The association between occlusal factors and noncarious cervical lesions: a systematic review.
OBJECTIVES This study aimed to systematically review the scientific evidence for the association between noncarious cervical lesions (NCCL) and occlusal risk factors (ORF) [occlusal interferences in excursive movements; occlusal force; premature contacts; type of guidance; skid of centric occlusion to maximum intercuspidation] in adults. SOURCES Pubmed, Web of Science, Cochrane, Lilacs, Clinical Trials, National Research Register and National Institute for Health were searched. STUDY SELECTION From 1082 potentially eligible studies, 106 were selected for full text analysis. Two independent reviewers (Kappa=0.8; p<0.001) selected the studies, abstracted information and assessed quality based on standardised scales. Six cross sectional, two case controls and one clinical trial were included. Several occlusal variables were analysed among the studies, but there was no standardisation of the units used in the analysis of occlusal factors. The majority of studies did not find significant associations between NCCL and ORF. Three studies found associations between NCCL and some variables (occlusal contact area, right canine guidance, premature contacts in centric relation and working side) (p<0.05) The methodological quality varied across studies, and there was high heterogeneity among them. CONCLUSION Current scientific evidence does not support an association between ORF and NCCL. Further prospective studies with standardised methods are vital to strengthen the evidence. CLINICAL SIGNIFICANCE Understanding the risk factors for NCCL is important to control the causes and to help the dentist choose the best approach for the patient. The evidence does not support intervention to alter some occlusal factors for the prevention or control of the progression of NCCL.
Journal of dentistry