Patient: 64 yr old Hispanic Male Pt presents with Parkinson’s disease. Pt reports eating a lot of lemons. Pt uses a medium bristle toothbrush. QuickTime™ and a decompressor are needed to see this picture. ABFRACTION Pathologic loss of tooth structure from biomechanical forces on the tooth (tooth flexion, compression, and tension) along with chemical degradation, most visible as a V-shaped notches in cervical area of tooth. -Darby QuickTime™ and a decompressor are needed to see this picture. Abnormal tooth Flexure In vitro studies and Finite Element Analysis (Geramy & Sharafoddin, 2003) demonstrated that tooth flexure disrupts the bonds between enamel rods, causing microfractures and, eventually, loss of tooth substance QuickTime™ and a decompressor are needed to see this picture. How to Evaluate: Check for signs of TMD Check maximum opening Check for corrosive factors Acidic diet Acid reflux QuickTime™ and a decompressor are needed to see this picture. Evaluate for toothbrush abrasion. Deep abfraction with dentin exposure. Chan, D., Browning, W., Pohjola, R., Hackman, S., Myers, M. (2006) Predictors of non-carious loss of cervical tooth tissues. Operative Dentistry, 31(1), 84-88.