress at cervical tooth, resulting in microfractures of hard mineral tissue in that critical zone: Abfraction. New experiences had made born new theories, in which the occlusion is relegated to a less relevant place, as co-factor of the other two aetiologies, and both erosion and abrasion working in a synergic form in the large context of tooth surface loss (TSL), by non carious or traumatic agents. Anthropological evidences indicate that NCCL are a modern population’s defect, conditioned to the occidental way of life. Anyway, the aetiology of the NCCL, above all wedge-shaped lesion, is nevertheless being object of discussion.
The non carious cervical lesions (NCCL) are considered frequent defects, characterized by an insidious unfolding, and controversial aetiology. At first its genesis was attributed to acid erosion (exogenous or endogenous), and also associated to a mechanical-abrasive brushing, or abusive brushing. At the eighties decade, with the intention to solve the disagreements about the origin of this lesions, appears the Flexural Theory, to offer a primary aetiology of the wedge-shaped defects, whereas the oclusal parafunctional loads, concentred the stress at cervical tooth, resulting in microfractures of hard mineral tissue in that critical zone: Abfraction. New experiences had made born new theories, in which the occlusion is relegated to a less relevant place, as co-factor of the other two aetiologies, and both erosion and abrasion working in a synergic form in the large context of tooth surface loss (TSL), by non carious or traumatic agents. Anthropological evidences indicate that NCCL are a modern population’s defect, conditioned to the occidental way of life. Anyway, the aetiology of the NCCL, above all wedge-shaped lesion, is nevertheless being object of discussion.
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OPERATORIA DENTAL, ABRASION DENTAL, ETIOLOGIA