Attrition

Attrition of the tooth structure is the result of tooth-to-tooth contact during mastication and occlusion.^5,39 This condition affects the incisal and occlusal surfaces of the teeth and can be exacerbated by contact or ingestion of abrasive materials, abrasive foods, and behaviors like teeth grinding or bruxism.^5,9,39Attrition is quite prevalent in adults and tends to be more severe in men.⁹ Both clinical and radiographic manifestations can be observed. Clinically, the incisal edges demonstrate broadening and wear facets will be evident on the cusps and ridge anatomy of posterior teeth (Figures 58‑60).^5,9,39 The dentin can become exposed and the wear facets, which appear flat and shiny, can deepen over time, and become stained.⁹ Radiographically, the teeth will appear flattened and shorter coronally with reduction in the size of the pulp chambers and canals due to deposition of secondary dentin.^9,39 Ultimately, the pulpal structures can become completely obliterated.^9,39

Figure 58.

Figure 58.

Periapical radiograph of mandibular left posterior teeth with attrition.

Figure 59.

Figure 59.

Periapical radiograph of mandibular anterior teeth with attrition.

Figure 60.

Figure 60.

Panoramic radiograph demonstrating universal attrition of the permanent dentition. Note the extensive flattening of incisal and occlusal surfaces.