AtlasDentalAttrition

Dental Diseases

Attrition

aka Occlusal Wear · Tooth Wear

Physiological or pathological loss of tooth structure from tooth-to-tooth contact.

Cause
Tooth-to-tooth contact
Feature
Flat, shiny facets
Rx
Splint + restorations

§ overviewOverview

Mechanical wear of incisal/occlusal surfaces due to functional or parafunctional masticatory contact.

§ icdICD Classification

K03.0

§ etiologyEtiology

  • 01Normal ageing
  • 02Bruxism
  • 03Coarse diet
  • 04Loss of posterior support
  • 05Malocclusion

§ epidemiologyEpidemiology

Increases with age; severe in bruxers.

§ pathogenesisPathogenesis

Repetitive enamel-to-enamel/dentin contact → progressive surface loss.

§ clinicalClinical Features

  • 01Flat, shiny wear facets
  • 02Exposed dentin (yellow)
  • 03Cupping of cusp tips
  • 04Shortening of clinical crown
  • 05Matching facets on opposing teeth

§ differentialDifferential Diagnosis

  • 01Erosion (smooth, concave)
  • 02Abrasion (V-shaped notches)
  • 03Abfraction

§ investigationsInvestigations

  • 01Clinical examination
  • 02Study models / photographs for monitoring

§ treatmentTreatment

  • 01Manage bruxism: occlusal splint
  • 02Restore lost structure: composite, crowns
  • 03Rehabilitate VDO if severe

§ complicationsComplications

  • 01Pulp exposure
  • 02Sensitivity
  • 03Loss of vertical dimension

§ prognosisPrognosis

Good if aetiology addressed and VDO restored.

§ examKey Examination Points

  • 01Matching wear facets = attrition
  • 02Bruxism = primary cause in young adults
  • 03Distinguish from erosion (acid) by facet pattern

§ revisionQuick Revision Summary

  • 01Shiny, flat facets
  • 02Matching opposing wear
  • 03Occlusal guard for bruxism

§ vivaBDS Viva Questions

  • 01How does attrition differ from erosion?
  • 02What is the role of occlusal splints?
  • 03When is restorative intervention required?

§ mcqsMCQs — Assessment (3)

Question 1

Attrition is caused by:

Question 2

Characteristic feature of attrition:

Question 3

Primary management of bruxism-related attrition:

References

  1. Neville BW. Oral & Maxillofacial Pathology, 4e
  2. Tyas MJ. Tooth Wear and Sensitivity. 2000

Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.