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The effect of occlusal restoration and loading on the development of abfraction lesions: A finite element study

Background: Abfraction, a type of non-carious cervical tooth loss, is a poorly understood condition. One factor thought to contribute to the development of these lesions is the effect of occlusal loading and the presence of occlusal restoration. Aim and Objectives: The aim of this paper is to study the stress profile in the cervical region of mandibular first premolar with variation of occlusal loads, and to compare the stress profile between sound and occlusally restored tooth under variation of occlusal load, using two-dimensional plane strain finite element model. Materials and Methods: A mandibular first premolar was sectioned and modeled in the finite element software, along with its peridontium. Varying occlusal loads were applied along the cuspal inclines, with and without an occlusal restoration. The software used was NISA II EMRC. Result: It was found that higher occlusal loads caused more cuspal flexure and that the maximum shear stress was much higher and closer to the cervical area. It was also observed that there was a slight increase in shear stress when occlusal restoration was present. Conclusion: It was suggested that high occlusal loading and the presence of an occlusal amalgam restoration increased the stress concentration at the cervical area, which may lead to the breakdown of enamel at the cervical region.