Cuneoid dentition - causes and treatment

Cuneoid tooth defectThe beauty of a smile depends entirely on the health of the teeth, so it is extremely important to monitor the condition gums and enamel, in time to detect the problem at an early stage and to conduct the correct treatment.

A wedge-shaped defect is a destructive process that destroys hard tooth tissues. It occurs on the symmetrically placed teeth of the lower and upper jaws. The disease is characterized by the formation of defects in the form of a wedge on small molars and canines. The localization of the affected enamel is the area near the gum, that is the anterior surface of the tooth near the gum line.

Effective treatment of a wedge-shaped tooth defect may include remineralizing therapy, filling, the installation of veneers or artificial crowns, the optimization of occlusion.

Causes of a wedge-shaped defect

Why there is a wedge-shaped defect of the teeth, and what is it? The disease appears on the outside of the tooth surface by the formation of a small V-shaped depression. The wedge-shaped point of the tooth is directed into the oral cavity. Often the defect is manifested on those teeth that are maximally stressed by the process of chewing food. These are fangs and premolars. The sphenoid defect is usually observed in the root part of the tooth. Therefore, it is sometimes confused and diagnosed as a cervical caries.

At present, there are several theories that describe the causes of the appearance of a wedge-shaped defect of the teeth, and the greatest recognition was obtained:

  1. Mechanical theory or theory of abrasionis based on the belief that the wedge-shaped defect occurs under the influence of a pronounced and constant mechanical load on the enamel of the teeth. Supporters of mechanical theory believe that the reason for abrasion of the enamel in the area of ​​the neck of the teeth can be even a fairly rigid toothbrush. In the proof, the fact that the right-handed progression of the defect on the left side of the jaw is more pronounced, and left-handers on the right one.
  2. Physico-mechanical theory (load theory)- its adherents believe that the main cause of the formation of a wedge-shaped defect of the teeth are various forms of malocclusion. These disorders occur in one form or another in 95% of the population, so the sphenoid defect can become a pathology that can affect every person. With changes in the occlusion, the normal biomechanics of the act of chewing food is disrupted, and some teeth take a much greater load than those located nearby - computer simulation of the chewing process and the loads experienced by each individual tooth, proved that the greatest load (maximum stress) attached to the place where the changes in the photo will be detected - the wedge-shaped defect is located in the cervical area of ​​the tooth crown.
  3. Chemical theory - theory of erosion- according to those who support this theory, the main factor contributing to the emergence of such a lesion is an aggressive environment in the oral cavity. Too much acidity is caused by the often consumed carbonated drinks and certain foods. Sometimes the cause of acidic environment are different pathologies of the gastrointestinal tract, in which part of the contents of the stomach can be thrown into the mouth.

Regardless of the stage of the disease, treatment of a wedge-shaped defect should include the elimination of traumatic and provoking factors.

How does the wedge-shaped defect of teeth look like:

To recognize the defect is quite simple: on the part of the tooth located in the immediate vicinity of the gum, a slight darkening is formed, which is not caries. Darkening can have a gray or yellowish hue, the touch is more roughen than enamel. To make it clear, we offer detailed photos to view.

It is noteworthy that the flaw affects only the teeth falling into the zone of the smile line: front, fangs and small molars.

Stages of development

The wedge-shaped defect of the teeth is a slowly developing disease, characterized by a change in the periods of progression of the lesion and stabilization of the process.

In the absence of treatment, it goes through the following stages:

  • I stage (initial changes)- the wedge-shaped defect is not yet visible with a simple eye, it can only be distinguished by a magnifying device.
  • II stage (superficial lesion)- the wedge-shaped defect is determined visually in the form of a surface abrasion or crack depth of 0.2 mm and a length of 3-3.5 mm. Hyperesthesia of affected teeth is noted.
  • III stage (moderate changes)- wedge-shaped defect depth of 0.2-0.3 mm, length up to 3.5-4 mm; The defect is formed by two planes that converge at an angle of 45 degrees.
  • IV stage (deep distribution)- the length of the wedge-shaped defect is more than 5 mm. The loss of tissue often seizes deep layers of dentin; in severe cases it can reach the pulp chamber.

The development and aggravation of the disease is very slow. Sometimes this process drags on even for decades. If the early stage, when you see small crevices or cracks under a strong magnifying glass, will appear about 30 years, the last, the fourth, is observed in patients at retirement age.

Treatment of a wedge-shaped defect

With the diagnosed wedge-shaped defect of the tooth, treatment involves the elimination of traumatic and provoking factors, regardless of the stage of the disease. It is also important to eliminate bite abnormalities in a timely manner.

Depending on the stage of the disease for its treatment can use:

  1. With deformations of small sizes, sealing is not required. Wedge-shaped formations are filled with special dental compositions that eliminate hypersensitivity and prevent further destruction. Usually, the method of fluoridation of enamel is used, which implies the use of formulations with a high content of fluoride or special applications. Remineralizing therapy is also prescribed to restore calcium deficiency in enamel. A good result is also achieved with pasta with fluorine content. However, in order for the effect to have a prolonged effect, the pastes must be used for a long time.
  2. The wedge-shaped defect of medium and large size is corrected by filling. Since this is not a carious lesion, the treatment is dispensed with without reaming tissues. However, with a vertical load on the tooth, the seal is squeezed out of it, so it often falls out. Therefore, in order that after the treatment the seal should be kept on the tooth, enamel liftings are made before the filling.

The wedge-shaped defects are located in the prigesneva area - in the immediate vicinity of the moistened saliva of the gum, as well as from the dentogingival groove, from which the gingival fluid is constantly secreted. Therefore, when sealing is very important to achieve complete isolation of the surface of the tooth from saliva and wet breathing, because the filling materials are very sensitive to these factors.

You can also solve the problem by installing a veneer. This will even prevent a relapse. The problem is that the veneers are usually not too strong, so the load can not stand. Replacing them will have quite often.


Any illness is better to warn than to cure. Prevention is especially important for the wedge-shaped defect, since this ailment at the initial stages is almost invisible. Therefore, it is necessary to know what preventive measures must be taken to minimize the possibility of the onset of the disease:

  • regular and regular brushing of teeth;
  • alternate use of calcined and fluorinated pastes;
  • remineralizing therapy;
  • timely treatment of dental diseases (parodontosis, gingivitis and others);
  • treatment of diseases of internal organs;
  • correction of malocclusion.

In conclusion, it is necessary to pay attention to the fact that all methods and methods of treatment of the wedge-shaped defect listed above, apply in each individual case after careful examination of the problem by your dentist. Treatment of a wedge-shaped defect is a rather individual, long-term and labor-intensive process. In this case, understanding from the patient is necessary, and the professional dentist will do everything possible to give you the joy of an open and bright smile.

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