NON-CARIOUS CERVICAL LESIONS: CHALLENGES IN DIFFERENTIAL DIAGNOSIS AND MULTIFACTORIAL MANAGEMENT — AN INTEGRATIVE REVIEW
DOI:
https://doi.org/10.63330/aurumpub.068-033Keywords:
Dental materials, Dentin hypersensitivity, Non-carious cervical lesions, Optical coherence tomography, Tooth wearAbstract
Non-carious cervical lesions (NCCLs) are characterized by irreversible loss of mineralized dental tissues in the cervical region that is not primarily attributable to dental caries. This integrative review aimed to analyze evidence on challenges in differential diagnosis and multifactorial management of NCCLs, including preventive, non-restorative, and restorative strategies. A structured literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, SciELO, and Google Scholar, followed by screening, descriptive critical appraisal, and qualitative synthesis of 11 studies. The available evidence is compatible with a multifactorial etiopathogenesis in which frictional, chemical/erosive, and biomechanical factors may interact. In silico and ex vivo studies provide mechanical plausibility for higher stress concentration and microdamage under non-axial loading; however, clinical evidence does not establish abfraction as an isolated etiological entity and does not support prophylactic occlusal adjustment to prevent NCCL progression. Optical coherence tomography (OCT) has shown potential as a complementary method in ex vivo research, whereas stereomicroscopy mainly contributes to micromorphological characterization of extracted teeth. Management should prioritize identification and control of associated factors and conservative measures. The reviewed literature suggests that some diode-laser protocols may reduce dentin hypersensitivity without impairing restoration retention, although outcomes are protocol-dependent. Biomimetic approaches using P26 peptide and chitosan remain experimental. When restoration is indicated, composite resins and resin-modified glass ionomer cements show favorable clinical performance, with no consistent evidence of overall superiority of one material across all outcomes. NCCL management should therefore be individualized, conservative, and guided by lesion activity, associated factors, and the patient's clinical needs.
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