Attrition (dental)

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Attrition (dental)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview[edit | edit source]

Attrition, also known as dental attrition or occlusal wear, is a type of tooth wear[1] that is the loss of tooth structure by mechanical forces from opposing teeth[2]. Attrition initially affects the enamel and, if unchecked, may proceed to the underlying dentin. Once past the enamel, attrition quickly destroys the softer dentin.

The most common cause of attrition is bruxism. Functional habits are those such as chewing and swallowing, which usually puts very little force on opposing teeth. Parafunctional habits, such as clenching and clicking the teeth together nervously, place greater amounts of forces on opposing teeth and begin to wear the teeth. As expected, wear usually begins on the incisal or occlusal surfaces.

Diagnosis[edit | edit source]

Imaging[edit | edit source]

Intraoral Scanners can assist in diagnosis and directing treatment.[3]

Treatment[edit | edit source]

Treatment options have been systematically reviewed.[4][5] Clinical practice guidelines recommend less invasive options, usually direct, for initial treatment.[6]

Approaches include: Direct options are fabricated directly in the mouth, while indirect options are fabricated outside the mouth and then cemented. Crowns, laminates, and veneers are typically considered indirect restorations

  • Direct (fabricated directly in the mouth, easier). Direct options are preferred for initial therapy.[6]
    • Resin composite[7]
    • Veneers / Laminates
    • Others
  • Indirect fabricated outside the mouth and then cemented. The indirect approach involves tooth preparation by removing dental tissue. Materials include "Porcelain veneers, ceramic crowns and onlays, indirect resin composite, indirect ceramic/composite, metal onlays, metal palatal veneers and polymer-infiltrated ceramic network"[4]
    • Crowns

See also[edit | edit source]

References[edit | edit source]

  1. Anonymous (2026), Tooth wear (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Anonymous (2026), Dental attrition (English). Medical Subject Headings. U.S. National Library of Medicine.
  3. Eggmann F, Blatz MB (December 2024). "Recent Advances in Intraoral Scanners". J Dent Res. 103 (13): 1349–1357. doi:10.1177/00220345241271937. PMC 11633065 Check |pmc= value (help). PMID 39382136 Check |pmid= value (help).
  4. 4.0 4.1 Alani A, Mehta S, Koning I, Loomans B, Pereira-Cenci T (May 2025). "Restorative options for moderate and severe tooth wear: A systematic review". J Dent. 156: 105711. doi:10.1016/j.jdent.2025.105711. PMID 40127753 Check |pmid= value (help).
  5. Chan AK, Tsang YC, Lai EH, Chu CH (January 2024). "Tooth Wear in Older Adults: A Review of Clinical Studies". Geriatrics (Basel). 9 (1). doi:10.3390/geriatrics9010012. PMC 10801519 Check |pmc= value (help). PMID 38247987 Check |pmid= value (help).
  6. 6.0 6.1 Loomans B, Opdam N, Attin T, Bartlett D, Edelhoff D, Frankenberger R, Benic G, Ramseyer S, Wetselaar P, Sterenborg B, Hickel R, Pallesen U, Mehta S, Banerji S, Lussi A, Wilson N (2017). "Severe Tooth Wear: European Consensus Statement 
on Management Guidelines". J Adhes Dent. 19 (2): 111–119. doi:10.3290/j.jad.a38102. PMID 28439579.
  7. Milosevic A (August 2016). "Direct Placement Composite: the Treatment Modality of Choice to Restore the Worn or Eroded Dentition in Primary Dental Care". Prim Dent J. 5 (3): 25–29. doi:10.1177/205016841600500301. PMID 28826460.
  • Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 56. ISBN 0-7216-9003-3.


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