1
|
Jiang S, Zheng L, Miao Z. Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study. Front Genet 2023; 13:1061550. [PMID: 36685839 PMCID: PMC9845290 DOI: 10.3389/fgene.2022.1061550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023] Open
Abstract
Background: The association between Gastroesophageal reflux disease (GERD) and oral symptoms has been reported in observational studies, but the causality of GERD to oral symptoms remained unknown. We aimed to assess the causal effect of GERD on five oral symptoms (mouth ulcers, toothache, loose teeth, bleeding gums, and periodontitis) using the two-sample Mendelian randomization (MR) method. Methods: Summary-level statistics for GERD and five oral symptoms were obtained from large-scale genome-wide association studies. Rigorous quality control of genetic instruments was conducted before MR analysis. Several analytical methods, including the inverse-variance weighted (IVW) method, MR-Egger regression, weighted median, maximum likelihood, and robust adjusted profile score (RAPS) were utilized, and the results of IVW were taken as the main results. The MR-Egger intercept test, Cochran's Q test, and leave-one-out test were used as sensitivity analysis for quality control. Results: After Bonferroni, IVW detected a significant effect of GERD on mouth ulcers (OR = 1.008, 95% CI = 1.003-1.013, p = 0.003), loose teeth (OR = 1.009, 95% CI = 1.005-1.012, p = 9.20 × 10-7), and periodontitis (OR = 1.229, 95% CI = 1.081-1.398, p = 0.002). Consistent patterns of associations were observed across several MR models and sensitivity analysis found little evidence of bias. Nominal significant associations were observed in toothache and bleeding gums (p < 0.05), and heterogeneity was detected. Conclusion: Our MR analyses supported the positive causal effect of GERD on oral symptoms, especially for mouth ulcers, loose teeth, and periodontitis. Our findings might shed light on the mechanism of oral disease and might imply that oral care should be enhanced in patients with GERD.
Collapse
Affiliation(s)
- Shijing Jiang
- Department of Gastroenterology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Liang Zheng
- Department of Gastroenterology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China,Jiangsu Provincial TCM Technology Engineering Research Center of Health and Health Preservation, Nanjing, China,*Correspondence: Liang Zheng, ; Zhiwei Miao,
| | - Zhiwei Miao
- Department of Gastroenterology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, China,*Correspondence: Liang Zheng, ; Zhiwei Miao,
| |
Collapse
|
2
|
Prevalence and Risk of Dental Erosion in Patients with Gastroesophageal Reflux Disease: A Meta-Analysis. Dent J (Basel) 2022; 10:dj10070126. [PMID: 35877400 PMCID: PMC9316498 DOI: 10.3390/dj10070126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/27/2022] [Indexed: 12/19/2022] Open
Abstract
Aim: The present paper aims to systematize data concerning the prevalence and risk of dental erosion (DE) in adult patients with gastroesophageal reflux disease (GERD) compared to controls. Materials and methods: Core electronic databases, i.e., MEDLINE/PubMed, EMBASE, Cochrane, Google Scholar, and the Russian Science Citation Index (RSCI), were searched for studies assessing the prevalence and risk of DE in adult GERD patients with publication dates ranging from 1 January 1985 to 20 January 2022. Publications with detailed descriptive statistics (the total sample size of patients with GERD, the total sample size of controls (if available), the number of patients with DE in the sample of GERD patients, the number of patients with DE in the controls (if available)) were selected for the final analysis. Results: The final analysis included 28 studies involving 4379 people (2309 GERD patients and 2070 control subjects). The pooled prevalence of DE was 51.524% (95 CI: 39.742–63.221) in GERD patients and 21.351% (95 CI: 9.234–36.807) in controls. An association was found between the presence of DE and GERD using the random-effects model (OR 5.000, 95% CI: 2.995–8.345; I2 = 79.78%) compared with controls. When analyzing studies that only used validated instrumental methods for diagnosing GERD, alongside validated DE criteria (studies that did not specify the methodologies used were excluded), a significant association between the presence of DE and GERD was revealed (OR 5.586, 95% CI: 2.311–13.503; I2 = 85.14%). Conclusion: The meta-analysis demonstrated that DE is quite often associated with GERD and is observed in about half of patients with this extremely common disease of the upper gastrointestinal tract.
Collapse
|
3
|
Correlation between Bruxism and Gastroesophageal Reflux Disorder and Their Effects on Tooth Wear. A Systematic Review. J Clin Med 2022; 11:jcm11041107. [PMID: 35207380 PMCID: PMC8879082 DOI: 10.3390/jcm11041107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
Abstract
Bruxism and gastroesophageal reflux (GERD) can lead to wear of the dental tissues. Wear has a mechanical or chemical origin, and it is of extrinsic or intrinsic type. Bruxism and GERD are two etiological factors of dental wear. The intrinsic mechanical wear (abfraction) of Bruxism and intrinsic chemical wear (erosion) of GERD are both involved in sleep disorders; indeed, they could have associations and act in synergy in dental wear. The purpose of this review was to find out the possible associations between bruxism and GERD and their effects on tooth wear. The research was conducted on PubMed and the Cochrane Library using the following Keywords/Mesh Terms: Tooth wear, Bruxism, Sleep Bruxism, Sleep Disorders, or GERD. Only systematic reviews and clinical studies performed exclusively on human subjects were included in the review. Initially, the research gave more than 630 results on dental wear, bruxism and GERD and after application of the inclusion criteria irrelevant studies were excluded, and 5 studies were finally included in this review. It was possible to observe the presence of some associations between the two problems (reflux and GERD) and hypothesize negative effects on tooth wear. This research revealed the presence of an interconnection between these three problems (reflux, GERD and tooth wear) that can further act in synergy by attacking the hard dental tissues both from a chemical (reflux) and mechanical (bruxism) point of view. The dentist could play a role of “sentinel” in a multidisciplinary team, intercepting these problems early in order to treat them in the most appropriate way. PROSPERO Registration Number: CRD42021234209.
Collapse
|
4
|
Efficacy of Two Toothpaste in Preventing Tooth Erosive Lesions Associated with Gastroesophageal Reflux Disease. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients suffering from acid reflux due to endogenous causes are often affected by gastroesophageal reflux disease which, in the oral environment, causes lingual and palatal enamel erosion. As enamel does not have the intrinsic ability to repair itself, the application of alloplastic materials, such as toothpastes is suggestable. The aim of this “in vitro” study was to compare the effectiveness of two different toothpastes in preventing erosion due to gastroesophageal reflux disease. Six tooth elements from bovine jaws were prepared using a high-speed diamond bur and water irrigation. Acid attack simulation was carried out using a 15% HCl hydrochloric acid solution. After that, two different toothpastes with or without fluoride, were brushed at the sample surface using an electric toothbrush at standard position and force. SEM and profilometer analysis were performed. Statistically significant difference was found in average tooth surface roughness after using toothpaste with or without fluoride after the acid attack, as the former offered a greater remineralization. No difference was found in long-term prevention. Fluoridated toothpastes offer a greater degree of remineralization at a first acid attack, however, there is no difference in long-term prevention independently from the toothpaste type.
Collapse
|
5
|
Investigation of the effect of gastroesophageal reflux disease on dental erosion and oral tissue alterations. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.943150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
6
|
Picoș AM, Petean I, Picoș A, Dădârlat-Pop A, Răchișan AL, Tomșa AM, Petrăchescu NM, Petri C, Badea ME, Măgurean ID. Atomic force microscopy analysis of the surface alterations of enamel, dentin, composite and ceramic materials exposed to low oral pH in GERD. Exp Ther Med 2021; 22:673. [PMID: 33986838 PMCID: PMC8112109 DOI: 10.3892/etm.2021.10105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Dental erosion is a significant topic in medical literature, both for gastroenterology and dental medicine. Dental structure loss has a psychosocial and functional significance. The pathogenesis of dental erosion in patients diagnosed with gastroesophageal reflux disease (GERD) characterized by the presence of an acidic oral environment after reflux episodes, is not well understood. The present study was designed to observe the effect of low oral pH in time on natural surfaces including enamel and dentine, but also on materials used in treating these dental destructions such as composites and ceramics. The acidic oral environment was estimated in relation to salivary pH. In the dental laboratory, 5-mm2 and 1-mm composite pieces of thick enamel, dentine, Emax Ceramic and Nexco Ivoclar were cut in order to be analyzed using atomic force microscopy (AFM) and to observe the surface alterations. Gastric acid was collected and mixed with saliva until a pH value of 6.0 was obtained, in which the pieces were immersed for 24, 120, 240 h. Roughness of each surface was calculated at a microstructure and nanostructure level. The results showed significant alterations in enamel and dentine exposed to a lower pH level beginning even at a short immersion time, in comparison with composites and ceramics which had no alterations. In conclusion, multidisciplinary attention should be given to detect and manage acidity of the oral cavity caused by GERD, in order to prevent dental erosion.
Collapse
Affiliation(s)
- Alina Monica Picoș
- Department of Dental Prosthetics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Ioan Petean
- Faculty of Chemistry and Chemical Engineering, ‘Babes Bolyai’ University, 400028 Cluj-Napoca, Romania
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Alexandra Dădârlat-Pop
- Department of Cardiology ‘Nicolae Stancioiu’ Heart Institute, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Andreea-Liana Răchișan
- Department of Pediatrics II, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Anamaria Magdalena Tomșa
- Department of Pediatrics II, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Narcisa Mădălina Petrăchescu
- Second Department of Internal Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | | | - Mândra Eugenia Badea
- Department of Dental Prosthetics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Irina Dora Măgurean
- Department Photo-Video, University of Arts and Design, 400148 Cluj-Napoca, Romania
| |
Collapse
|
7
|
Soygun K, Soygun A, Dogan MC. The effects of chitosan addition to glass ionomer cement on microhardness and surface roughness. J Appl Biomater Funct Mater 2021; 19:2280800021989706. [PMID: 33784189 DOI: 10.1177/2280800021989706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the surface microhardness and roughness properties of a modified glass ionomer cement formed by adding different ratios of Chitosan, when exposed to saliva and acid erosive gastric acid cycle environments. METHODS Chitosan was added to conventional glass ionomer liquid at volumes of 5% and 10%. The chitosan-modified glass ionomer was used for the experimental group, and traditional glass ionomer formed the control group. All the groups were separated into two subgroups. One of these subgroups was subjected to a gastric acid erosive cycle. The other subgroup was immersed in artificial saliva. Microhardness, surface roughness with optical profilometer and AFM measurements of all the samples were taken. Qualitative surface topographic evaluations were made using a SEM. The data were analyzed by Kruskal-Wallis and Mann Whitney U-test for pairwise comparisons of the groups at the 0.05 level of significance. RESULTS The addition of chitosan to GIC had a positive effect on the microhardness values. The gastric acid erosive cycle application negatively affected the microhardness and surface roughness properties of the sample groups. CONCLUSION The chitosan-modified glass ionomer cement samples showed clinically acceptable surface roughness values. Although the results of the addition of the biopolymer, chitosan, to GIC are promising, there is a need for further in-vivo studies.
Collapse
Affiliation(s)
- Koray Soygun
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Arzu Soygun
- Fatma Kemal Timucin Dental Health Hospital, Ministry of Health, Adana, Turkey
| | - Muharrem Cem Dogan
- Department of Pediatric Dentistry, Faculty of Dentistry, Cukurova University, Adana, Turkey
| |
Collapse
|
8
|
Penoni DC, Gomes Miranda MEDSN, Sader F, Vettore MV, Leão ATT. Factors Associated with Noncarious Cervical Lesions in Different Age Ranges: A Cross-sectional Study. Eur J Dent 2021; 15:325-331. [PMID: 33535250 PMCID: PMC8184301 DOI: 10.1055/s-0040-1722092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Understanding the possible risk factors of noncarious cervical lesion (NCCL) is important for prevention and clinical management of the condition. The aim of this study was to investigate the factors associated with the prevalence of NCCL among adolescents, adults, and elderly people. MATERIALS AND METHODS A cross-sectional study involving 501 participants aged 15 years or older was conducted. Participants were examined to assess the number of natural teeth and the prevalence and severity of NCCL by calibrated examiners. Data on age, gender, harmful toothbrushing habits, and acidogenic diet were collected through individual interviews. Multivariate Poisson's regression models were used to evaluate the association between the independent variables and the prevalence of NCCL according to the three age groups: 15 to 39, 40 to 64, and 65 years or older. RESULTS : The prevalence of NCCL among participants was 62.5% (95% confidence interval: 58.2-66.7). Among 15- to 39-year-old participants, the mean of NCCL was higher in males, those with lower number of teeth and acidogenic diet intake. Males aged 40 to 64 years and those with harmful brushing habits were more likely to present higher mean of NCCL. Elderly people with harmful toothbrushing habits had a greater mean of NCCL. CONCLUSION Demographic (age and gender), clinical (number of teeth), and behavioral characteristics (harmful brushing habits and acidogenic diet) were meaningful factors associated with NCCL severity. The above-mentioned relationships varied between age groups.
Collapse
Affiliation(s)
- Daniela Cia Penoni
- Department of Preventive Dentistry, Brazilian Navy, Odontoclínica Central da Marinha, Rio de Janeiro, Brazil.,Division of Periodontics, Department of Dental Clinic, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Flávia Sader
- Division of Periodontics, Department of Dental Clinic, Brazilian Navy, Odontoclínica Central da Marinha, Rio de Janeiro, Brazil
| | - Mario Vianna Vettore
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Anna Thereza Thomé Leão
- Division of Periodontics, Department of Dental Clinic, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
9
|
Martini T, Rios D, Dionizio A, Cassiano L, Taioqui Pelá V, e Silva C, Taira E, Ventura T, Magalhães A, Carvalho T, Baumann T, Lussi A, de Oliveira R, Palma-Dibb R, Buzalaf M. Salivary Hemoglobin Protects against Erosive Tooth Wear in Gastric Reflux Patients. Caries Res 2020; 54:466-474. [DOI: 10.1159/000507110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Objective:</i></b> Saliva is the most important biological factor to protect against erosive tooth wear (ETW). Gastroesophageal reflux disease (GERD) patients have an increased risk of ETW due to the frequent presence of intrinsic acids in the oral cavity. Remarkably, not all GERD patients suffer from ETW, which might be due to differences in the composition of the saliva. <b><i>Methods:</i></b> This study compared the proteomic profile of saliva in patients (1) with GERD and ETW (basic erosive wear examination, BEWE, score ≥9; GE group) and (2) with GERD without ETW (BEWE = 0; GNE group) using shotgun label-free quantitative proteomic analysis nLC-ESI-MS/MS. The ability of hemoglobin (Hb) to protect against initial enamel erosion caused by a daily 10-s immersion of enamel specimens in 0.01 M HCl (pH 2.3) for 3 days was evaluated in vitro for proof of concept. Surface hardness change was used as response variable. <b><i>Results:</i></b> The differential expression of Hb subunits was significantly increased in the GNE group versus the GE group, in particular the Hb α-subunit that showed a >22-fold increase. Expressions of serum albumin (4.5-fold) and isoforms of cytoskeletal keratin type II (>3-fold) were also increased in the GNE group. Proteinase inhibitors, such as α<sub>1</sub>-antitrypsin and α<sub>2</sub>-macroglobulin, were only identified in the GNE group. In vitro, Hb (1.0 and 4.0 mg/mL) significantly reduced initial enamel erosion compared to a negative control after 3 days. <b><i>Conclusions:</i></b> Our results indicate that many proteins, with special emphasis on Hb, may be involved in the resistance of GERD patients to the occurrence of ETW. These proteins may be candidates for inclusion in dental products to protect against ETW.
Collapse
|
10
|
Lechien JR, Chiesa-Estomba CM, Calvo Henriquez C, Mouawad F, Ristagno C, Barillari MR, Schindler A, Nacci A, Bouland C, Laino L, Saussez S. Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review. PLoS One 2020; 15:e0237581. [PMID: 32797062 PMCID: PMC7428125 DOI: 10.1371/journal.pone.0237581] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives To investigate the role of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in the development of dental disorders. Methods The first outcome was review of the role of reflux in the development of dental disorders in adults. The second outcome was review of the potential pathophysiological mechanisms underlying the association between reflux and dental disorders. Three investigators screened publications for eligibility and exclusion based on predetermined criteria through a literature search conducted on PubMed, Cochrane Library, and Scopus according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results From 386 publications, 24 studies were kept for analysis. Objective approaches were used in 16 studies to confirm GERD diagnosis. Pharyngeal reflux episodes (LPR) were considered in 2 studies. No study considered nonacid reflux. The study results supported a higher prevalence of dental erosion and caries in reflux patients compared with healthy individuals. Patients with dental erosion have a higher prevalence of reflux than controls. The pathophysiological mechanisms would involve changes in the saliva physiology. No study investigated the microbiota modifications related to reflux although the findings are supporting the critical role of microbiota change in the development of dental disorders. There is an important heterogeneity between studies about diagnostic methods and clinical outcome evaluation. Conclusion The involvement of reflux in the development of dental disorders is not formally demonstrated and requires future investigations considering pharyngeal acid and nonacid reflux episodes and in particular their potential impact on oral microbiota.
Collapse
Affiliation(s)
- Jerome R. Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France
- * E-mail:
| | - Carlos M. Chiesa-Estomba
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Department of Otorhinolaryngology—Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Christian Calvo Henriquez
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francois Mouawad
- Department of Otorhinolaryngology and Head and Neck Surgery, CHRU de Lille, Lille, France
| | | | - Maria Rosaria Barillari
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - Antonio Schindler
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy
| | - Andrea Nacci
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- ENT Audiology and Phoniatric Unit, University of Pisa, Pisa, Italy
| | - Cyril Bouland
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS)
- Department of Stomatology-Maxillofacial Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, L. Vanvitelli University, Napoli, Italy
| | - Sven Saussez
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| |
Collapse
|
11
|
Picos A, Lasserre JF, Chisnoiu AM, Berar AM, d'Incau E, Picos AM, Chira A, des Varannes SB, Dumitrascu DL. Factors associated with dental erosions in gastroesophageal reflux disease: a cross-sectional study in patients with heartburn. Med Pharm Rep 2020; 93:23-29. [PMID: 32133443 PMCID: PMC7051812 DOI: 10.15386/mpr-1332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/19/2019] [Accepted: 06/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background and aim Dental erosion (DE) represents a frequent condition in adults and the elderly. The gastroesophageal reflux disease (GERD) is considered an important endogenous factor causing dental erosions. The objective of this study was to assess the prevalence of DE in GERD patients and to establish the correlation between pathogenic intrinsic and extrinsic factors of DE and their relation to GERD. Methods A cross-sectional study was conducted on 263 patients (median age 43). Patients with heartburn were recruited in two countries with different prevalence of GERD. Patients were recruited from France (n=158, 60%) and Romania (n=105, 40%) including 163 females and 100 males. The Basic Erosive Wear Examination (BEWE) index for diagnosis and evaluation of dental erosion was used. Based on the value of BEWE score, each patient was included in a risk group for DE development (low risk: BEWE=3-8, medium risk: BEWE=9-13, high risk: BEWE ≥14). Patients filled a questionnaire regarding GERD symptoms, medications, life style. Salivary parameters (pH and buffering capacity) were also assessed and analyzed. Results DE was significantly more frequent and more severe in GERD subjects than in the non-GERD controls. Low salivary pH but not salivary buffering capacity was associated with BEWE scores. Buffering capacity however was significantly more altered in patients with BEWE score over 9 (medium DE) than in patients with mild DE (BEWE <9). Although extrinsic factors (consumption of citrus fruits, soda drinks) were associated with DE in GERD, there was no statistical correlation with the BEWE score. From the total of 263 patients, 229 (87.1%) presented BEWE score <9, and 34 (12.9%) presented BEWE ≥9. The DE was significantly associated with the presence of GERD (p<0.001). BEWE score >9 was more frequently present in GERD patients (30 patients: 21.3%) than in non GERD patients (4 patients: 3.3%). DE were more frequent in French subjects compared to Romanian subjects. Romanians had lower BEWE scores than the French. Conclusions DE is more frequent and more severe with GERD vs. non-GERD. DE in GERD is associated with extrinsic dietary factors like citrus fruits and soda drinks.
Collapse
Affiliation(s)
- Andrei Picos
- Department of Prevention in Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Andrea M Chisnoiu
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Antonela M Berar
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Emmanuel d'Incau
- Faculté d' Odontologie, Université Victor Segalen Bordeaux, France
| | - Alina M Picos
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Chira
- 2 Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Dan L Dumitrascu
- 2 Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
12
|
Jordão HWT, Coleman HG, Kunzmann AT, McKenna G. The association between erosive toothwear and gastro-oesophageal reflux-related symptoms and disease: A systematic review and meta-analysis. J Dent 2020; 95:103284. [PMID: 32006670 DOI: 10.1016/j.jdent.2020.103284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/21/2020] [Accepted: 01/29/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis to explore the association between erosive toothwear and gastro-oesophageal reflux disease or symptoms (GERD/S). SOURCES Electronic searches were performed in Scopus, Embase, and Web of Science databases for the identification of relevant studies, from 1980 until 2nd August 2019. STUDY SELECTION The review protocol was registered on PROSPERO (CRD42018096959) and the review was conducted according to PRISMA guidelines. Observational studies which examined the association between erosive toothwear, and GERD/S were included and categorised according to the use of objective or subjective measures of GERD/S. Where possible, odds ratios (OR) and 95 % confidence intervals (CI) were derived and pooled in a meta-analysis. DATA 27 studies were considered relevant for the qualitative synthesis and 19 studies were pooled. Significantly increased odds of erosive toothwear were observed in individuals with GERD/S. This trend was more strongly associated with objectively measured GERD/S (OR 4.13, 95 % CI 1.68-10.13), compared to subjectively measured GERD/S (OR 2.69, 95 % CI 1.13-6.38). Whilst heterogeneity was very high these trends remained in most sensitivity and subgroup analyses conducted. CONCLUSION Individuals with GERD/S have a 2-4 fold increased odds ratio of also presenting with evidence of erosive toothwear compared with individuals who do not have GERD/S. CLINICAL SIGNIFICANCE This review suggests the need for a multidisciplinary medical and dental approach to managing individuals who present with erosive toothwear or GERD/S. Timely referrals between oral health services and gastroenterology should be considered as part of effective diagnosis and management.
Collapse
Affiliation(s)
- Haydée W T Jordão
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom.
| | - Helen G Coleman
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom; Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom.
| | - Andrew T Kunzmann
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom.
| | - Gerry McKenna
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom.
| |
Collapse
|
13
|
Warsi I, Ahmed J, Younus A, Rasheed A, Akhtar TS, Ain QU, Khurshid Z. Risk factors associated with oral manifestations and oral health impact of gastro-oesophageal reflux disease: a multicentre, cross-sectional study in Pakistan. BMJ Open 2019; 9:e021458. [PMID: 30928919 PMCID: PMC6475213 DOI: 10.1136/bmjopen-2017-021458] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Gastro-oesophageal reflux disease (GORD) is a relatively common disorder and manifests with extraoesophageal symptoms, such as dental erosions (DE), cough, laryngitis, asthma, and oral soft- and hard-tissue pathologies. This study aimed (1) to identify oral soft and hard-tissue changes in patients with GORD and (2) to evaluate these oral changes as indices for assessing GORD and its severity. SETTING This cross-sectional study was conducted at four major tertiary care government hospitals, in two metropolitan cities of Pakistan. PARTICIPANTS In total, 187 of 700 patients who underwent oesophago-gastro-duodenoscopy and having GORD were included in the study. Patients with GORD were divided according to the presence of DE into group A (with DE, chronic/severe GORD) and group B (without DE, mild GORD). Patients who were unconscious and had extremely limited mouth opening were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Abnormal conditions and lesions of the oral mucosa were recorded. The impact of oral hard and soft-tissue changes on the oral health-related quality of life was assessed using the Pakistani (Urdu) version of the validated Oral Health Impact Profile-14 (OHIP-14) instrument. RESULTS Oral submucous fibrosis (66.3%), ulceration (59.4%) and xerostomia (47.6%) were significantly more common in group A (p<0.05). The prevalence of GORD was 26.7%, within which the prevalence of DE was 35.3%. Unhealthy dietary pattern, nausea/vomiting, oesophagitis, xerostomia, ulceration, gingivitis and angular cheilitis showed a statistically significant association with chronic GORD and DE. All subscales of OHIP-14 were positively correlated (p<0.05) in patients with GORD and DE, with notable impact on psychological discomfort (rs=0.30), physical disability (rs=0.29), psychological disability (rs=0.27) and functional limitation (rs=0.20). CONCLUSION Patients with GORD and DE presented with more severe oral manifestations than did those with GORD and no DE. We recommend timely dental check-ups to assess the severity of both systemic and oral disease.
Collapse
Affiliation(s)
- Ibrahim Warsi
- Masters in Medical Science and Clinical Investigation, Harvard Medical School, Boston, Massachusetts, USA
| | - Javeria Ahmed
- Oral and Maxillofacial Surgery (Jinnah Postgraduate Medical Center, JPMC), Jinnah Sindh Medical University, Karachi, Pakistan
| | - Anjum Younus
- Department of Community Dentistry, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdur Rasheed
- Department of Research and Biostatistics, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Tayyab Saeed Akhtar
- Gastroenterology and Liver Centre, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Qurrat Ul Ain
- Department of Internal Medicine, Shalamar Hospital, Lahore, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, King Faisal University, Al-Hasa, Saudi Arabia
| |
Collapse
|
14
|
Martini T, Rios D, Cassiano LPS, Silva CMDS, Taira EA, Ventura TMS, Pereira HABS, Magalhães AC, Carvalho TS, Baumann T, Lussi A, Oliveira RB, Palma-Dibb RG, Buzalaf MAR. Proteomics of acquired pellicle in gastroesophageal reflux disease patients with or without erosive tooth wear. J Dent 2019; 81:64-69. [DOI: 10.1016/j.jdent.2018.12.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 01/11/2023] Open
|
15
|
|
16
|
Schlueter N, Luka B. Erosive tooth wear – a review on global prevalence and on its prevalence in risk groups. Br Dent J 2018; 224:364-370. [DOI: 10.1038/sj.bdj.2018.167] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 11/09/2022]
|
17
|
Lourenço M, Azevedo Á, Brandão I, Gomes PS. Orofacial manifestations in outpatients with anorexia nervosa and bulimia nervosa focusing on the vomiting behavior. Clin Oral Investig 2017; 22:1915-1922. [PMID: 29177814 DOI: 10.1007/s00784-017-2284-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This case-control study aims to evaluate the oral health status and orofacial problems in a group of outpatients with eating disorders (ED)-either anorexia nervosa (AN) or bulimia nervosa (BN)-further focusing on the influence of vomit. MATERIALS AND METHODS Fifty-five women outpatients with AN or BN diagnosis were invited to participate, of which 33 agreed. ED outpatients and matched controls were submitted to a questionnaire and clinical oral examination. RESULTS Multivariate analysis identified a significantly higher incidence of teeth-related complications (i.e., tooth decay, dental erosion, and self-reported dentin hypersensitivity), periodontal disease, salivary alterations (i.e., hyposalivation and xerostomia), and oral mucosa-related complications in ED outpatients. Dental erosion, self-reported dentin hypersensitivity, hyposalivation, xerostomia, and angular cheilitis were found to be highly correlated with the vomiting behavior. CONCLUSIONS ED outpatients were found to present a higher incidence of oral-related complications and an inferior oral health status, compared to gender- and age-matched controls. Alterations verified within outpatients were acknowledged to be quite similar to those previously reported within inpatients, in both of nature and severity, thus sustaining that the cranio-maxillofacial region is significantly affected by ED, even in the early/milder forms of the condition, as expectedly verified within outpatients.
Collapse
Affiliation(s)
| | | | | | - Pedro S Gomes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, Porto, Portugal. .,REQUIMTE/LAQV, U. Porto, Porto, Portugal.
| |
Collapse
|
18
|
Restorative Rehabilitation of a Patient with Dental Erosion. Case Rep Dent 2017; 2017:9517486. [PMID: 28828189 PMCID: PMC5554566 DOI: 10.1155/2017/9517486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/21/2017] [Accepted: 06/05/2017] [Indexed: 11/26/2022] Open
Abstract
Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.
Collapse
|
19
|
Ramachandran A, Raja Khan SI, Vaitheeswaran N. Incidence and Pattern of Dental Erosion in Gastroesophageal Reflux Disease Patients. J Pharm Bioallied Sci 2017; 9:S138-S141. [PMID: 29284953 PMCID: PMC5731001 DOI: 10.4103/jpbs.jpbs_125_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aim: Gastroesophageal reflux disease (GERD) is a very common condition whose consequences of are localized not only in the esophagus; extra-esophageal involvement has frequently been reported. The aim of the study is to examine the incidence and pattern of dental erosion in GERD patients. Methodology: A total of 50 patients were recruited in this study (control -25 and GERD -25). All participants diagnosed having GERD by the endoscopic examination by their gastroenterologist are included. The patients were examined for dental erosion and will be quantified using Basic erosive wear examination index. Results: The results showed that the incidence of dental erosion was 88% as compared to 32% in the control group which was found to be statistically significant.
Collapse
Affiliation(s)
- Anupama Ramachandran
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Sulthan Ibrahim Raja Khan
- Lecturer, Restorative Dentistry and Endodontics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | |
Collapse
|
20
|
Kandanuru V, Madhusudhana K, Ramachandruni VK, Vitta HM, Babu L. Comparative evaluation of microhardness of dentin treated with 4% titanium tetrafluoride and 1.23% acidic phosphate fluoride gel before and after exposure to acidic pH: An ex vivo study. J Conserv Dent 2016; 19:560-563. [PMID: 27994319 PMCID: PMC5146773 DOI: 10.4103/0972-0707.194032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to comparatively evaluate the effect of 4% titanium tetrafluoride (TiF4) and 1.23% acidic phosphate fluoride (APF) gel on the microhardness of human coronal dentin. MATERIALS AND METHODS Thirty noncarious extracted premolars were collected and sectioned buccolingually with the help of diamond disk. Exposing the sectioned surface, teeth were embedded in self-cure acrylic. Exposed coronal dentin was polished with abrasive papers starting with 220-5000 grit. Microhardness was evaluated by Vickers microhardness evaluator, at four different stages as follows - stage 1: Baseline values, Stage 2: Exposure of specimens to acidic environment at a pH 1 for 5 min, Stage 3: Application of 1.23% APF gel and 4% TiF4 (after dividing the specimens into two groups, i.e., Group A and B, respectively), and Stage 4: Followed by exposure of fluoridated specimens to acidic protocol as mentioned above. RESULTS Paired t-test was used to compare the readings between Groups A and B. Group B has shown greater resistance to decrease in microhardness of coronal dentin (P < 0.05) on exposure to acidic protocol. CONCLUSION Due to acidic pH (1.5) of 4% TiF4, amount of increase in microhardness of dentin is <1.23% APF gel. 4% TiF4 was more effective in resisting demineralization than 1.23% APF gel.
Collapse
Affiliation(s)
- Vivek Kandanuru
- Department of Conservative Dentistry and Endodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
| | - Koppolu Madhusudhana
- Department of Conservative Dentistry and Endodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
| | - Vamsi Krishna Ramachandruni
- Department of Conservative Dentistry and Endodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
| | | | - Lenin Babu
- Department of Conservative Dentistry and Endodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
| |
Collapse
|
21
|
Loke C, Lee J, Sander S, Mei L, Farella M. Factors affecting intra-oral pH - a review. J Oral Rehabil 2016; 43:778-85. [DOI: 10.1111/joor.12429] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 12/30/2022]
Affiliation(s)
- C. Loke
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - J. Lee
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - S. Sander
- Department of Chemistry; University of Otago; Dunedin New Zealand
| | - L. Mei
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - M. Farella
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| |
Collapse
|
22
|
|
23
|
Braga SRM, de Oliveira E, Sobral MAP. Effect of neodymium:yttrium-aluminum-garnet laser and fluoride on the acid demineralization of enamel. ACTA ACUST UNITED AC 2015; 8. [PMID: 26283312 DOI: 10.1111/jicd.12185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 06/30/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to evaluate the protective effect of the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and acidic phosphate fluoride (APF) on enamel erosion caused by hydrochloric acid. METHODS Fifty human enamel specimens were distributed according to the following treatments (n = 10): untreated (control), APF (1.23%) 4 min, Nd:YAG laser (100 mJ, 1 W, 10 Hz, 141.5 J/cm2 ), APF + Nd:YAG laser, and Nd:YAG laser + APF. For 14 days the specimens were submitted to erosive challenge: 5 min in 3 mL hydrochloric acid (0.01 M, pH 2.2), rinsed with distilled water, and stored in artificial saliva for 3 h. This cycle was repeated four times per day. The calcium (Ca) loss was determined in demineralizing solution by atomic emission spectroscopy, and superficial roughness (Ra) was measured before and after the erosive challenge. RESULTS The mean Ca loss was (mg/L, ± standard deviation): control 12.74 ± 3.33, APF 1.71 ± 0.11, laser 1.64 ± 0.08, APF + laser 1.38 ± 0.08, and laser + APF 1.48 ± 0.07. Kruskal-Wallis test showed a significant difference between the control and other groups. APF + laser showed minor loss of Ca. After the erosive challenge, the APF + laser group showed Ra alteration. CONCLUSION A significant reduction in tooth dissolution was observed after fluoride application combined with Nd:YAG irradiation.
Collapse
Affiliation(s)
- Sheila Regina Maia Braga
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Elisabeth de Oliveira
- Department of Fundamental Chemistry, Chemistry Institute, University of São Paulo, São Paulo, Brazil
| | - Maria Angela Pita Sobral
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
24
|
Deppe H, Mücke T, Wagenpfeil S, Kesting M, Rozej A, Bajbouj M, Sculean A. Erosive esophageal reflux vs. non erosive esophageal reflux: oral findings in 71 patients. BMC Oral Health 2015. [PMID: 26208714 PMCID: PMC4513381 DOI: 10.1186/s12903-015-0069-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The purpose of this clinical study was to assess the prevalence of acidic oral mucosal lesions and periodontal conditions in patients suffering from erosive esophageal reflux disease (ERD) compared with non erosive esophageal reflux disease (NERD) patients, both treated with long term proton pump inhibitors (PPI). METHODS Seventy-one patients with diagnosed GERD were studied: i.e. 29 ERD and 42 NERD patients. Thorough visual examination of the oral mucosa and a periodontal evaluation was performed. The primary outcome was defined as a statistically significant difference, between the two groups, in the presence of acidic lesions of the oral mucosa and specific periodontal parameters. RESULTS This study failed to demonstrate statistically significant differences between ERD and NERD patients with respect to the prevalence of oral mucosal lesions. However, significantly more ERD patients suffered from severe periodontitis (CAL ≥ 5 mm) as compared to NERD patients. Accordingly, it may be assumed that PPI-use had no adverse effects on the prevalence of acidic oral mucosal lesions and on periodontal destruction. CONCLUSIONS Within the limitations of this study it may be concluded that ERD and NERD patients need separate evaluation with respect to periodontal destruction. Moreover, long term PPI medication had no adverse clinical impact on acidic oral mucosal lesions and periodontal destruction. Further studies are necessary to elucidate the role of reflux in the periodontal destruction of ERD individuals.
Collapse
Affiliation(s)
- Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany. .,Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, D-81675, München, Germany.
| | - Thomas Mücke
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, University of Saarland, Homburg/Saar, Germany.
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Anna Rozej
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Monther Bajbouj
- Department of Internal Medical Department II, Technical University of Munich, Klinikum rechts der Isar, München, Germany.
| | - Anton Sculean
- Department of Periodontology, University of Berne, Bern, Switzerland.
| |
Collapse
|
25
|
Pauwels A. Dental erosions and other extra-oesophageal symptoms of gastro-oesophageal reflux disease: Evidence, treatment response and areas of uncertainty. United European Gastroenterol J 2015; 3:166-70. [PMID: 25922676 DOI: 10.1177/2050640615575972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/11/2015] [Indexed: 12/19/2022] Open
Abstract
Extra-oesophageal symptoms of gastro-oesophageal reflux disease (GORD) are often studied, but remain a subject of debate. It has been clearly shown that there is a relationship between the extra-oesophageal symptoms chronic cough, asthma, laryngitis and dental erosion and GORD. Literature is abundant concerning reflux-related cough and reflux-related asthma, but much less is known about reflux-related dental erosions. The prevalence of dental erosion in GORD and vice versa, the prevalence of GORD in patients with dental erosion is high but the exact mechanism of reflux-induced tooth wear erosion is still under review.
Collapse
|
26
|
Wilder-Smith CH, Materna A, Martig L, Lussi A. Gastro-oesophageal reflux is common in oligosymptomatic patients with dental erosion: A pH-impedance and endoscopic study. United European Gastroenterol J 2015; 3:174-81. [PMID: 25922678 DOI: 10.1177/2050640614550852] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/16/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dental erosion is a complication of gastro-oesophageal reflux disease (GORD) according to the Montreal consensus statement. However, GORD has not been comprehensively characterized in patients with dental erosions and pH-impedance measures have not been reported. OBJECTIVES Characterize GORD in patients with dental erosions using 24-h multichannel intraluminal pH-impedance measurements (pH-MII) and endoscopy. METHODS This single-centre study investigated reflux in successive patients presenting to dentists with dental erosion using pH-MII and endoscopy. RESULTS Of the 374 patients, 298 (80%) reported GORD symptoms <2 per week, 72 (19%) had oesophagitis and 59 (16%) had a hiatal hernia. In the 349 with pH-MII the mean percentage time with a pH <4 (95% CI) was 11.0 (9.3-12.7), and 34.4% (31.9-36.9) for a pH <5.5, a critical threshold for dental tissue. The mean numbers of total, acidic and weakly acidic reflux episodes were 71 (63-79), 43 (38-49) and 31 (26-35), respectively. Of the reflux episodes, 19% (17-21) reached the proximal oesophagus. In 241 (69%) patients reflux was abnormal using published normal values for acid exposure time and reflux episodes. No significant associations between the severity of dental erosions and any reflux variables were found. The presence of GORD symptoms and of oesophagitis or a hiatal hernia was associated with greater reflux, but not with increased dental erosion scores. CONCLUSIONS Significant oligosymptomatic gastro-oesophageal reflux occurs in the majority of patients with dental erosion. The degree of dental erosion did not correlate with any of the accepted quantitative reflux indicators. Definition of clinically relevant reflux parameters by pH-MII for dental erosion and of treatment guidelines are outstanding. Gastroenterologists and dentists need to be aware of the widely prevalent association between dental erosion and atypical GORD.
Collapse
Affiliation(s)
- Clive H Wilder-Smith
- Brain-Gut Research Group, Gastroenterology Group Practice, Bern, Switzerland ; Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Andrea Materna
- Brain-Gut Research Group, Gastroenterology Group Practice, Bern, Switzerland
| | - Lukas Martig
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
| |
Collapse
|
27
|
Seong J, Virani A, Parkinson C, Claydon N, Hellin N, Newcombe RG, West N. Clinical enamel surface changes following an intra-oral acidic challenge. J Dent 2015; 43:1013-20. [PMID: 25868879 DOI: 10.1016/j.jdent.2015.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/27/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Investigation of early enamel erosion using replica impressions to compare changes in enamel surface topography in vivo prior to and over a 24 h period following acid challenge. METHOD A single treatment, blinded, enamel replica clinical study was undertaken in 20 healthy subjects. Replica tooth impressions were taken at baseline, following acid challenge and 2, 4, 7 and 24 h post challenge. Subjects consumed 500 ml of acidic soft drink over 30 min. Scanning electron microscopy of surface tomography was characterised with a descriptive 5 point scale by four judges. Duplicate impressions were taken to assess reproducibility. RESULTS 18 subjects had scorable sequences. Descriptive analyses showed erosive changes following acid consumption and reparative changes in the subsequent 24 h period. Comparing baseline replica to the 24 h replica, there were no significant differences (p=0.26) in tooth surface characteristics. Comparing the replica taken immediately following acidic challenge with the subsequent replicas at 2, 4, 7 and 24 h, showed clear reduction of erosive effects on the enamel surface at 2 h (p=0.02) and a highly significant reduction at 4, 7 and 24 h (p<0.001). CONCLUSION This methodology demonstrated the ability to follow the progression and recovery of early erosive enamel lesions over 24 h being accurate and reproducible. This study suggests enamel repair commences within 2 h following a substantial acidic challenge and is completed 4-24 h later. After 24 h, the tooth surface appeared visibly indistinguishable from the original tooth surface, suggestive of a recovery process occurring. CLINICAL SIGNIFICANCE Healthy erosive lifestyles often culminate in tooth wear. The time taken for enamel remineralisation following acidic challenge is unknown however, this study suggests the repair process is relatively slow following a substantial acidic challenge, and at least 4-24 h should elapse prior to further acidic consumption to allow for recovery.
Collapse
Affiliation(s)
- J Seong
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - A Virani
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - C Parkinson
- Oral Care Medical Affairs Consumer Healthcare R&D, GlaxoSmithKine, Weybridge, UK
| | - N Claydon
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - N Hellin
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - R G Newcombe
- Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK
| | - N West
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK.
| |
Collapse
|
28
|
West NX, Sanz M, Lussi A, Bartlett D, Bouchard P, Bourgeois D. Prevalence of dentine hypersensitivity and study of associated factors: A European population-based cross-sectional study. J Dent 2013; 41:841-51. [DOI: 10.1016/j.jdent.2013.07.017] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/22/2013] [Accepted: 07/25/2013] [Indexed: 11/17/2022] Open
|
29
|
Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function. J Gastroenterol 2012; 47:412-20. [PMID: 22200941 DOI: 10.1007/s00535-011-0515-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 10/31/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND This preliminary clinical study aimed to evaluate the effects of salivary flow volume and swallowing function on oral symptoms including dental erosion in gastroesophageal reflux disease (GERD). METHODS The subjects were 40 GERD patients and 30 (15 younger, 15 older) healthy controls. Detailed medical, dietary, and dental histories were obtained to identify individual behavioral habits potentially associated with dental erosion. Oral examination evaluated dental erosion and determined scores for the decayed, missing, filled (DMF) index, the papillary, marginal, attached (PMA) index for gingivitis, and the Simplified Oral Hygiene Index (OHI-S). Salivary flow volume and swallowing function were evaluated by the Saxon test and repetitive saliva swallowing test, respectively. RESULTS The DMF index and OHI-S scores differed significantly between all 3 groups. The PMA index was significantly different between the GERD group and the two control groups. The prevalence of dental erosion was 24.3% in the GERD group (0% in the control groups). No specific relationship was found between the incidence of dental erosion and dietary history or behavioral habits. The Saxon test results were significantly lower in the GERD group than in both the control groups. Frequency of swallowing was significantly lower and time to first swallow was significantly longer in the GERD group than in the two control groups. CONCLUSIONS Oral symptoms in GERD are likely to be associated with impaired salivary flow volume or swallowing function. Treatment for the oral dryness induced by reduced salivary flow volume and rehabilitation for swallowing function could be indicated in patients with GERD.
Collapse
|
30
|
Dental erosion and its growing importance in clinical practice: from past to present. Int J Dent 2012; 2012:632907. [PMID: 22505907 PMCID: PMC3312266 DOI: 10.1155/2012/632907] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 12/18/2011] [Indexed: 12/28/2022] Open
Abstract
Since the mid-1990s, the focus of studies on tooth wear has steadily shifted from the general condition towards the more specific area of dental erosion; equally, a shift has occurred from studies in adults to those in children and adolescents. During this time, understanding of the condition has increased greatly. This paper attempts to provide a critical overview of the development of this body of knowledge, from earlier perceptions to the present. It is accepted that dental erosion has a multifactorial background, in which individual and lifestyle factors have great significance. Notwithstanding methodological differences across studies, data from many countries confirm that dental erosion is common in children and young people, and that, when present, it progresses rapidly. That the condition, and its ramifications, warrants serious consideration in clinical dentistry, is clear. It is important for the oral healthcare team to be able to recognize its early signs and symptoms and to understand its pathogenesis. Preventive strategies are essential ingredients in the management of patients with dental erosion. When necessary, treatment aimed at correcting or improving its effects might best be of a minimally invasive nature. Still, there remains a need for further research to forge better understanding of the subject.
Collapse
|
31
|
Abstract
Numerous case-control and other studies involving confirmation of gastroesophageal reflux disease (GERD) by esophageal pH-metry and the assessment of dental erosions have shown significant associations between the two conditions in both adults and children. By contrast, when asked to vote on whether GERD may cause dental erosions, only 42% of physicians strongly agreed that such an association existed in adults, and just 12.5% strongly agreed for children, respectively in two global consensus reports. Part of this divergence between the perceptions of physicians and the findings of research publications may reflect a general lack of oral health education during medical training, and cursory oral examinations being made under less-than-ideal conditions. Adequate salivary secretions are essential for the protection of the teeth and the oropharyngeal and esophageal mucosa. The quantity and quality of the saliva require monitoring as many drugs, including several of the proton pump inhibitors (PPIs), can cause hyposalivation. In addition, PPIs do not always result in adequate acid suppression. Therefore, collaboration between physicians and dentists is strongly advocated to prevent or ameliorate possible adverse oral effects from both endogenous and exogenous acids, and to promote adequate saliva production in patients with GERD.
Collapse
Affiliation(s)
- Sarbin Ranjitkar
- School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia.
| | | | | |
Collapse
|
32
|
Lindquist B, Lingström P, Fändriks L, Birkhed D. Influence of five neutralizing products on intra-oral pH after rinsing with simulated gastric acid. Eur J Oral Sci 2011; 119:301-4. [PMID: 21726291 DOI: 10.1111/j.1600-0722.2011.00841.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aetiology of dental erosion may be of both extrinsic and intrinsic origin. The aim of the present study was to test the ability of various neutralizing products to raise the low intra-oral pH after an erosive exposure, in this case to gastric acid, which was simulated using hydrochloric acid (HCl). Eleven adults participated. They rinsed with 10 ml of 10 mM HCl (pH 2) or 10 ml of 100 mM HCl (pH 1) for 1 min, after which the pH was measured intra-orally for up to 30 min at four sites (two approximal, one buccal, and the dorsum of the tongue). After rinsing with the two acid solutions (pH 1 and pH 2), the following products were used: (i) antacid tablet; (ii) gum arabic lozenge; (iii) mineral water; (iv) milk; and (v) tap water (positive control). The negative control was no product use. The five test products were used for 2 min after the erosive challenge. All the products produced an initially higher pH compared with the negative control. The antacid tablet resulted in the greatest and most rapid increase in pH, followed by the lozenge. In dental practice, the use of any of the neutralizing products tested, especially the antacid tablet, could be recommended in order to increase the intra-oral pH after an erosive challenge.
Collapse
Affiliation(s)
- Birgitta Lindquist
- Department of Cariology, Institute of Odontology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | | | | | | |
Collapse
|
33
|
Jager DHJ, Vieira AM, Ligtenberg AJM, Bronkhorst E, Huysmans MCDNJM, Vissink A. Effect of salivary factors on the susceptibility of hydroxyapatite to early erosion. Caries Res 2011; 45:532-7. [PMID: 21997255 DOI: 10.1159/000331938] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 08/05/2011] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Salivary pellicle is known to reduce the erosion of enamel and differences in the level of protection exist between individual saliva sources, but which parameters or components are important is not known. The focus of this study was to investigate the relationship between saliva parameters and early erosion of hydroxyapatite (HAp) with an in situ grown saliva film. METHODS Twenty-eight volunteers carried two HAp and one porcelain discs in their buccal sulcus for 1.5 h. Next, the discs covered with pellicle and the attached saliva film were exposed extraorally to 50 mM (pH = 3) citric acid for 2 min and unstimulated and stimulated saliva was collected. Calcium loss from HAp after erosive challenge was measured, corrected for calcium loss from pellicle on porcelain discs and averaged. Several salivary parameters were analysed. Pearson's linear correlation and multiple regression analysis were used to study the relation between saliva parameters and HAp erosion. RESULTS Significant correlations were found between HAp erosion and the concentration of phosphorus in unstimulated saliva (r = 0.40, p = 0.03) and between HAp erosion and the concentration of sodium (r = -0.40, p = 0.03), chloride (r = -0.47, p = 0.01), phosphorus (r = 0.45, p = 0.01) and flow (r = -0.39, p = 0.04) of stimulated saliva. Multivariate analysis revealed a significant role in the HAp erosion for sodium, urea, total protein, albumin, pH and flow of unstimulated saliva and for sodium, potassium, urea, and phosphorus of stimulated saliva. CONCLUSIONS Several salivary parameters are associated with the susceptibility of HAp to erosion.
Collapse
Affiliation(s)
- D H J Jager
- UMCG Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
34
|
Almeida e Silva JS, Baratieri LN, Araujo E, Widmer N. Dental erosion: understanding this pervasive condition. J ESTHET RESTOR DENT 2011; 23:205-16. [PMID: 21806751 DOI: 10.1111/j.1708-8240.2011.00451.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dental erosion is a contemporary disease, mostly because of the change of the eating patterns that currently exist in society. It is a "silent" and multifactorial disease, and is highly influenced by habits and lifestyles. The prevalence of dental erosion has considerably increased, with this condition currently standing as a great challenge for the clinician, regarding the diagnosis, identification of the etiological factors, prevention, and execution of an adequate treatment. This article presents a dental erosion review and a case report of a restorative treatment of dental erosion lesions using a combination of bonded ceramic overlays to reestablish vertical dimension and composite resin to restore the worn palatal and incisal surfaces of the anterior upper teeth. Adequate function and esthetics can be achieved with this approach.
Collapse
|
35
|
Abstract
Dental erosion is increasingly recognized as a common condition in paediatric dentistry with complications of tooth sensitivity, altered aesthetics and loss of occlusal vertical dimension. The prevalence of erosion in children has been reported to range from 10% to over 80%. The primary dentition is thought to be more susceptible to erosion compared to the permanent dentition due to the thinner and less mineralized enamel. The aim of this paper was to critically review dental erosion in children with regards to its prevalence, aetiology, diagnosis and prevention. The associations between erosion and other common conditions in children such as caries and enamel hypoplasia are also discussed.
Collapse
Affiliation(s)
- S Taji
- Centre for Paediatric Dentistry Research and Training, School of Dentistry, The University of Queensland
| | | |
Collapse
|
36
|
Abstract
BACKGROUND The authors conducted a study to determine the occurrence of erosive tooth lesions in patients with alcoholism and to establish the influence of salivary flow rates and pH levels on their appearance. METHODS The authors conducted a cross-sectional study in 140 participants (70 with clinically diagnosed alcoholism who were undergoing therapy for their addiction were in the test group and 70 who did not consume alcohol were in the control group). The authors determined the participants' salivary statuses by measuring the flow rates and pH levels of both unstimulated and stimulated saliva. RESULTS The authors found more erosive lesions in the test group (P < .01). They detected a higher number of erosive lesions in participants in the test group who had a pH range of 5 to 6 compared with a pH range of 6 to 7 (P = .01). They found a significant correlation between alcoholism and unstimulated salivary flow rate (P < .05). CONCLUSIONS The salivary flow rate was similar in control and test groups. The prevalence of erosion in the test group was higher than that in the control group, which may be related to the decrease in salivary pH of both stimulated and unstimulated saliva in this group. The results of the study showed no connection between erosion prevalence and pH levels and stimulated salivary flow rates. CLINICAL IMPLICATIONS Patients with alcoholism may be at risk of developing erosive lesions on their teeth owing to the low pH level of their oral environment and decreased saliva levels.
Collapse
|
37
|
Abstract
Introduction Gastroesophageal reflux is a frequent disease which has a significant influence on the development of dental erosions. Objective The aim of this research was to determine the frequency of dental erosions among the patients with gastroesophageal reflux, as well as to verify the most common symptoms of gastroesophageal disease. Methods The research comprised of two groups, each consisting of 30 patients aged 18-80 years. The experimental group comprised of patients diagnosed with gastroesophageal reflux disease (GERD), while the control group was composed of patients who were not diagnosed with GERD. Based on the illness history data, all patients of the experimental group were registered to have gastroesophageal and extraesophageal symptoms. Dental erosions were diagnosed during a stomatological inspection by using index system according to Eccles and Jenkins. Data processing was accomplished by the Statgraphics Centurion software package. Results Dental erosions were found in 76.7% of experimental group patients, and in 53.3% of control group patients. Fortynine percent of teeth of the experimental group patients and 31.1% of the control group patients showed erosive changes. On average, the number of teeth with erosions in the experimental group was 15.7 per person and in the control group 10 per person. The teeth of the front region of the upper jaw, as well as the lower first molars had the highest average value of dental erosion index. In the experimental group 12.8% of teeth and 24% of teeth in the control group were diagnosed to have dental erosion index value 1. Furthermore, 23.4% of teeth in the experimental group and 7.1% of teeth in the control group were registered to have dental erosion index value 2. Finally, the dental erosion index value 3 was found in 13.0% of teeth in the experimental group only. The highest average value of regional erosion index in the experimental group was found in the region 13-23 equalling 1.0. The same value in the control group equalled 0.6. In the experimental group the average value of dental erosion index for the upper jaw was 0.9, while this value for the lower jaw equalled 0.8. The analysis of the illness history data obtained showed that there was a statistically significant difference between the two observed groups in terms of burning pain (noncardiac in origin) around the heart area, bad breath and dentine hypersensitivity as the dominant symptom of dental erosion (p<0.05). Conclusion Dental erosions could be considered to be the extraesophageal manifestation of gastroesophageal reflux. .
Collapse
|
38
|
Wilder-Smith CH, Wilder-Smith P, Kawakami-Wong H, Voronets J, Osann K, Lussi A. Quantification of dental erosions in patients with GERD using optical coherence tomography before and after double-blind, randomized treatment with esomeprazole or placebo. Am J Gastroenterol 2009; 104:2788-95. [PMID: 19654570 PMCID: PMC4167766 DOI: 10.1038/ajg.2009.441] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Dental erosion, the chemical dissolution of enamel without bacterial involvement, is a rarely reported manifestation of gastroesophageal reflux disease (GERD), as well as of recurrent vomiting and dietary habits. It leads to loss of tooth substance, hypersensitivity, functional impairment, and even tooth fracture. To date, dental erosions have been assessed using only very basic visual methods, and no evidence-based guidelines or studies exist regarding the prevention or treatment of GERD-related dental erosions. METHODS In this randomized, double-blind study, we used optical coherence tomography (OCT) to quantify dental tissue demineralization and enamel loss before and after 3 weeks of acid-suppressive treatment with esomeprazole 20 mg b.i.d. or placebo in 30 patients presenting to the Berne University Dental Clinic with advanced dental erosions and abnormal acid exposure by 24-h esophageal pH manometry (defined as >4% of the 24-h period with pH<4). Enamel thickness, reflectivity, and absorbance as measures of demineralization were quantified by OCT before and after therapy at identical localizations on teeth with most severe visible erosions as well as several other predefined changes in teeth. RESULTS The mean+/-s.e.m. decrease of enamel thickness of all teeth before and after treatment at the site of maximum exposure was 7.2+/-0.16 black trianglem with esomeprazole and 15.25+/-0.17black trianglem with placebo (P=0.013), representing a loss of 0.3% and 0.8% of the total enamel thickness, respectively. The change in optical reflectivity to a depth of 25 black trianglem after treatment was-1.122 +/-0.769 dB with esomeprazole and +2.059+/-0.534 dB with placebo (P 0.012), with increased reflectivity signifying demineralization. CONCLUSIONS OCT non-invasively detected and quantified significantly diminished progression of dental tissue demineralization and enamel loss after only 3 weeks of treatment with esomeprazole 20 mg b.i.d. vs. placebo. This suggests that esomeprazole may be useful in counteracting progression of GERD-related dental erosions. Further validation of preventative treatment regimens using this sensitive detection method is required, including longer follow-up and correlation with quantitative reflux measures.
Collapse
Affiliation(s)
- Clive H Wilder-Smith
- Brain-Gut Research Group and Gastroenterology Group Practice, Bern, Switzerland.
| | | | | | | | | | | |
Collapse
|
39
|
REIS ALESSANDRA, HIGASHI CRISTIAN, LOGUERCIO ALESSANDRODOURADO. Re-anatomization of Anterior Eroded Teeth by Stratification with Direct Composite Resin. J ESTHET RESTOR DENT 2009; 21:304-16. [DOI: 10.1111/j.1708-8240.2009.00281.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Holbrook WP, Furuholm J, Gudmundsson K, Theodórs A, Meurman JH. Gastric reflux is a significant causative factor of tooth erosion. J Dent Res 2009; 88:422-6. [PMID: 19493884 DOI: 10.1177/0022034509336530] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Dental erosion is caused by dietary or gastric acid. This study aimed to examine the location and severity of tooth erosion with respect to causative factors, and to determine whether the clinical pattern of erosion reflected the dominant etiological factor. The study involved 249 Icelandic individuals and included: a detailed medical history; clinical oral examination; salivary sampling, and analysis for flow rate, pH, and buffering capacity. Reflux was assessed in 91 individuals by gastroscopy, esophageal manometry, and 24-hour esophageal-pH monitoring. Reflux symptoms were reported by 36.5% individuals. Manometry results were abnormal in 8% of study participants, abnormal esophageal pH in 17.7%, and a pathological 24-hour pH recording in 21.3%. 3.6% were positive for Helicobacter pylori. Normal salivary flow was found in 92%, but low salivary buffering (10.4%) was associated with erosion into dentin (P < 0.05). Significant associations were found between erosion and diagnosed reflux disease (OR 2.772; P < 0.005) and daily consumption of acidic drinks (OR 2.232; P < 0.005).
Collapse
Affiliation(s)
- W P Holbrook
- University of Iceland, Vatnsmyrarvegi 16, IS 101 Reykjavík, Iceland.
| | | | | | | | | |
Collapse
|
41
|
Higo T, Mukaisho K, Ling ZQ, Oue K, Chen KH, Araki Y, Sugihara H, Yamamoto G, Hattori T. An animal model of intrinsic dental erosion caused by gastro-oesophageal reflux disease. Oral Dis 2009; 15:360-5. [PMID: 19371399 DOI: 10.1111/j.1601-0825.2009.01561.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To explore the association between dental erosion and gastro-oesophageal reflux disease (GORD), we used an animal model of GORD. MATERIALS AND METHODS We performed an operation to force gastro-duodenal contents reflux in male Wistar rats, and examined the teeth in the reflux rats at 15 or 30 weeks postoperatively. Dental erosion was evaluated based on a slightly modified index from a previous report. Estimation of pH was employed in the oesophageal and gastric contents. RESULTS Macroscopically, dental erosion was only detected in the reflux rats. Histopathologically, dentin exposure was detected in three of the seven cases after 30 weeks. Alveolar bone destruction and osteomyelitis were also noted in severe cases. The pH of the oesophageal and stomach contents was 6.93 +/- 0.15 and 3.7 +/- 0.39, respectively. CONCLUSIONS We confirmed the relationship between dental erosion and GORD. First step of dental erosion caused by GORD is the loss of surface enamel induced by regurgitation of an acidic liquid and acidic gas. Subsequently, further destruction of dental hard tissues and tooth supporting structure is accelerated by mixed juice with gastric and duodenal contents. The reflux animal model is a useful tool to examine the mechanism of dental erosion in GORD.
Collapse
Affiliation(s)
- T Higo
- Department of Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
|
43
|
Abstract
PURPOSE OF REVIEW To emphasize oral complications in children with gastroesophageal reflux disease. Interest of pediatricians to conduct an orodental examination or to include a dental examination performed by a dentist should be encouraged, as dental erosion, for instance, may be present in these children. RECENT FINDINGS Dental caries, dental erosion, mucosal lesions and oral bacterial load have been studied extensively in children with gastroesophageal reflux disease, but there is no sound consensus about the impact of gastroesophageal reflux disease on oral health parameters. SUMMARY Gastroesophageal reflux and oral health deserve to be better understood and recognized by medical staff, pediatricians in particular. Literature on this subject contains many case reports and some cross-sectional studies, resulting in confusing conclusions for clinicians and researchers. Dental caries, dental erosion, mucosal lesions and oral bacterial load are the most frequently studied items in these kinds of study. Dental erosion seems to be an oral finding that should be studied in depth in these children, as conflicting results have been reported in literature, the latter being the result of the use of different indexes to collect clinical data.
Collapse
Affiliation(s)
- Evelyn Vega Alfaro
- Department of Pediatric Dentistry and Centre for Special Care, Ghent University, Dental School, Ghent, Belgium
| | | | | |
Collapse
|
44
|
Pace F, Pallotta S, Tonini M, Vakil N, Bianchi Porro G. Systematic review: gastro-oesophageal reflux disease and dental lesions. Aliment Pharmacol Ther 2008; 27:1179-86. [PMID: 18373634 DOI: 10.1111/j.1365-2036.2008.03694.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dental erosion (DE), which is the irreversible loss of tooth substance that does not involve bacteria ranging from a minimal loss of surface enamel to the partial or complete exposure of dentine by a chemical process, is acknowledged as an established extra-oesophageal manifestation of gastro-oesophageal reflux disease (GERD). However, the real impact of GERD in the genesis of this lesion remains unclear. AIM To review the existing literature to assess the relationship between DE and GERD. METHODS Studies that assessed the prevalence of DE in individuals with GERD or vice versa were identified in Medline and the Cochrane Controlled Trials Register via a systematic research strategy. RESULTS Seventeen studies met the selection criteria. Studies, however, differed greatly as far as design, population methods of diagnosing GERD, duration of follow-up and, consequently, findings. The median prevalence of DE in GERD patients was 24%, with a large range (5-47.5%), and the median prevalence of GERD in DE adults patients was 32.5% (range: 21-83%) and in paediatric population 17% (range: 14-87%). Children with GERD are found by a majority of studies at increased risk of developing DEs in comparison with healthy subjects, as are intellectually disabled people. CONCLUSIONS This systematic review shows that there is a strong association between GERD and DE. The severity of DEs seems to be correlated with the presence of GERD symptoms, and also, at least in adults, with the severity of proximal oesophageal or oral exposure to an acidic pH. The inspection of the oral cavity in search for DEs should become a routine manoeuvre in patients with GERD.
Collapse
Affiliation(s)
- F Pace
- Division of Gastroenterology, Department of Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | | | | | | | | |
Collapse
|
45
|
Di Fede O, Di Liberto C, Occhipinti G, Vigneri S, Lo Russo L, Fedele S, Lo Muzio L, Campisi G. Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center case-control study. J Oral Pathol Med 2008; 37:336-40. [DOI: 10.1111/j.1600-0714.2008.00646.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
46
|
Ganss C. How valid are current diagnostic criteria for dental erosion? Clin Oral Investig 2008; 12 Suppl 1:S41-9. [PMID: 18228062 PMCID: PMC2238791 DOI: 10.1007/s00784-007-0175-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Accepted: 12/17/2007] [Indexed: 11/26/2022]
Abstract
In principle, there is agreement about the clinical diagnostic criteria for dental erosion, basically defined as cupping and grooving of the occlusal/incisal surfaces, shallow defects on smooth surfaces located coronal from the enamel–cementum junction with an intact cervical enamel rim and restorations rising above the adjacent tooth surface. This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research. Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor. Besides other aspects, this finding might be due to lack of validity with respect to diagnostic criteria. In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted. Knowledge about the validity of current diagnostic criteria of different forms of tooth wear is incomplete, therefore further research is needed.
Collapse
Affiliation(s)
- Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany.
| |
Collapse
|
47
|
|
48
|
Abstract
Gastroesophageal reflux disease (GERD) is a common medical condition affecting approximately 35-40% of the adult population in the western world. The role of GERD in causing extra-esophageal symptoms including laryngitis, asthma, cough, chest pain, and dental erosions is increasingly recognized with renewed interest among gastroenterologists and other specialists. Direct injury by mucosal contact, and vagally mediated reflex from distal esophageal acid exposure are the two possible mechanisms by which reflux-related extra-esophageal tissue injuries may occur. Several investigational techniques may be used to diagnose gastroesophageal reflux; however, because of the poor sensitivity of endoscopy and pH monitoring, and the poor specificity of laryngoscopy, empiric therapy with proton-pump inhibitors (PPI) is now considered the initial diagnostic step in patients suspected of having GERD-related symptoms. In those who improve with such therapy, it is likely that GERD may be the cause of the extra-esophageal presentation. In those who are unresponsive to such therapy, other diagnostic testing such as impedance/pH monitoring may be reasonable in order to exclude continued acid or weakly acid reflux. However, PPI-unresponsive patients usually have causes other than GERD for the extra-esophageal symptoms and signs.
Collapse
Affiliation(s)
- F Farrokhi
- Division of Gastroenterology and Hepatology, Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | |
Collapse
|
49
|
Hayashi M, Shimizu K, Takeshige F, Ebisu S. Restoration of erosion associated with gastroesophageal reflux caused by anorexia nervosa using ceramic laminate veneers: a case report. Oper Dent 2007; 32:306-10. [PMID: 17555184 DOI: 10.2341/06-102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Ceramic laminate veneers are useful to restore incisors suffering from severe erosion.
Collapse
Affiliation(s)
- Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan.
| | | | | | | |
Collapse
|
50
|
Lamanda A, Cheaib Z, Turgut MD, Lussi A. Protein buffering in model systems and in whole human saliva. PLoS One 2007; 2:e263. [PMID: 17327922 PMCID: PMC1803027 DOI: 10.1371/journal.pone.0000263] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 02/09/2007] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to quantify the buffer attributes (value, power, range and optimum) of two model systems for whole human resting saliva, the purified proteins from whole human resting saliva and single proteins. Two model systems, the first containing amyloglucosidase and lysozyme, and the second containing amyloglucosidase and α-amylase, were shown to provide, in combination with hydrogencarbonate and di-hydrogenphosphate, almost identical buffer attributes as whole human resting saliva. It was further demonstrated that changes in the protein concentration as small as 0.1% may change the buffer value of a buffer solution up to 15 times. Additionally, it was shown that there was a protein concentration change in the same range (0.16%) between saliva samples collected at the time periods of 13:00 and others collected at 9:00 am and 17:00. The mode of the protein expression changed between these samples corresponded to the change in basic buffer power and the change of the buffer value at pH 6.7. Finally, SDS Page and Ruthenium II tris (bathophenantroline disulfonate) staining unveiled a constant protein expression in all samples except for one 50 kDa protein band. As the change in the expression pattern of that 50 kDa protein band corresponded to the change in basic buffer power and the buffer value at pH 6.7, it was reasonable to conclude that this 50 kDa protein band may contain the protein(s) belonging to the protein buffer system of human saliva.
Collapse
Affiliation(s)
- Andreas Lamanda
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
| | | | | | | |
Collapse
|