Abfractions- Common in patients with Obstructive Sleep Apnea.
Nocturnal bruxism, which is indicative of OSA, plays a major role. The effective solution requires treatment of the causes- OSA with occlusal imbalance.
 
Abfractions are non-carious cervical lesions (NCCL) caused by flexural forces; the enamel, especially at the cemento-enamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods.  Studies show that within the same patient, teeth with abfractions presented more gingival attachment loss than those without abfractions.  
 
 

 

An abfraction occurs on the lower part of the crown of a tooth, near the gum line.

            The enamel covering the crown tapers down to its thinnest there.  Uneven pressures on the biting surfaces of teeth cause a torque on the tooth which produces a slight bend at the center where the crown meets the root. As the tooth keeps bending, the thin enamel at the bottom of the crown, near the gum line, chips away.

 

The sensitive “dentin” surface inside the enamel is now exposed. Vigorous, improper teeth brushing will then wear away the unprotected dentin and the notches will grow deeper and larger.  The dentin also becomes vulnerable to acid erosion from foods such as citrus.