1/3

c e r v i c a l

my clinical observation of modern human natural dentition

the first concensus
the area limited by immaginary line
2 mm apical to alveolar crest through
2 mm coronal to gingival crest
in 2 Dimential view

1/3 cervical
 the life cycle of 1/3 cervical misery

1 2 3 4 5 6

sensitive visible lesion death dentoid

aesthetic challenges physical challenges pathological challenges

a specific force worked creating unique lesion in 1/3 cervical area

left clinical observation on 1/3 cervical lesion apical margin

these three teeth adjacent to each other has different cervical lesion margin relative
distance to ginggival crest
 clinical observation on 1/3 cervical lesion apical margin

* *
variations on the apical lesion margin position to ginggival crest
*
*suspected these variations are interrelated between position of alveolar crest and line
of force which positioned the fulcrum accordingly
left clinical observation on 1/3 cervical lesion location

age
maxillary 65% mandibular 35%
21-40~16%; 41-60~60%; 61-80~23%

anterior 30% (canine) posterior 70% (pre-molar)

distal mid mesial

clinical observation and scientific papers statictic of the lession location and
demographic
 clinical observation on 1/3 cervical lesion unique shape

*
*specific configuration found on buccal side of upper molar ( i called it as enamel
bridge)
 clinical observation on 1/3 cervical lesion unique location within a tooth

mostly the position of the lesion are off central line angle
 clinical observation on 1/3 cervical lesion incidence

often these lesion found on a individual with relatively nice teeth arangement
 clinical observation on 1/3 cervical lesion incidence

5 years post reconstruction

5 years post dentistr y inter vention

 clinical observation on 1/3 cervical lesion incidence

over a decade post

or thodontic treatment
decade post dentistr y inter vention
 clinical close observation on 1/3 cervical lesion

*
Dr Grippo hypothesis clinically pictured !. *extreem dried tooth
 clinical close observation on 1/3 cervical lesion

Dr Grippo concept of material fatique

research found that tooth are more funarable on flextural changes than compresive
Dr Grippo
 clinical close observation on 1/3 cervical lesion
it might explain how the bio-corrosion develope
 ?
British Dental Journal 210, E19 (2011)
Published online: 10 June 2011 | doi:10.1038/sj.bdj.
2011.430
!

The survival of Class V restorations Results At two years, 156 of 989 restorations had
in general dental practice.
failed (15.8%), with 40 (4%) lost to follow-up. The biggest influence on
Univariate analysis showed a significant association
Part 2, early failure
between restoration failure and increasing patient age, early failure of Class V
payment method, the treating practitioner, non-carious
! cavities, cavities involving enamel and dentine, cavity restorations was the
preparation and restoration material. Multi-variable
D. A. Stewardson1, P. Thornley2, T. Bigg3, C. Bromage4, analysis indicated a higher probability of early failure clinician who placed the
A. Browne5, D. Cottam6, D. Dalby7, J. Gilmour8, J.
Horton9, E. Roberts10, L. Westoby11, S. Creanor12 &
associated with the practitioner, older patients, glass
ionomer and flowable composite, bur-preparation and restoration.
T. Burke13
moisture contamination.
!
!

current dental material technology are develops surpassing the knowlage of

most dentist on the clinical finding of tooth cervical lession
 3

clinical close observation of a common chronic non-carious cervical lession associate

with abfraction showed; (1)sharp enamel margin , (2)crack lines, and (3)sclerotic
dentin .
 lesion preparation

before

the use of gingival cord* not just control the sulcular fluid but push the gingival
crest apically enough to reveal the lession cervical margin clearly
* 000 ultrapack (Ultradent)
the case gingival retracted cervical margin preparation
cur iosity ar ise on the bubble patter n

mid area.... calcium rich dentin

etch pattern related to bubble and bond failure and preparation

create space enough for restoration material

small amount of flowable composite*
on the deepest part of the lesion

* type........flowable composite, dentin color

thin layer of flowable composite* on the
rest of dentine tooth structure

* flowable composite type..... dentin color

composite resin sculpturing
 absolutely require adequate material thickness

clinical observation
 adjusting

the occlusion and articulation
brush & pumice
 preparation

increase material thickness

eliminate sharp angle

wider enamel surface

( better rods orientation)
adhesive
flowable
flowable
flowable
flowable
flowable
 flowable

surface sealant
finishing
!
c a r e f u l

bite adjustment