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Le lesioni non cariose del terzo cervicale

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Aumento riscontro clinico lesioni cariose terzo cervicale

Negli ultimi anni si è sempre più spesso riscontrato la presenza di condizioni caratterizzate dalla perdita di sostanza dura dal dente a livello del terzo cervicale. Queste particolari lesioni sono diventate addirittura più frequenti della patologia cariosa.

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Diverse sono le ipotesi più probabili coinvolte nella patogenesi di queste lesioni, denominate lesioni non cariose del terzo cervicale o NCCL, che non presentano accumuli di placca e tartaro e sono prive di tessuto dentale molliccio.

Stando agli attuali orientamenti, l’uso dello spazzolino e dei dentifrici non sono fattori primari nel loro sviluppo ma fungono da co-fattori quando agiscono su smalto cervicale demineralizzato in seguito all’esposizione a un agente corrosivo; un agente riscontrabile nella comune dieta del paziente oppure derivante dal succo gastrico dello stesso.

E’ stato inoltre ipotizzato che quando si manifestano carichi occlusali eccessivi, per esempio in caso di malocclusione, si assiste a un’alternanza di forze di tensione e compressione a livello cervicale che può condurre a micro-fratture della struttura dentale, inevitabilmente responsabili della perdita di sostanza dura (detta abfraction).

Relativamente alla pratica clinica, un intervento si rende necessario per contenere la lesione o per la comparsa di fenomeni d’ipersensibilità dentinale o per specifiche richieste estetiche. Il trattamento in fase avanzata prevede un restauro conservativo che adopera procedure adesive ai tessuti duri del dente e resine composite.

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