ATTRITION

Attrition is a constant form of retrogressive change in teeth,characterized by wear of tooth substance or restoration as a result of tooth-to-tooth contact during mastication or parafunction.
It is an age related process and older individuals often exhibit more attrition in their teeth as compared to the young.
The rate and severity of attrition depends upon several factors such as

• Diet quality
• Dentition
• Force of the masticatory muscles
• Chewing habits etc.

Types of Attrition

1. Physiological attrition
2. Pathological attrition.

Physiological Attrition

• The tooth loss in physiological attrition is fairly constant and is appropriate to the age of the individual.
• Physiological attrition begins with the wearing of the install incisal edge of incisors.; it is followed by the palatal cusp of maxillary molars and buccal cusp of mandibular molars.
• Attrition also occurs in the proximal surfaces of teeth in the contact point areas.

Pathological Attrition

• Pathological attrition occurs due to certain abnormalities in occlusion, chewing pattern or due to some structural defects in the teeth.
• The tooth wear in this type of attrition does not maintain a consistent pattern.
• The amount of tooth loss is not proportionate to the age of the individuals.

Causes of Pathological Attrition

• Abnormal occlusion. May be developmental, may be acquired.
• Abnormal chewing habits :- Parafunctional chewing habits e.g.. Bruxism acc chronic persistent chewing of coarse and abrasive foods or other substance,e.g. Tobacco and betel nut etc.
• Structural defects in teeth

1. Amelogenesis imperfecta
2. Dentinogenesis imperfecta.

Clinical features of Attrition

• Clinically manifested by the formation of well-polished facets on the tip of the cursors, incisal edges and on the proximal contact areas of the teeth.
• Attrition may lead to severe reduction in the cuspal height with complete wearing of enamel and flattening of the occlusal surface.
• When dentin becomes exposed it generally becomes discolored brown.
• When the enamel is lost on the occlusal surface, the dentin becomes attrited at a faster rate.
• Men shows more severe attrition of teeth than women.
• In some cases, attrition may even result in pulp exposure.
• Attrition may also occur on the restorations of teeth.
• Possibly lead to fracture of the cusps of the teeth or restorations.

Treatment

Treatment of attrition is difficult, however certain things can be done to reduce further tooth wear.

• Correction of developmental abnormalities causing traumatic occlusion.
• Correction of para-functional chewing habits.
• Protection of tooth by metal or metal-ceramic crowns where structural defects(e.g. Amelogenesis or Dentinogenesis imperfecta) exit.
• Construction of occlusal guard if Bruxism habit is persisting.