Patient: 64 yr old Hispanic Male Pt presents with

Parkinson’s disease.

Pt reports eating a lot of lemons.

Pt uses a medium bristle toothbrush.

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ABFRACTION Pathologic loss of tooth

structure from biomechanical forces on the tooth (tooth flexion, compression, and tension) along with chemical degradation, most visible as a V-shaped notches in cervical area of tooth. -Darby

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Abnormal tooth Flexure

In vitro studies and Finite Element Analysis (Geramy & Sharafoddin, 2003) demonstrated that tooth flexure disrupts the bonds between enamel rods, causing microfractures and, eventually, loss of tooth substance

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How to Evaluate:

Check for signs of TMD

Check maximum opening

Check for corrosive factors Acidic diet Acid reflux

Evaluate for toothbrush abrasion.

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Deep abfraction with dentin exposure.

Chan, D., Browning, W., Pohjola, R., Hackman, S., Myers, M. (2006) Predictors of non-carious loss of cervical tooth tissues. Operative Dentistry, 31(1), 84-88.