Clinical Question Do patients with malocclusion have a higher rate of non carious cervical lesions than patients without malocclusion?
Clinical Bottom Line There does not seem to be a causal relationship between malocclusion and non-carious cervical lesions. This conclusion is drawn from the 28 total articles used in this systematic review.
Key results Many of the studies that were used in this systematic review showed no association between malocclusion and non-carious cervical lesions. The evidence that could suggest malocclusion as an etiological factor in the creation of non-carious cervical lesion is negated by the heterogeneity in the studies. Also, the lack of control of other etiological factors, such as improper tooth brushing technique and abrasive toothpaste, negates any positive association that could be concluded from those studies.
The Evidence Validity: This study reviewed a total of 286 research articles and found 147 that were eligible for this studies purpose. They decided on 28 of the 147 articles to include in this systematic review. Of the 28 articles 3 are prospective studies and 25 are cross-sectional studies. These 28 articles included major heterogeneity in their population, age, and occlusal parameters. As a result they were unable to perform a meta-analysis and used these studies to draw a conclusion from the evidence presented individually. They also noted certain bias, such as a single evaluator of lesion and occlusal wear within the individual studies. Perspective: More research is needed with a larger population. Also, needed are tighter parameters on what type of malocclusion, size of cervical lesions, and blinded examiners. The overall study design is difficult do to the nature of NCCLs and the time needed to create such lesions.
Applicability Non-carious cervical lesions are a problem that must be corrected and prevented for many people. In preventing cervical lesions, practitioners should not suggest correction of malocclusion as a primary course of action.