Lesões cervicais não cariosas, hipersensibilidade dentinária, recessão gengival e fatores de risco associados – estudo transversal

Abstract

The loss of dental structure at the cementoenamel junction, unrelated to the presence of caries, has been identified as non-carious cervical lesions (LCNCs). It has been reported the combination of factors such as stress, biocorrosion and friction as determinants in its formation and/or progression. Taking into account the combined effects of all potential etiological factors, the pattern of lesion formation and progression may alter and culminate in different outcomes such as cervical dentin hypersensitivity (CDH), plaque acumulation, pulpal involvement, root fractures and aesthetic changes. It has also been recognized that gingival recession (GR) is often associated with cervical wear. Under these circumstances, it is noticed that the predominance of NCCLs is high and the relations between the etiological factors are still not clear. Therefore, this study aimed to evaluate the prevalence of patients with NCCLs, CDH and GR, as well as their risk factors in a specific population. Because this was a cross-sectional study, all patients who attended the clinic of the "Ambulatory Program for Rehabilitation of Patients with Non-Carious Cervical Lesions and Dentin Hypersensitivity" from August 2013 to August 2016 were evaluated. Thus, a questionnaire was applied to 185 individuals, totalizing 5180 teeth, and then a calibrated examiner performed the clinical exams to determine the presence of NCCL, CDH and GR. NCCLs were classified according to their morphology and depth; the sensitivity levels of the teeth were evaluated through cold air stimuli, measured by the Visual Analog Scale; the GRs were categorized according to the Miller classification. The odds ratio was used as an association measure to evaluate the odds ratio and the differences between the analyzed groups and factors (p<0.05). For the correlations, Pearson and Spearman tests were used, with a confidence level of 95%. The results showed that the prevalence of NCCL, CDH and GR were 88,1%, 89,1% and 59,4%, respectively. The group with more than 50 years presented the largest number of individuals with NCCL, CDH and GR. The maxillary premolars were the most affected teeth by the three conditions. The correlation between age and NCCLs, and between age and GR was positive, and there was no correlation between age and CDH. Positive correlation was found between NCCL and CDH; CDH and GR; GR and NCCL. Age, sex, oral hygiene, gastroesophageal diseases 17 and occlusal trauma were significant for all conditions. The acid diet was not statistically significant. In conclusion, greater the age, greater the possibility of more teeth affected by NCCL and GR; the formation and progression of NCCLs is associated with teeth affected by plaque accumulation, excessive force brushing, gastroesophageal diseases and occlusal trauma; NCCL, CDH and GR are positively correlated.