Etiology of dental erosion--intrinsic factors

Morphological characteristics of non-carious cervical lesions. A systematic review

OBJECTIVES

This systematic review assessed the morphological characteristics of non-carious cervical lesions (NCCL), among clinical and ex-vivo studies assessed by observational and imaging methods.

DESIGN

The search strategy was conducted on four online databases (MEDLINE, Embase, Scopus and Web of Science) and grey literature (Google Scholar and OpenGrey). The study selection was performed by three reviewers from March to September (2023). The eligibility criteria were established according to the PICO strategy and included NCCL, morphological characteristics and clinical and ex-vivo study designs. The data extraction considered general data that identifies the study, evaluation method, parameter to assess the outcome and the main results for each study. The risk of bias was evaluated using Joanna Briggs Institute critical appraisal tool, and a personalized tool.

RESULTS

The search resulted in 252 studies. A total of 14 studies were included. Prevalence of NCCLs ranged from 3.5 %to 77.78 % with a higher presence in premolars. Common characteristics were wear facets, occluded tubules or cracks, occlusal stress, scratch marks, dimples and craters, structure loss, and dentin sclerosis, which appear more often on buccal surface and were generally classified as wedge-shaped, saucer-shaped. Etiological hypothesis was mainly related to multifactorial factors. In most of the studies, the risk of bias was classified as high.

CONCLUSIONS

The morphological characteristics of NCCL showed a wide range of descriptions regarding appearance, prevalence, lesion-related measures, and macro and microscopic descriptions.

Evaluating the protective effects of mouthguards with neutralizing agents against chlorinated water-induced enamel erosion

Introduction

Dental erosion is a common problem among swimmers. This study evaluated the effects of mouthguard use with or without neutralizing agents, compared to no mouthguard use, on the microhardness of dental enamel after a swimming simulation.

Methods

Ninety-six human premolars were randomly allocated into six groups of 16 each: Group A (no mouthguard), Group B (mouthguard only), Group C (mouthguard with fluoride toothpaste), Group D (mouthguard with fluoride-free toothpaste), Group E (mouthguard with CPP-ACP), and Group F (mouthguard with arginine-fluoride toothpaste). Enamel slabs were fixed in a wax model (Typodont Articulator) and used to fabricate mouthguards for all groups except Group A. Each specimen underwent cyclic immersion: 2 h in acidic chlorinated water (pH 3.1) followed by 22 h in artificial saliva, for 28 days, to simulate swimming exposure. The change in enamel surface hardness was measured using a Vickers hardness tester. All groups underwent microhardness testing, scanning electron microscopy, and polarized light microscopy.

Results

The enamel hardness significantly decreased in all groups after the swimming simulation (paired t-test, P-values < 0.001), except for Group F, which used a mouthguard with arginine-fluoride toothpaste [mean reduction: 17.9 kg/mm2, 95% confidence interval (CI): -1.9, 37.7, P-value = 0.07]. Group A, without a mouthguard, exhibited the highest reduction in enamel surface hardness (mean: 190.6 kg/mm2; 95%CI: 177.4, 203.9), significantly differing from all other groups with mouthguards (P-values < 0.001). However, no statistically significant differences were observed in enamel hardness reduction among the mouthguard groups. SEM micrographs illustrated rough, irregular erosion patterns and several deep porous areas on enamel surfaces of Group A. In contrast, all mouthguard groups showed enamel surfaces similar to sound tooth surfaces. A polarized light microscopic study revealed the deepest dark areas on the enamel surface of Group A.

Conclusions

Mouthguards significantly reduced enamel microhardness loss compared to no mouthguard use. While no significant differences were found among mouthguard groups with or without neutralizing agents, those lined with arginine-fluoride toothpaste showed the least enamel loss, suggesting its potential protective effect. Within the limitations of this in vitro study, further clinical trials are needed to validate these results.

Erosion Effects of OTC Paediatric Oral Liquids and Traditional Chinese Medicine on Primary Teeth

BACKGROUND

This study compared the in vitro erosive effects of 2 western and 2 Chinese medicinal over-the-counter paediatric medications on primary teeth in a continuous time scale.

METHODS

Twenty enamel blocks obtained from 10 deciduous incisors were randomly assigned into 5 groups (n = 4 each): Group GA and Group GB-paracetamol liquid (Jean-Marie Pharmacal Co. Ltd and Universal Pharmaceutical Laboratories Ltd, respectively); Group GC and Group GD-reconstituted Chinese medicinal granules (Huarun 999 and Guizhou Bailing Group Pharmaceutical Co. Ltd, respectively); and deionised water (control group). The pH levels of these liquids were assessed. The immersion process was repeated for 20 rounds. For each round, each sample was immersed in liquid for 15 seconds and then rinsed with deionised water for 15 seconds. Mean hardness ratio (MHR) at 5, 10, 15, and 20 rounds was evaluated using Vickers microhardness test. The initial and final surface morphology and chemistries were analysed by scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS).

RESULTS

All 4 liquid medications have shown acidic pH (4.74-5.76). After 20 rounds of immersion, the MHR20 of the GA (0.886) and GB (0.930) groups decreased significantly from the original MH0. The GC (0.978) and GD (0.985) groups illustrated a similar trend as the deionised water control group (0.985). Despite EDS, chemical analysis showed an increase of Ca/C mole ratio after drug immersion, and no significant difference (P > .05) was found on the ratios Ca/P and Ca/C and the amounts of magnesium or sodium before and after immersion according to the Wilcoxon signed-rank analysis. Distinctive enamel loss with irregular craters, and a corroded surface with fracture lines along the border of prism head were observed in the SEM of groups GA and GB, respectively. However, findings in both Chinese medicine groups were similar, such that erosive changes were barely seen, similar to the control group.

CONCLUSIONS

This study concluded that the pH of liquid medication may not be a significant factor that contributes to enamel softening. Traditional Chinese granule medications may be a safer option for primary teeth.

Influence of bottled salad dressings on the development of enamel erosion in the presence or absence of salivary pellicle - An in vitro study

Background

Acidic beverages are believed to elevate the risk of enamel surface erosion. In addition to the intake of soft drinks, the increased consumption of salad dressings has been linked to a higher prevalence of dental erosion. Therefore, the current study aimed to investigate the influence of bottled salad dressings on the development of enamel erosion in the presence or absence of pellicle through in vitro experiment.

Methods

Preliminary pH and calcium analyses of solutions were performed. Highest pH and calcium content was found for sandwich spread i.e., 4.69 and 55.4 mg/100 g grams, respectively. Eighty tooth specimens (measuring 4 × 4 × 3 mm) were prepared from extracted human premolars and randomly assigned to four groups (group 1: orange juice; group 2: eggless plain mayonnaise; group 3: sandwich spread; and group 4: thousand island dressing) with 20 samples in each group. Ten tooth specimens from each group were immersed in 20 ml of the respective solutions for 5 min (control group). The remaining ten tooth specimens from each group were submerged in 5 mL saliva vials for 3 min to facilitate salivary pellicle formation before being immersed in their respective solutions for 5 min (saliva-covered group). Pre and post-experimental assessments of enamel roughness and hardness were conducted using a surface roughness tester and Knoop Hardness indenter, respectively.

Results

Overall, enamel roughness was notably elevated in the control group, with the eggless plain mayonnaise (0.52 ± 0.38) and thousand island dressing groups (0.57 ± 0.29) showing a significant increase in surface roughness post-test (p = 0.05). Nevertheless, there was no significant difference in the enamel roughness between the groups. On the other hand, regardless of the presence/absence of the salivary pellicle, a marked decrease in enamel hardness was observed among all groups except for group 3 (sandwich spread) with a mean score of 311.5 ± 82.6 (p < 0.05).

Conclusion

A significant increase in surface roughness and reduction in enamel hardness was observed with salad dressings. However, in vitro formed salivary pellicle showed a protective effect against tooth erosion.

Carbon dots combined with phytosphingosine inhibit acid-induced demineralization of hydroxyapatite in vitro

OBJECTIVES

To study the effects of carbon dots (CDs), in combination with phytosphingosine (PHS), against acid-induced demineralization of hydroxyapatite in vitro.

METHODS

CDs were generated from citric acid and urea by microwave heating. Transmission electron microscope (TEM), FT-IR, and fluorescence intensity were used to characterize the CDs. A hydroxyapatite (HAp) model was used to investigate the protective effects of CDs, PHS, and their combinations with and without a salivary pellicle against acid-induced demineralization in vitro. Ca2+ release as a parameter to evaluate the inhibition of demineralization was measured by capillary electrophoresis. The interactions between CDs, PHS, and HAp discs were investigated using a fluorescence detector.

RESULTS

Uniform-sized CDs were synthesized, showing typical optical characteristics. CDs exhibited no inhibition of acid-induced demineralization in vitro, in contrast to PHS. Notably, a pre-coating of CDs increased the protective effects of PHS against acid-induced demineralization, which was not disturbed by the presence of a salivary pellicle and Tween 20. Scanning electron microscope (SEM) confirmed the binding and layers formed of both CDs and PHS to the HAp surfaces. Based on fluorescence spectra CDs binding to HAp seemed to be dependent on Ca2+ and PO43- interactions.

CONCLUSIONS

CDs combined with PHS showed protective effects against acid-induced demineralization of HAp discs in vitro.

Damage from Carbonated Soft Drinks on Enamel: A Systematic Review

The present study was conducted to analyze the erosive potential of the ever-increasing consumption of carbonated drinks on the dental surface. To identify relevant studies, a comprehensive search was conducted on PubMed, Scopus, and Web of Science covering the last 5 years (2018–2023) using the following Boolean keywords: “soft drinks AND tooth”. Finally, a total of 19 studies were included. The initial search provided a total of 407 items. Nineteen records were finally involved in the inclusion phase, seven of which were in vivo and twelve in vitro. An abuse of carbonated acid substances leads to an increase in the possibility of dental erosion with consequent structural disintegration and reduction of the physical and mechanical properties of the enamel. There is thus greater bacterial adhesion on rougher surfaces, determined by the erosive process, and therefore a greater risk of caries. The pH of most commercialized carbonated drinks is lower than the critical pH for the demineralization of the enamel. Carbonated drinks’ pH and duration of exposure have different deleterious effects on enamel.

Hardness and surface roughness of differently processed denture base acrylic resins after immersion in simulated gastric acid

STATEMENT OF PROBLEM

The effect of gastric acid on the surface properties of denture base acrylic resin is unknown.

PURPOSE

The purpose of this in vitro study was to evaluate changes in the surface roughness and hardness of denture base acrylic resins after immersion in simulated gastric acid.

MATERIAL AND METHODS

Acrylic resin specimens (n=10) were prepared with 3 different processing techniques (compression-molded, injection-molded, and computer-aided design and computer-aided manufacturing [CAD-CAM] milled) and exposed to either gastric acid or artificial saliva (control). Surface roughness and hardness were measured at baseline (T0) and after 24-hour (T24) and 96-hour (T96) immersion in the solutions. The surface roughness and hardness data were analyzed by 3-way ANOVA and the Tukey HSD test (α=.05).

RESULTS

At T24, the greatest change in surface hardness was observed for compression-molded specimens in gastric acid (P<.05). At T96, changes in hardness values were higher in compression-molded specimens than those in milled specimens (P<.05). Regarding surface roughness, at T24, compression-molded and injection-molded specimens showed higher values than milled specimens in gastric acid (P<.05). Concerning specimens in artificial saliva, compression-molded specimens showed significantly higher changes in roughness than those of the others (P<.05). At T96, injection-molded specimens had the greatest roughness values (P<.05). Among specimens immersed in artificial saliva, milled specimens showed lower roughness values than the injection-molded or compression-molded specimens (P<.05).

CONCLUSIONS

Gastric acid exposure adversely affected the roughness and hardness of all the acrylic resins evaluated. CAD-CAM milled specimens showed better resistance to acid exposure after 24 and 96 hours in terms of roughness and hardness.

The Effect of Gastric Acid on the Surface Properties of Different Universal Composites: A SEM Study

The aim of this study is to compare surface roughness and microhardness changes of three monochromatic (Omnichroma, Vittra Unique, and Charisma Diamond One) and three universal shade (Neo Spectra ST, G-ænial A'CHORD, and Nova Compo C) resin composites after exposure to simulated gastric acid. A total of 144 disc-shaped specimens (24 discs of each composite resin) were prepared using plexiglass molds (R = 5 mm × h = 2 mm) for evaluation from each material. Specimens of each material were divided into two main groups for the evaluation of the microhardness and surface roughness and also two subgroups for 7- and 14-day exposures to simulated gastric acid. Initial microhardness and surface roughness measurements of all samples were measured before immersion (T1) followed by exposing the samples to simulated gastric acid for 7 days (T2) and 14 days (T3), and then, the microhardness and roughness measurements were repeated. Randomly selected specimens of each material for each of the time intervals (T1, T2, and T3) were evaluated with scanning electron microscopy (SEM). One-way ANOVA revealed that the surface roughness and hardness values of all tested composite resin restorative materials show no statistically significant difference for the initial (T1) value (p > 0.05). Regarding the 7^th day (T2) and 14^th day (T3) surface roughness and microhardness value of all composites, there are statistically significant differences between the groups (p < 0.05), while there was no statistically significant difference between the surface hardness reduction percentage between the time intervals (p > 0.05). As a result of this in vitro study, increase in surface roughness and decrease in microhardness of the tested universal composite materials when exposed to simulated gastric acid were statistically significant.

Continuously Quantifying Oral Chemicals Based on Flexible Hybrid Electronics for Clinical Diagnosis and Pathogenetic Study

Simultaneous monitoring of diverse salivary parameters can reveal underlying mechanisms of intraoral biological processes and offer profound insights into the evolution of oral diseases. However, conventional analytical devices with bulky volumes, rigid formats, and discrete sensing mechanisms deviate from the requirements of continuous biophysiological quantification, resulting in huge difficulty in precise clinical diagnosis and pathogenetic study. Here, we present a flexible hybrid electronic system integrated with functional nanomaterials to continuously sense Ca2+, pH, and temperature for wireless real-time oral health monitoring. The miniaturized system with an island-bridge structure that is designed specifically to fit the teeth is only 0.4 g in weight and 31.5×8.5×1.35 mm3 in dimension, allowing effective integration with customized dental braces and comfort attachment on teeth. Characterization results indicate high sensitivities of 30.3 and 60.6 mV/decade for Ca2+ and pH with low potential drifts. The system has been applied in clinical studies to conduct Ca2+ and pH mappings on carious teeth, biophysiological monitoring for up to 12 h, and outcome evaluation of dental restoration, providing quantitative data to assist in the diagnosis and understanding of oral diseases. Notably, caries risk assessment of 10 human subjects using the flexible system validates the important role of saliva buffering capacity in caries pathogenesis. The proposed flexible system may offer an open platform to carry diverse components to support both clinical diagnosis and treatment as well as fundamental research for oral diseases and induced systemic diseases.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

HASTABAŞI CAD-CAM BLOKLARIN EROZE DENTİNE MAKASLAMA BAĞLANMA DAYANIMI

Amaç: Bu çalışmada hastabaşı bilgisayar destekli tasarım-bilgisayar destekli üretim (CAD-CAM) bloklarının self-etch ve self-adeziv rezin simanlar kullanılarak gastrik erozyona uğratılmış dentine olan makaslama bağlanma dayanımlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Yüz seksen dentin örneği sağlam dentin ve eroze dentin olmak üzere iki gruba ayrılmıştır. Eroze dentin grubunda örnekler HCI (0,01 M, pH 2, 2 dk) ile erozyona uğratılmış ve 60 dk yapay tükrükte bekletilmiş, sonrasında, elektrikli diş fırçası kullanılarak (2N, 15 s) fırçalanmıştır. Bu döngü üç kere tekrar edilmiştir. Lava Ultimate (LU), Vita Enamic (VE) ve Vita Suprinity (VS) CAD-CAM blokları (3x3x3 mm3, n=15/grup) self-etch Multilink N (MN) ve self-adeziv RelyX U200 Automix (RU) rezin simanları kullanılarak sağlam ve eroze dentin örneklerine simante edilmiştir. Makaslama bağlanma dayanımı 24 saat sonra ölçülmüştür. Başarısızlık tipi stereomikroskop kullanılarak değerlendirilmiştir. Veriler üç-yönlü ANOVA ve Bonferroni düzeltmesi kullanılarak analiz edilmiştir (p˂0,05). Bulgular: Makaslama bağlanma dayanımı ana faktörlerden önemli ölçüde etkilenmiştir: diş yapısı (p=0,011), rezin simanlar (p˂0,001) ve CAD-CAM bloklar (p=0,001). LU sağlam dentine RU ile simante edildiğinde, eroze dentinle karşılaştırıldığında daha yüksek bağlanma dayanımı elde edilmiştir (p=0,001). MN kullanıldığında, RU’dan daha yüksek bağlanma dayanımı değerleri elde edilmiştir (p

Long-term effects of simulated gastric juice alternated with brushing on hardness, substance loss, flexural strength and reliability of CAD-CAM monolithic materials

OBJECTIVES

The purpose of this study is to evaluate, over a simulated 5-year period, the effect of simulated gastric juice alternated with brushing on CAD-CAM monolithic materials considering microhardness, substance loss, flexural strength, and reliability of the materials.

METHODOLOGY

Blocks from Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), IPS e.max CAD (EMAX), and Vita Suprinity (VS) were milled into cylinders and sliced into disks. The EMAX and VS were crystallized, and all specimens were polished with silicon carbide papers and allocated as follows: 1) artificial saliva + brushing or 2) simulated gastric juice (0.113% hydrochloric acid (HCl) solution in deionized water, pH 1.2) + brushing, simulating 1, 3, and 5 years of clinical function. Each year of clinical function was simulated by three repetitions of immersion for 3 hours in artificial saliva or simulated gastric juice followed by 1,217 brushing cycles. The microhardness and substance loss were evaluated at baseline (T0) and at each year by using a Vickers hardness tester and an analytical balance. The biaxial flexural strength (BFS) test was performed in a mechanical testing machine at the end of the 5th year. Weibull modulus was calculated from the BFS data.

RESULTS

The microhardness of the LU was not influenced by the treatment, whereas that of the other materials, in certain years, was significantly lower in the gastric juice + brushing groups in comparison with artificial saliva + brushing groups. In general, the materials did not present a significant change in microhardness over time, for either of the treatments. The LU alone showed greater substance loss in the gastric juice + brushing groups for every year. In both treatments, the LU, VE, and EMP exhibited a significant increase in the substance loss over time. The treatment did not affect the BFS of the materials. The gastric juice + brushing decreased the reliability of the VE.

CONCLUSIONS

All materials were somehow impaired by the gastric juice + brushing in at least one of the evaluated parameters, except for the BFS. However, in a deeper analysis, the LU would be the least indicated materials, followed by VE, for patients with eating disorders.

Effect of erosive challenge with HCl on restorative materials

OBJECTIVE

Investigate the effect of erosive challenge with hydrochloric acid (HCl) on the surface of five different restorative materials.

MATERIAL AND METHODS

Ten plates of five restorative materials (Admira Fusion, Activa BioActive-Restorative, Charisma, Equia Forte HT Fil/EF, Filtek Universal Restorative/FU) were obtained. Half of the plate surfaces was covered with an adhesive tape, creating a control area, and the other side was submitted to the HCl (0.06 M HCl; pH 1.2; at 37 °C; for 30 h). Plates with control and HCl-treated areas were analyzed regarding the surface roughness (Sa), roughness profile (Rv), surface loss (SL), microhardness (MI), and gloss (GL) (n = 10). Surface morphology was analyzed by SEM and chemical elements were identified by EDX (n = 5). Data were evaluated by ANOVA and Tukey's test (α = 0.05).

RESULTS

Most materials were not affected by HCl. FU showed the lowest Sa and Rv, and the highest GL after HCl. On the other hand, EF presented the highest Sa, Rv, and SL, and the lowest GL. The MI of materials was not changed after HCl. Topographical and chemical alterations were observed after HCl only for EF.

CONCLUSIONS

The composites showed minor surface changes after HCl, which was not observed for the glass ionomer cement (EF). FU presented the best performance regarding the parameters evaluated.

CLINICAL RELEVANCE

The effects of erosive challenge with HCl on composites were minimal, while the glass ionomer cements might not be indicated as restorative material for patients with gastroesophageal reflux disease.

4D microstructural changes in dentinal tubules during acid demineralisation

OBJECTIVE

Dental erosion is a common oral condition caused by chronic exposure to acids from intrinsic/extrinsic sources. Repeated acid exposure can lead to the irreversible loss of dental hard tissues (enamel, dentine, cementum). Dentine can become exposed to acid following severe enamel erosion, crown fracture, or gingival recession. Causing hypersensitivity, poor aesthetics, and potential pulp involvement. Improving treatments that can restore the structural integrity and aesthetics are therefore highly desirable. Such developments require a good understanding of how acid demineralisation progresses where relatively little is known in terms of intertubular dentine (ITD) and peritubular dentine (PTD) microstructure. To obtain further insight, this study proposes a new in vitro method for performing demineralisation studies of dentine.

METHODS

Advanced high-speed synchrotron X-ray microtomography (SXM), with high spatial (0.325 μm) and temporal (15 min) resolution, was used to conduct the first in vitro, time-resolved 3D (4D) study of the microstructural changes in the ITD and PTD phases of human dentine samples (∼0.8 × 0.8 × 5 mm) during 6 h of continuous acid exposure.

RESULTS

Different demineralisation rates of ITD (1.79 μm/min) and PTD (1.94 μm/min) and their progressive width-depth profiles were quantified, which provide insight for understanding the mechanisms of dentine demineralisation.

SIGNIFICANCE

Insights obtained from morphological characterisations and the demineralisation process of ITD and PTD during acid demineralisation would help understand the demineralisation process and potentially aid in developing new therapeutic dentine treatments. This method enables continuous examination of relatively large volumes of dentine during demineralisation and also demonstrates the potential for studying the remineralisation process of proposed therapeutic dentine treatments.

Evaluation of the Erosive and Cariogenic Potential of Over-the-Counter Pediatric Liquid Analgesics and Antipyretics

To evaluate the cariogenic and erosive potentials of over-the-counter pediatric oral liquid antipyretics and analgesics, we tested nine over-the-counter pediatric oral liquid medications classified as antipyretic or analgesic medicines available in Korea. For each substance, we measured the pH with a pH meter and the sugar content with a sugar content meter. We determined the titratable acidity (TA) levels based on the volumes of NaOH solution that had to be added to reach a pH of 7.0. We also evaluated the dental erosion potentials with an International Organization for Standardization method based on observing changes in the pH of a CaPO₄ solution upon introducing a small volume of the solution to be tested. The oral liquid medications had pH values of 3.40–5.68. In the TA assessments, several oral liquid medications required greater volumes of NaOH solution to reach a pH of 7.0. The dental erosion potentials varied but correlated strongly with the NaOH volumes needed to reach a neutral pH (r = 0.84; p < 0.0001). Many oral liquid antipyretics and analgesics have features that can promote dental erosion. A correct understanding of pediatric antipyretics and analgesics is required in dentistry for children’s oral health.

Evaluation of the microhardness of different resin-based dental restorative materials treated with gastric acid: Scanning electron microscopy-energy dispersive X-ray spectroscopy analysis

The aim of this study is to evaluate the microhardness, relative surface roughness, and elemental changes of resin-based dental restorative materials (RDRMs) after gastric acid treatment. Five different RDRMs (Group 1 [Filtek Z550], Group 2 [Beautifil II], Group 3 [Vertise Flow], Group 4 [Dyract XP], Group 5 [Fuji II LC]) were used. Samples were formed by using plexiglass molds of 10 mm diameter and 2 mm thickness. A total of 50 samples (n = 10) for microhardness tests and a total of 15 samples (n = 3) for scanning electron microscopy (SEM)-energy dispersive X-ray spectroscopy (EDX) analysis were prepared. All samples of each group were treated to gastric acid, simultaneously. A Vickers microhardness tester was used to evaluate the microhardness of the upper surfaces of each sample. SEM-EDX system was used for microstructure and elemental composition detection. The SEM-EDX, microhardness and relative surface roughness analysis were made prior to treatment in gastric acid for 14 days and analysis were repeated on the 14th day. As the difference in the microhardness values of RDRMs was compared, the time-dependent variation in all RDRMs was found to be statistically significant. It was observed that a drastic decrease in microhardness values was in Beautifil II, Filtek Z550, Vertise Flow, Fuji II LC, and Dyract XP, respectively. Average decrease rate of microhardness values compared to the initial state can be listed from high to low as Beautifil II (%35.72), Vertise Flow (% 28.88), Fuji II LC (% 21.09), Dyract XP (%17.60), and Filtek Z550 (% 16.58). As a result, in in-vitro conditions gastric acid decreased microhardness while increasing the relative surface roughness of RDRMs.

Dental erosive wear in primary teeth among five-year-olds - Bergen, Norway

OBJECTIVE

To estimate the prevalence of dental erosive wear among five-year-olds in Bergen, Norway, and to investigate associations between background factors and the condition.

METHODS

A total of 387 children received a dental examination in five Public Dental Service clinics in Bergen, Norway. The parents responded to items about the children's dental hygiene and drinking habits, type of beverage container, diet, and other habits, and about their own age, educational level and country of origin. We explored background variables for possible associations with the outcome status as worst affected by erosive wear (19.4%, n = 75). Chi-squared statistics and logistic regression (Odds Ratios (OR): 95% Confidence Intervals (CI), served as statistical tools).

RESULTS

Approximately 80% showed erosive wear (by SEPRS and by adopted diagnostic instrument (78.5% vs 79.8%)). The condition affected maxillary anterior teeth in 13.9% (n = 54), and cuppings in molars in 79.3% (n = 307) of cases. Grinding teeth during the day and/or night (OR: 1.87, CI: 1.07-3.25) and male sex (OR: 1.76, CI: 1.05-2.96) significantly related to outcome status as worst affected by erosive wear, respectively.

CONCLUSION

Dental erosive wear was widespread. Grinding teeth and male sex associated with outcome status as worst affected by erosive wear.

Contemporary diagnosis and management of dental erosion

OBJECTIVE

This article is aimed at providing an overview of the topic of erosive tooth wear (ETW), highlighting the clinical signs, diagnosis, and management of dental erosion.

OVERVIEW

With the increased prevalence of ETW, it is important that oral health professionals are able to recognize the early signs. Early clinical signs of dental erosion are characterized by loss of enamel texture, a silky glossy appearance, and sometimes a dulling of the surface gloss, referred to as the "whipped clay effect, cupping, and restorations 'standing proud'." The progression of ETW should be monitored by means of diagnostic models or clinical photographs. ETW can be as a result of acid attack of extrinsic or intrinsic origin.

CONCLUSION

There is an increase of ETW that is being recognized by the profession. The first step in diagnosing and management is to recognize as early as possible that the process is occurring. At that point a determination of whether the primary etiology is either intrinsic or extrinsic should be made. If these findings are confirmed, appropriate prevention, and management strategies can be adopted followed by appropriate restorative therapy.

CLINICAL SIGNIFICANCE

The prevalence of ETW continues to increase. It is therefore important that oral health care providers have a better understanding of the etiology, pathophysiology, and management of this condition. This review aims to provide the guidelines for diagnosis and management of dental erosion.

Erosive Tooth Wear and Erosive Esophagitis in Children: An Observational Study in Porto Alegre, Brazil

The aim of this study was to establish and compare the prevalence and severity of erosive tooth wear (ETW) in children with and without erosive esophagitis. Children aged 5-12 years, scheduled for upper digestive endoscopy at the Pediatric Gastroenterology Service of the Children's Hospital Santo Antonio, Porto Alegre, Brazil, were eligible to participate in this study. Patients who presented erosive esophagitis at endoscopy were defined as gastroesophageal reflux disease (GERD) carriers, and the severity was described according to the Los Angeles classification. The oral cavity examination was performed by a trained and calibrated dentist and ETW was classified using the Basic Erosive Wear Examination (BEWE) index. Parents/guardians answered a questionnaire about the patients' diets and frequency of consumption of acidic foods and beverages. A total of 110 children were included in the study. Erosive esophagitis was observed in 24 patients (21.8%) and all of them (100%) presented ETW, showing a statistically significant association between these 2 conditions (p < 0.05). Among children who did not present with erosive esophagitis (n = 86), 54 (64.3%) had an ETW risk level of none according to their BEWE scores (0-2). The results of this study showed a statistically significant association between erosive esophagitis and ETW, thus it can be concluded that it is important to recognize groups at risk of ETW and act together with medical professionals to ensure adequate oral health for these patients.

A Review on Impact of Medicinal Plants on the Treatment of Oral and Dental Diseases

Plants play a vital role in the general wellbeing of an individual. Globally plants are habitually used by the people for the treatment and prevention of various ailments. There is an increased attempt made from ancient days to prevent the disease occurrence rather than to treat it. Through the development of modern scientific procedures, it is now identified that the usage of plants in different forms promotes the health of the patient. Oral and dental hygiene is the primary factor of a human being to lead a healthy life. Poor diet, nutrition and improper hygienic practices lead to teeth and gum diseases, dental cavities and plaque etc., Use of herbal extracts and their products in day-to-day life is a promising and interesting alternative to synthetic compounds to control oral diseases. The present review summarizes the usage of medicinal plants in the treatment and prevention of oral and dental diseases in different aspects.

The effect of gastric acid on chitosan modified glass ionomer cement: SEM-EDS

This study aimed to use scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS) to examine the elements that passed into the gastric acid solution after the application of a gastric acid erosive cycle to chitosan modified glass ionomer cement (GIC). Chitosan modified GIC samples were obtained by adding chitosan (vol/vol) of 5 and 10% to GIC for the experimental groups. These two experimental groups and a control group were subjected to gastric acid erosive treatment for 60 s six times a day for 10 days. The sample surfaces were coated with approximately 1 nm of gold to increase conductivity with the Q 150R ES device (Quorum Technologies, East Sussex, England). Surface topography images were obtained with a SEM. Besides, EDS analysis was also determined the number of elements graphically in the region where the fast electron beam hit. In the samples examined, the amount of element was determined. After gastric acid application, cracks and voids were observed on the surfaces of the samples. In the EDS analysis of the 5 and 10% chitosan modified GIC and control groups, Si, Al, Na, and F was found. It is necessary to investigate the antibacterial properties and physical properties of chitosan modified glass ionomer-free elements and fluorine ions using advanced techniques.

Influence of Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin

This in vitro study evaluated the influence of the Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin. Eighty dentin specimens were selected and divided into eight groups (n = 10): G1: negative control; G2: positive control (5% fluoride varnish-FV); G3: Er,Cr:YSGG laser; G4: FV + laser; G5: 3% potassium oxalate; G6: 3% potassium oxalate + laser; G7: biphasic calcium silicate/phosphate gel (gel); G8: gel + laser. Laser parameters: 0.5 W, 6.25 J/cm² at 1-mm distance. The erosive drink used was a cola soft-drink (pH = 2.42 at 4 °C), lasting 5 min, twice a day, with 6-h intervals between the challenges, during 14 days. Kolmogorov-Smirnov and Levene's tests were satisfied. The surface roughness data were submitted to ANOVA and Tukey post hoc tests. For the wear profile, Kruskal-Wallis and Dunn post hoc tests were used. Afterwards, the Spearman correlation test was performed. All statistical tests assumed a significance level of 5% (α = 0.05). G1 presented the highest surface roughness value after the erosive challenge (3.586 μm² ± 0.205 μm²) and the G7 presented the lowest surface roughness value after the erosive challenge (1.071 μm² ± 0.180 μm²). For the lost volume, G4 presented the lowest percentage (9.7% ± 0.9%), while G1 had the highest percentage (41.8% ± 2.5%), both with p < 0.05. There was a weak correlation between the response variables (ρ = 0.33). All groups presented lower values of surface roughness and loss of volume when compared to the negative control group. For the surface roughness, the biphasic calcium silicate/phosphate gel presented the best result. For volume loss, the 5% fluoride varnish + Er,Cr:YSGG laser showed the best results compared to the other groups.

Erosive tooth wear: Knowledge among young adults and their preferred information sources

OBJECTIVES

The aim of this study was to learn more about levels of knowledge relating to erosive tooth wear and about the most desirable way of disseminating dental information among young adults.

METHODS

The research was a cross-sectional study of 331 young adults (20-25 years old) attending 25 dental care practices. Participants were asked to fill out a questionnaire with questions about their background, knowledge relating to erosive tooth wear and the preferred way of acquiring information about erosive tooth wear.

RESULTS

The results showed that there are gaps in the knowledge of young adults about erosive tooth wear. The knowledge score depended on educational level and dental information received in the past. The preferred way of acquiring information was chairside information from an oral health care professional complemented by tailored information in writing.

CONCLUSION

There is a lack of knowledge among young adults about erosive tooth wear. They prefer to receive information from the oral health care professionals accompanied by tailored information in writing. Further research should focus on developing this tailored information in line with the advice given by the oral health care professional.

Anti-erosive effect of calcium carbonate suspensions

Background

This study aimed to investigate the ability of different concentrations of calcium carbonate (CaCO3) suspensions to control enamel surface loss.

Material and Methods

Seventy-five enamel slabs were embedded, ground and polished in a pneumatic grinder-polisher machine. Reference areas were created with UPVC tape and the specimens were randomly allocated into five groups (n = 15) for exposure to hydrochloric acid solution to simulate gastric juice (0.01 M, pH 2) for 2 minutes. The samples were then exposed to suspensions containing 0.0001, 0.001, 0.01 or 0.1 mmol/L CaCO3 for 1 minute. Artificial saliva was used as control. The samples were subjected to a total of five erosive cycles followed by treatment with CaCO3 suspension. Surface loss was measured (in µm) using optical profilometry.

Results

One-way ANOVA (p = 0.009) and Tukey's test showed a significant reduction in surface loss when compared to the group not exposed to CaCO3 (0.74, +/- 0.23 µm), and the 0.01 mmol/L (0.40; +/- 0.23 µm) and 0.1 mmol/L suspensions (0.37; +/- 0.26 µm).

Conclusions

The lower concentrated suspensions were incapable of significantly reducing enamel surface loss. Rinsing with 0.01 and 0.1 mmol/L calcium carbonate suspensions was revealed as a potentially promising strategy to prevent enamel erosion. Key words:Tooth erosion, gastric acid, calcium carbonate, prevention and control.

Aspirin is associated with low oral pH levels and antacid helps to increase oral pH

Objective

Aspirin is a commonly used medicine for primary and secondary prevention of cardiovascular diseases. It is an acidic medicine associated with gastric irritation and acid reflux, which in turn can lead to low oral pH levels. Therefore, it is important to understand the association between aspirin and oral pH levels in order to achieve an optimum oral health condition among patients who take aspirin on prescription.

Results

Out of 373 patients, 162 (44%) were males and 245 (66%) were on aspirin. 71% of aspirin taking patients and 29% of non-aspirin taking patients had oral pH less than 6.5 (P < 0.01). Aspirin showed a significant association with low oral pH levels (odds ratio = 1.91, 95% CI 1.23–2.99, P < 0.01). 78 patients were given antacids and followed up for 4 weeks, 63 of them (81%) showed an improvement in oral pH and the improvement was marked in the group who had oral pH between 5.5–6.0 compared to the group who had oral pH between 6.0–6.5 (P = 0.03). The results show that aspirin therapy is associated with low oral pH and administration of an antacid with aspirin helps to increase the oral pH level.

Effect of Mouthrinses containing Olive Oil, Fluoride, and Their Combination on Enamel Erosion: An in vitro Study

AIM

The aim of the study was to evaluate the effect of mouth-rinses containing olive oil, fluoride, and their combination on enamel erosion.

MATERIALS AND METHODS

An in vitro study of 45 enamel specimens, which were prepared from 45 extracted teeth, was employed. Each specimen was subjected to 10 alternative demineralization and remineralization cycles. Remineralizing cycle includes 5 minutes exposure with one of the mouthrinse, and demineralizing cycle includes 3 minute exposure to 1% citric acid. Mean surface roughness (Ra) was measured from surfometry before and after cycles. Statistical tests used were Student's unpaired t-test and one-way analysis of variance (ANOVA), followed by Tukey's post hoc test.

RESULTS

Among the three mouthrinses, Listerine and Xerostom showed maximum protection against erosion on enamel. The 2% olive oil mouthrinse showed the least protection against erosion on enamel.

CONCLUSION

The study indicated that the Listerine and Xerostom mouthrinses are valuable preventive measures.

CLINICAL SIGNIFICANCE

Mouthrinses are effective for lessening erosive demineralization and in aggregating remineralization of tooth surfaces which are the important factors to prevent enamel erosion.

Prevalence of erosive lesions with respect to risk factors in a young adult population in Poland-a cross-sectional study

OBJECTIVE

The study was conducted to investigate the prevalence of erosive lesions and related risk factors in the population of 18-year-old young adults in Poland.

MATERIALS AND METHODS

Calibrated examiners measured erosive tooth wear according to Basic Erosive Wear Examination (BEWE) scoring system in 1869 patients and assessed the impact of risk factors with a questionnaire.

RESULTS

Erosion was present in 42.3% of the patients. Early damage to the enamel was the most frequent finding (BEWE 1)-28.9%. More advanced lesions (BEWE 2) were observed in 12% of the patients. Advanced damage to the teeth (BEWE 3) was diagnosed rarely-1.4% of the examined population. Acidic diet, hygienic habits, and medical conditions such as asthma, eating disorders, and esophageal reflux showed statistical significance, as associated with erosion in the examined population.

CONCLUSIONS

The present study indicates that dental erosion is a common oral disease in the 18-year-old population with prevalence of frequency and intensity in males. However, on the basis of observations carried out in recent years, it may be assumed that the prevalence of this type of lesion is increasing.

CLINICAL RELEVANCE

Present findings support other longitudinal studies toward evaluation of the BEWE system as a valuable standard for assessing erosive and related risk factors among different populations.

The proteomic profile of the acquired enamel pellicle according to its location in the dental arches

OBJECTIVE

This study evaluated the variation in the protein profile of the acquired enamel pellicle (AEP) formed in vivo according to its location in the dental arches.

DESIGN

The AEP was formed for 120min in 9 volunteers. Pellicle formed at upper+lower anterior facial (ULAFa; teeth 13-23 and 33-43), upper anterior palatal (UAPa; teeth 13-23), lower anterior lingual (LALi; teeth 33-43), upper+lower posterior facial (ULPFa; teeth 14-17 24-27, 34-37 and 44-47), upper posterior palatal (UPPa; teeth 14-17 and 24-27) and lower posterior lingual (LPLi; teeth 34-37 and 44-47) regions were collected separately and processed for analysis by label-free LC-ESI-MS/MS.

RESULTS

Three-hundred sixty three proteins were identified in total, twenty-five being common to all the locations, such as Protein S100-A8, Lysozyme C, Lactoferrin, Statherin, Ig alpha-2, ALB protein, Myeloperoxidase and SMR3B. Many proteins were found exclusively in the AEP collected from one of the regions (46-UAPa, 33-LALi, 59-ULAFa, 31-ULPFa, 44-LPLi and 39-UPPa).

CONCLUSIONS

The protein composition of the AEP varied according to its location in the dental arches. These results provide important insights for understanding the differential protective roles of the AEP as a function of its location in the dental arches.

[Self-assessment of opinions, habits and oral health status by pregnant women in the south of Galicia, Spain]

An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems.

Paediatric Over-the-Counter (OTC) Oral Liquids Can Soften and Erode Enamel

This study investigated the softening and erosive effects of various paediatric over-the-counter (OTC) oral liquids on deciduous teeth. Twenty sectioned and polished deciduous enamel blocks were ground on the buccal surface (2 × 2 mm²) and randomly divided into five groups, immersed into four commercially-available paediatric OTC oral liquids (two for paracetamol, both sugared; and two for chlorpheniramine, one sugared and one sugar-free), with deionized water as control. The pH of the oral liquids ranged from 2.50 to 5.77. Each block was immersed into the test or control groups for 15 s, rinsed with deionized water, and Vickers micro-hardness (n = 5) was measured. After twenty cycles of immersion and hardness measurements, Scanning Electron Microscope (SEM) and Energy Dispersive X-ray Spectrometry (EDS) were used to evaluate the surface morphology and chemistry of the tooth blocks, respectively. The pH values of the liquids were also recorded. Rapidly descending trends in the micro-hardness ratios of the four test groups were observed that were statistically different from the control group (p < 0.001). EDS showed an increase of Ca/C ratio after drug immersion, whereas SEM showed an enamel loss in all the test groups. Paediatric OTC oral liquids could significantly soften the enamel and render them more susceptible to caries, such that the formulation of the oral liquids is the major factor.

Bodybuilding supplementation and tooth decay

Supplementation is a key component in bodybuilding and is increasingly being used by amateur weight lifters and enthusiasts to build their ideal bodies. Bodybuilding supplements are advertised to provide nutrients needed to help optimise muscle building but they can contain high amounts of sugar. Supplement users are consuming these products, while not being aware of their high sugar content, putting them at a higher risk of developing dental caries. It is important for dental professionals to recognise the increased risk for supplement users and to raise awareness, provide appropriate preventative advice and be knowledgeable of alternative products to help bodybuilders reach their goals, without increasing the risk of dental caries.

Effects of simulated gastric juice on color stability, surface roughness and microhardness of laboratory-processed composites

Medical problems such as gastroesophageal reflux disease can cause considerable damage to restorations in the oral environment. This study evaluated the effects of gastric juice on the surface characteristics of different types of laboratory-processed indirect composites with different filler particles and polymerization modes. Specimens were prepared from Tescera (TES; Bisco), Sinfony (SIN; 3M ESPE), Solidex (SOL; Shofu), and Adoro (AD; Ivoclar Vivadent). Before exposing the specimens to simulated gastric juice for 24 h, color, surface roughness, and microhardness were measured on one half of the polished flat surface of each specimen. After exposure to the simulated gastric juice, the same tests were repeated on the other half of specimen surface. Results indicated that gastric juice had a significant impact on color change (p<0.001). AD showed the largest surface roughness change among the resins (p<0.001). Gastric juice also significantly affected the microhardness of the materials, and AD and TES showed statistically similar change in microhardness (p>0.05).

The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

Objective:

The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors.

Materials and Methods:

A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria.

Results:

In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05).

Conclusions:

The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion.

Combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine

OBJECTIVE

This study evaluated the combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine.

DESIGN

Sixty slabs of bovine root dentine (2×2×2mm) were eroded with citric acid 0.3% (pH 3.2) during 2h and then kept in artificial saliva during 24h. Specimens were randomly assigned in 6 groups (n=10), to receive the following treatments: fluoride varnish; fluoride varnish+Er:YAG laser; fluoride varnish+Nd:YAG laser; non-fluoride varnish; non-fluoride varnish+Er:YAG laser; non-fluoride varnish+Nd:YAG laser. The Er:YAG (100mJ, 3Hz) and Nd:YAG (70mJ, 15Hz) were applied for 10s. Specimens were subjected to further erosive challenges with citric acid 0.3% 4×/day, during 1min, for 5 days, remaining in artificial saliva between cycles. Dentin permeability was then assessed. Two-way ANOVA demonstrated no significant interaction between laser and varnish (p=0.858).

RESULTS

No effect was also detected for the main factor varnish (p=0.768), while permeability of eroded root dentin was significantly lower when such substrate was laser-irradiated, no matter the laser source (p<0.001).

CONCLUSIONS

This study concluded that Er:YAG and Nd:YAG lasers can be employed to control the permeability of eroded root dentin, regardless of fluoride varnish application.

Erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration: An in vitro study

Aim:

This study evaluates erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration in vitro.

Materials and Methods:

Test medias used in this study included carbonated beverage, noncarbonated beverage, high-energy sports drink medicated cough syrup, distilled water as the control. A total of 110 previously extracted human premolar teeth were selected for the study. Teeth were randomly divided into two groups. Test specimens were randomly distributed to five beverages groups and comprised 12 specimens per group. Surface roughness (profilometer) readings were performed at baseline and again, following immersion for 14 days (24 h/day). Microleakage was evaluated. The results obtained were analyzed for statistical significance using SPSS-PC package using the multiple factor ANOVA at a significance level of P < 0.05. Paired t-test, Friedman test ranks, and Wilcoxon signed ranks test.

Results:

For surface roughness high-energy sports drink and noncarbonated beverage showed the highly significant difference with P values of 0.000 and 0.000, respectively compared to other test media. For microleakage high-energy sports drink had significant difference in comparison to noncarbonated beverage (P = 0.002), medicated syrup (P = 0.000), and distilled water (P = 0.000).

Conclusion:

High-energy sports drink showed highest surface roughness value and microleakage score among all test media and thus greater erosive potential to enamel while medicated syrup showed least surface roughness value and microleakage among all test media.

Prevalence and risk factors for dental erosion among 11- to 14-year-old school children in South India

This cross-sectional survey was conducted to assess the prevalence and severity of dental erosion and to determine the potential risk factors for dental erosion among 11- to 14-year-old school children in South India. The total sample size for the study was 605, of which 303 school children were from private schools and 302 from public schools. A questionnaire was designed to record information about socio-demographic characteristics, oral hygiene practices, dietary habits and risk factors for dental erosion. Chi square test, bivariate analysis and Logistic regression analysis were performed to analyse the data. The children who consumed lemon several times a day (OR = 13.41, P < 0.001), and those who preferred carbonated drinks (OR = 2.80, P = 0.007) had a higher tendency to develop dental erosion. The overall prevalence of dental erosion was found to be low (8.9%). Erosion was found to be greater in posterior teeth (65.6%) than anterior teeth (34.4%). Loss of enamel only with loss of surface contour was observed in most (94.8%) of the cases. The prevalence of dental erosion was found to be low in school children. Private school children were affected more by dental erosion. Frequency of lemon consumption and consumption of carbonated drinks were identified as risk factors.

Laser speckle imaging: a novel method for detecting dental erosion

Erosion is a highly prevalent condition known as a non-carious lesion that causes progressive tooth wear due to chemical processes that do not involve the action of bacteria. Speckle images proved sensitive to even minimal mineral loss from the enamel. The aim of the present study was to investigate the use of laser speckle imaging analysis in the spatial domain to quantify shifts in the microstructure of the tooth surface in an erosion model. 32 fragments of the vestibular surface of bovine incisors were divided in for groups (10 min, 20 min. 30 min and 40 min of acid etching) immersed in a cola-based beverage (pH approximately 2.5) twice a day during 7 days to create an artificial erosion. By analyzing the laser speckle contrast map (LASCA) in the eroded region compared to the sound it was observed that the LASCA map shifts, proportionally to the acid each duration, by: 18%; 23%; 39% and 44% for the 10 min; 20 min; 30 min and 40 min groups, respectively. To the best of our knowledge, this is the first study to demonstrate the correlation between speckle patterns and erosion progression.

Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials

In this in vitro study, the effects of a Cola drink, and fresh fruit juice (citrus) on the surface roughness on flowable composite and resin-modified glass ionomer cement (RMGIC) each was evaluated and compared. Using a brass mold 70 pellets each of flowable composite (Filtek™ Flow) and RMGIC tricure restorative material were prepared according to the manufacturer's instructions. Two groups (groups I and II) were formed containing 30 pellets of each material. Remaining 10 pellets of each restorative material did form the control group [water (group III)]. Experimental group pellets were again divided into three subgroups (mild, moderate and severe) containing 10 pellets each and were kept in plastic containers with 30 ml Cola drink (group I) and fresh fruit juice (group II) respectively. Immersion regime was followed according to M aupome G et al. Baseline and final surface roughness (Ra) value for each pellet was evaluated using a profilometer. Statistical analysis was done with Wilcoxon's signed rank test and analysis of variance (ANOVA) followed by Mann-Whitney test. Results showed that the erosive effect of both Cola drink and fresh fruit juice caused significant surface roughness on both flowable composite and RMGIC restorative materials in the mild, moderate and severe immersion regimes. How to cite this article: Maganur P, Satish V, Prabhakar AR, Namineni S. Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials. Int J Clin Pediatr Dent 2015;8(1):1-5.

Restorative management using hybrid ceramic of a patient with severe tooth erosion from swimming: a clinical report

This clinical report presents the clinical appearance and treatment approach in a case of excessive anterior teeth erosion resulted from swimming in a poorly-chlorinated swimming pool. Clinical findings revealed tooth sensitivity, severe enamel erosion resembling veneer preparations, and the presence of anterior open bite. A novel hybrid ceramic (Vita Enamic) was chosen for fabricating full-coverage crowns for this patient. After 6-months follow-up, the tooth sensitivity disappeared and the patient was satisfied with esthetic outcome. The hybrid ceramic restorations can be recommended with no complications.

Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study

Consumption of acidic foods and drinks and other factors that cause enamel wear are responsible for the daily enamel loss and degradation. Use of some toothpastes that have been showed to possess different properties of remineralisation and/or repair of the enamel surface may help to protect tooth enamel. The aim of this study was to evaluate whether the use of toothpaste containing Zn-carbonate hydroxyapatite (CHA) nanostructured microcrystals may exert remineralization/repair effects of the enamel surface. Two groups of patients, aged between 18 and 75 years, used a Zn-CHA nanocrystals-based toothpaste (experimental group) and a potassium nitrate/sodium fluoride toothpaste (active control group) for 8 weeks. At the end of this period, extractions were performed in five subjects per study group. Negative controls consisted of two subjects treated with non-specified fluoride toothpaste. Teeth were processed for morphological and chemical-physic superficial characterizations by means of Scanning Electronic Microscopy with Elementary analysis, X-Ray Diffraction analysis and Infrared analysis. In this study, the use of a Zn-CHA nanocrystals toothpaste led to a remineralization/repair of the enamel surface, by deposition of a hydroxyapatite-rich coating. On the other hand, the use of both a nitrate potassium/sodium fluoride and non-specified fluoride toothpastes did not appreciably change the enamel surface. In conclusion, this study demonstrates that the toothpaste containing Zn-CHA nanostructured microcrystals, differently from nitrate potassium/sodium fluoride and non-specified fluoride toothpastes, may promote enamel superficial repair by means of the formation of a protective biomimetic CHA coating.

Etching effect of acidic fluorides on human tooth enamel in vitro

OBJECTIVE

This in vitro study aimed to examine the etching effect of acidic fluoride solutions on enamel.

MATERIALS AND METHODS

24 human teeth divided into 48 enamel-specimens were partly isolated with impression material. Specimens were exposed for 10 min to 20ml of the following solutions: 1.6% TiF4, 3.9% SnF2, 0.2% HF and 1.8% citric acid (CA). The isolation was removed and 24 specimens analysed by profilometry (Δheight: exposed/isolated enamel surfaces, surface roughness parameters). For the remaining 24 specimens [Ca(2+)] in the test solutions was analysed by atomic absorption spectroscopy.

RESULTS

Median Δheights (μm) after exposure were: TiF4 0.07, SnF2 -0.03, HF -0.14 and CA -5.92. TiF4-exposed surfaces showed both deposits and etched areas and exhibited statistically significant different surface roughness parameters compared to the HF- and SnF2-exposed surfaces. Median [Ca(2+)] values (ppm): TiF4 1.88, SnF2 0.11, HF 0.10 and CA 2.17.

CONCLUSION

At the [F] tested in this study it can be concluded that SnF2- and HF solutions had negligible erosive effects on enamel. TiF4 solution resulted in an incomplete surface deposition associated with calcium dissolution suggesting that TiF4 applied as solution may not be advisable.

Er:YAG laser irradiation to control the progression of enamel erosion: an in situ study

This in situ study evaluated the effect of Er:YAG laser irradiation in controlling the progression of enamel erosion-like lesions. Fifty-six enamel slabs (330 KHN ± 10 %) with one fourth of the surface covered with resin composite (control area) were submitted to initial erosion-like lesion formation with citric acid. The slabs were divided into two groups: irradiated with Er:YAG laser and non-irradiated. Fourteen volunteers used an intraoral palatal appliance containing two slabs, in two phases of 5 days each. During the intraoral phase, in a crossed-over design, half of the volunteers immersed the appliance in citric acid while the other half used deionized water, both for 5 min, three times per day. Enamel wear was determined by an optical 3D profilometer. ANOVA revealed that when deionized water was used as immersion solution during the intraoral phase, lower values of wear were showed when compared with the groups that were eroded with citric acid, whether irradiated or non-irradiated with Er:YAG laser. When erosion with citric acid was performed, Er:YAG laser was not able to reduce enamel wear. Small changes on enamel surface were observed when it was irradiated with Er:YAG laser. It may be concluded that Er:YAG laser irradiation did not reduce the progression of erosive lesions on enamel submitted to in situ erosion with citric acid.