In vitro reproduction of noncarious cervical lesions

Statement of problem. A review of the dental literature indicates that noncarious cervical lesions (NCCLs) are formed by erosion, abrasion, and/or abfiraction of tooth structure, but their etiology remains scientifically unsubstantiated. Purpose. The purpose of this study was to reproduce noncarious cervical lesions in vitro. This study was not designed to statistically quantify the amount of lost tooth structure via abrasion, but rather to attempt to create NCCLs in the various shapes and sizes that are clinically observed. Material and methods. Three pairs of toothbrush types (generic and name-brand) with soft, medium, or firm bristles were tested with 3 different toothpastes of varying abrasive potentials (low, medium, and high) or with water only, on mounted human teeth with and without simulated gingival tissues (6 toothbrushes x 4 brushing solutions (L, M, H, dentifirices, or water only) x 2 gingival mask conditions = 48 test/control groups of 4 teeth each = 192). Results. The control sets, brushed in water only, demonstrated no visible loss of tooth structure. Each set brushed with toothpaste, regardless of the degree of abrasiveness or toothbrush bristle firmness, demonstrated visible wear at the level of the CEJ. Conclusions. Significant noncarious cervical lesions were created via horizontal brushing with common commercial toothpaste, while brushing with water only did not create these cervical lesions.