Non-carious cervical lesions imaged by focus variation microscopy

Objective The aim of this study is to characterize the morphological and histological features of NCCLs in a group of extracted teeth using a focus variation optical microscopic technique that is capable of detecting minute variation in surface topography. Methods Twenty three extracted teeth containing NCCLs were collected. Histological features of the surface and longitudinal cross sections were examined using a focus variation microscope (FVM). Results The sample included 8 teeth with wedge-shaped lesions; the remaining 15 contained saucer-shaped lesions. Wedge-shaped lesions showed obliterated dentinal tubules, parallel furrows and micro-fractures in the surface; longitudinal cross sections revealed subsurface micro-fractures extending toward the pulp chamber. The surfaces of typical saucer-shaped lesions were smooth and relatively featureless. Conclusions FVM imaging shows microstructures that are consistent with simultaneous erosion and toothbrush abrasion. Saucer shaped lesions have a smooth featureless surface as well as craters and dimples that could be attributed to uneven acid attack. In wedge-shaped lesions, the presence of scratches and furrows could be attributed to mechanical forces such as tooth brush abrasion. The furrows and in-surface micro-factures of wedge shaped lesions suggest a possible role of tensile stresses but require further investigation. Clinical significance NCCLs present in two morphologies, either saucer-shaped or wedge-shaped. Erosion and toothbrush abrasion are important in both types of lesions. Tensile stresses due to occlusal loading may be important in some wedge-shaped lesions. Knowing the etiology of cervical lesions is the key for their prevention.