Association of Non-carious Cervical Lesions With Oral Hygiene Aspects and Oclusal Force
Abstract One of the theories that contribute to explaining the evolution of non-carious cervical lesions (NCCLs) refers to fatigue wear, in which the concentration of stresses in the cervical region leads to the formation of microfractures in the dental tissues and progressive structure loss. However, due to a combination of factors that may cause wear, there is still uncertainty about the role of the occlusal factor as a risk factor that causes NCCLs. Objectives: The purpose of this case-control study was to investigate the association between the presence of NCCLs with occlusal force and other potential risk factors. Materials and Methods: Thirty-nine participants with NCCLs (cases) and 39 non-carrier patients (control), aged between 20 and 59 years old, were enrolled in the dental clinic of the Faculdade Integradas São Pedro (FAESA), located in Vitória, Espírito Santo State, Brazil. Information was collected through anamnesis, clinical examination, and a questionnaire addressing aspects related to tooth brushing, dentifrice, and mouthwash use. In clinical examination, patients were submitted to four measurements of occlusal force in the maxillary first premolars and maxillary first molars, using a strain gauge sensor of medium intensity, the Flexiforce (Tekscan, South Boston, MA, USA). The sensor was calibrated for the unit of measurement in Newtons (N). Results: Data was analyzed using a Student's t-test and multiple logistic regression, adopting the significance level of 5%. There was no statistically significant difference between the case and control groups regarding the bite force in the four measured regions. Logistic regression identified sex as a factor significantly associated with non-carious cervical lesions (p = 0.020). For the calculation of the odds ratio, the female sex presented a six-fold chance (OR = 6.082; CI = 1.332 - 27.765) higher than non-carious cervical lesions. Conclusions: It was concluded that females presented a higher risk factor for non-carious cervical lesions than men, whereas there was no association of occlusal strength, as well as aspects related to brushing and deleterious habits. Clinical Relevance: NCCLs are highly prevalent in daily clinical practices and can impact aesthetics and function, leading to hypersensitivity and impairment of oral-health-related quality of life. Gingival recession is an important clinical indicator for the presence of NCCLs.