Non-carious cervical lesion from abrasion/abfraction — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRestorative DentistryNon-carious cervical lesion from abrasion/abfractionORE Part 1

A 45-year-old right-handed patient has wedge-shaped defects on the buccal cervical surfaces of several left premolars. The lesions are hard, shiny and non-carious, with gingival recession and sensitivity to cold air. There is no radiographic caries. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Non-carious cervical tooth surface loss

The clinical presentation is diagnostic of non-carious cervical lesions (NCCL). The wedge-shaped morphology on buccal cervical surfaces of multiple premolars, hard and shiny appearance, absence of radiographic caries, gingival recession, and sensitivity are classic features of NCCL. NCCL is characterized by irreversible loss of dental hard tissue at the cemento-enamel junction unrelated to caries, typically resulting from multifactorial causes including abrasion, erosion, and stress-related forces (abfraction). Root surface caries is excluded by the 'non-carious' descriptor and absence of radiographic evidence. External cervical resorption typically presents with pink discoloration and progressive cavitation, not hard shiny lesions. Enamel hypoplasia is a developmental defect presenting as pits or grooves in a linear pattern, not acquired wedge-shaped lesions. Acute gingival ulceration affects mucosa rather than hard tooth tissue.

Reference: Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions. NCBI PMC 10221090 (2024). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221090/