The Class V lesion--aetiology and restoration

The aetiology of non-carious cervical lesions is discussed. These have been variously described as 'abrasion', 'erosion', 'abrasion/erosion', and 'idiopathic cervical'. However, many lesions do not fit the classical appearance or location of an erosive and/or abrasive origin, and there is increasing interest in the possible role of occlusal stress in their aetiology. Non-carious cervical lesions often require restoration, and there are essentially three options using tooth-coloured materials: a restorative glass ionomer cement, a liner/base glass ionomer cement overlayed with a resin composite, or a resin composite bonded by an enamel/dentine-adhesive. The materials and techniques used in these options are discussed, indicating their advantages and disadvantages. Results of available clinical trials of these systems are given, and the link with the stress theory of cervical tooth loss is described. The preferred restorative approaches in order are: resin-modified restorative glass ionomer; resin-modified liner/base glass ionomer with a microfine resin composite overlay; enamel/dentine bonding agent with a microfine resin composite.