Composite Class V Restorations – Lesion-Specific Approaches

The Non-Carious Cervical Lesion

More recently the term NCCL has been assigned to lesions in the cervical area of teeth, typically on the facial or lingual that are due to abrasion, erosion and/or abfraction, or a combination of these factors.  Occasionally the NCCL will trap plaque and a carious lesion will initiate within its boundaries, yet this lesion, which would be a “CCL” (remove the “non”) is very different in etiology than the true Class V cavity, as described by Black.  Nonetheless, most clinicians will not use lesion-specific preparations and materials to treat “gumline” lesions, regardless of etiology and challenges to their longevity. The greatest threat to the longevity of a NCCL is not recurrent decay.  The greatest threats are the same conditions that lead to the lesion in the first place, namely abrasion (toothbrush, tobacco chewing, cigars, etc.), erosion (from acid exposure, both intrinsic and extrinsic), and abfraction (from excess occlusal forces, due to function and/or parafunction).