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Risk Factors for Noncarious Cervical Lesions
TAKE-HOME MESSAGE
- This case–control study investigated the risk factors for noncarious cervical lesions (NCCLs). The authors found that, the higher the frequency of carbonated beverage consumption, the higher the probability of NCCLs. The Frankfort–mandibular plane angle was also a positive independent risk factor for NCCLs. The larger the sella–nasion–point B angle, the lower the probability of NCCL occurrence. The risk of NCCLs decreased by 10.4% for each 1° increase in the sella–nasion–point B angle.
- These results provide clinicians with information on preventing the loss of dental tissue. Patients should be advised to reduce carbonated beverage intake and to use a straw when consuming them to reduce contact with the teeth.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVES
Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case-control study was to explore the risk factors for NCCLs.
METHODS
Cone-beam computed tomography was used to determine whether a wedge-shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing-related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self-administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs.
RESULTS
Significant variables in the univariate analysis (i.e., p < .2) included frequency of carbonated beverage consumption, sella-nasion-point B angle (SNB) and Frankfort-mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039-9.532), FMA (OR = 1.100; 95% CI, 1.004-1.204) and SNB (OR = 0.896; 95% CI, 0.813-0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607-0.792; p < .001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612-0.796; p < .001).
CONCLUSIONS
The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue.
Additional Info
Risk factors for noncarious cervical lesions: A case-control study
J Oral Rehabil 2024 Sep 01;51(9)1684-1691, W Kong, H Ma, F Qiao, M Xiao, L Wang, L Zhou, Y Chen, J Liu, Y Wang, L WuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The etiology and management of patients with noncarious cervical lesions (NCCLs) is an unresolved topic in clinical dentistry. This case–control study presents patient-reported data obtained via telephone interviews to consider factors such as toothbrushing habits, consumption of carbonated beverages, teeth clenching, and exposure to acid due to vomiting or gastroesophageal reflux disease in the formation of NCCLs. Patients were evaluated with cone-beam CT imaging to determine whether the patients had NCCLs. The patient's skeletal data such as the sella–nasion–point B angle (SNB) and Frankfort–mandibular plane angle (FMA) were also considered. The study included 63 patients with NCCLs and 63 matched controls based on sex, age, and lifestyle. The authors' primary finding was that there was a positive association between the frequency of carbonated beverage intake and NCCLs.
The etiology of NCCLs is difficult to determine and controversial. The contributing factors for NCCLs have traditionally included occlusal forces, parafunctional habits, intrinsic and extrinsic acid exposure, and toothbrush abrasion. This study presents additional interesting factors that are less often considered: the frequency of consumption of carbonated beverages, FMA, and SNB. This study was limited by the number of factors considered in the patient questionnaire and did not consider occlusal forces, exposure to acid through diet (not limited to carbonated beverages), or forces applied during toothbrushing. The authors stated that the case and control groups had “identical” lifestyles, but details were not provided. Given the limitations of the data presented in this case–control study, it is difficult to accept the conclusion that the frequency of consumption of carbonated beverages is the primary etiological factor contributing to the development of NCCLs; yet, carbonated beverages are likely a factor.