This document discusses various non-carious lesions of teeth including attrition, abrasion, erosion, abfraction, dentinal sclerosis, dead tracts, secondary dentin, pulp stones, hypercementosis, and cementicles. It defines each lesion, describes the etiology and pathogenesis, and highlights key clinical features. Attrition is mechanical wear of teeth from tooth contact while abrasion is caused by external frictional forces. Erosion results from chemical dissolution of tooth structure by acids. Abfraction involves stress-induced cervical lesions. Dentinal sclerosis and dead tracts are age-related changes in dentin. Secondary dentin deposition occurs in response to stimuli. Pulp stones, hypercementosis and

1. REGRESSIVE
ALTERATIONS
OF TEETH
NON-CARIOUS
LESIONS OF
TEETH
Dr VASANTHI V
Senior Lecturer,
Dept of Oral Pathology

4. Attrition
•Mechanical wear of tooth
•Incisal/Occlusal/Proximal surface
•Tooth to tooth contact
•Age –dependent
•Usually physiologic
•Permanent > Primary
•Circular/Oval facets –tip of cusp
Latin verb -Attritum – rubbing against

5. Widening of
proximal
contact area
Decreased
mesiodistal
width
Proximal
attrition
Facet/Reverse
cusping
Loss of
vertical
dimension
Occlusal
attrition
Types - Attrition

6. Predisposing factors - Attrition

7. Clinical manifestations - Attrition
FACET SENSITIVITY SECONDARY
DENTIN
TMJ ISSUES

9. Abrasion
•Pathologic wearing of tooth
•Frictional force between tooth & external object
•Abnormal mechanical process
•Exposed root surfaces/incisal surface
•Improper brushing habits
•Abrasive dentrifice
•Left quadrant- right handed
•Occupation – carpenter, tailor, shoe maker
•Habits – pipe smokers
•Improper use of tooth pick, dental floss
Latin verb -Abrasum – to
scrape off

11. Erosion
•Saliva- buffering capacity, pH, SFR
•Non bacterial chemical process
•Erosum- to corrode
•Dissolution of mineralised tooth structure
•Acids – Intrinsic/Extrinsic
Erosion
Extrinsic causes
Intrinsic causes
•Perimolysis

12. Risk factors - Erosion

13. Extrinsic causes
Acidic foods
Beverages
Medicaments
Environmental
acids
Intrinsic causes
GERD, Bulimia nervosa,
Salivary gland hypofunction
Increased abdominal pressure
Increased acid production
Inappropriate relaxation of
lower sphincture
Vomiting – alcoholism, gastritis,
pregnancy, nervous disorders

15. Abfraction
•Pathologic loss of tooth substance
•Biomechanical loading
•Flexure of enamel/dentin at a location away from
loading
•Stress concentration at cervical areas of teeth
•Cervical region
•Wedge shaped
•Sharp internal/external line angles
•Latin word- Ab away, fractio breaking
•To break away

17. ABRASION ABFRACTION
Saucer shaped worn areas V-Shaped notches
Improper brushing/Foreign
substance
From clenching/grinding
(Stress induced)
Associated with recession Extend below gum line
Canines & Premolars Single teeth with eccentric
occlusal loads

20. DENTINAL SCLEROSIS
•Transparent Dentin
•Sclerosis of primary dentin
•Calcification of dentinal tubules
•Caries/abrasion
•Aging
•Translucent zone
•Difference in refractive index
•Source of calcium- fluid/dental lymph in tubules
•Slows carious process
•Decreased odontoblastic conductivity
•Harder, highly calcified than normal dentin

23. DEAD TRACTS
•Optical phenomenon
•Ground section
•Transmitted light- black
•Reflected light – white
•Difference in refractive index
•Retraction/degeneration of odontoblastic processes
•Death of odontoblasts
•Empty tubules/air filled
•Dental caries
•Attrition
•Abrasion
•Erosion
•Cavity preparation
•Initial step - Sclerotic dentin

25. SECONDARY DENTIN
•After root completion
•Normal/abnormal stimulus
•Irregular dentinal tubules
•Less calcium, phosphorus
•Less mineralised
•Physiologic secondary dentin
•Reparative/tertiary dentin
•Decreased tooth sensitivity
•Anterior > Posterior
•Pulp horn/proximal walls
•Decrease in size of pulp chamber/root canal
•Resting line, fewer tubules
•Osteodentin

27. PULP STONES
•Age
•Microorganisms??
•Dental procedures???
•Denticles/Diffuse calcifications
•True/false denticles
•Free/attached denticles
•Pain
•Mild neuralgia to excruciating pain??
•Purely coincidental finding
•Difficult pulp extirpation

38. HYPERCEMENTOSIS
•Cementum hyperplasia
•Excessive deposition of cementum
•Non-neoplastic
•Isolated/generalised
•Entire root/only apex
•Idiopathic/local/systemic
•Etiology – Accelerated elongation of tooth
Inflammation at apex
Tooth repair
Paget’s Disease
Calcified thrombosed vessels of PDL

43. CEMENTICLES
•Small foci of calcified tissue – Periodontal
ligament
•Regenerative change
•Dystrophic calcification
•Single/multiple
•Free/attached
•Etiology – Degenerative
Calcification of epithelial rests
Calcified sharpey’s bundles
Cemental tears
Calcified thrombosed vessels of PDL
•Calcium salts - connective tissue
•Union-Cementum/Alveolar bone
•Circular Lamellated structure