Incidence of failure in restored noncarious cervical lesions

Background: Noncarious cervical lesions (NCCLs) are structural defects located at the cervical portion of teeth that present significant restorative challenges in clinical dentistry. These lesions compromise both tooth integrity and esthetics and commonly arise from a combination of mechanical wear and chemical dissolution – primarily due to attrition, abrasion, or erosion. Successful management of NCCLs requires accurate identification of the causative factors and selection of suitable restorative materials and techniques to ensure long-term durability. Aim: This study aimed to investigate the prevalence and underlying causes of NCCLs and to determine the relationship between different restorative materials and the rate of restoration failure in affected teeth. Materials and Methods: The study included 400 patients visiting the department of conservative dentistry and endodontics. Each case was examined clinically with diagnostic tools and intraoral imaging. Based on etiology, lesions were divided into three groups: Group 1 – Attrition, Group 2 Abrasion, and Group 3 – Abfraction. Statistical analysis using the Chi-square test was carried out to evaluate the associations between lesion type and restorative material. Results: Of the 400 teeth examined, 156 (39%) were free from cervical lesions, while 224 (56%) showed attrition as the predominant cause. Abrasion and abfraction were identified in 10 cases each (2.5%). A significant association was observed for abfraction ( P = 0.0001). Composite resin was the most frequently used restorative material (43.25%), followed by amalgam (14.25%) and glass ionomer cement (6.25%). Attrition was the leading cause of failure across all restorative materials, showing a strong correlation between lesion type and restoration performance ( P = 0.001). Conclusion: Attrition was found to be the major etiological factor responsible for the development and failure of restorations in NCCLs. Composite resin restorations were preferred due to their esthetic benefits and conservative preparation, although their longevity is influenced by occlusal loading and adhesive properties. Comprehensive understanding of causative mechanisms and judicious material selection play a vital role in improving the clinical success and longevity of restorations in teeth affected by NCCLs.