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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.
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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
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Donovan T, Nguyen-Ngoc C, Abd Alraheam I, Irusa K. Contemporary diagnosis and management of dental erosion. J ESTHET RESTOR DENT 2021; 33:78-87. [PMID: 33410255 DOI: 10.1111/jerd.12706] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022]
Abstract
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.
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Affiliation(s)
- Terence Donovan
- Division of Comprehensive Oral Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Caroline Nguyen-Ngoc
- Department of Restorative Dentistry, Universite de Montreal, Montreal, Quebec, Canada
| | - Islam Abd Alraheam
- Department of Conservative Dentistry, University of Jordan, Amman, Jordan
| | - Karina Irusa
- Advanced Education in Operative Dentistry and Biomaterials, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Individuals With Gastroesophageal Reflux Disease or Symptoms May Have Increased Odds of Erosive Tooth Wear. J Evid Based Dent Pract 2020; 20:101497. [PMID: 33303089 DOI: 10.1016/j.jebdp.2020.101497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION The association between erosive toothwear and gastro-oesophageal reflux-related symptoms and disease: A systematic review and meta-analysis. Jordão HWT, Coleman HG, Kunzmann AT, McKenna G. J Dent 2020. https://doi.org/10.1016/j.jdent.2020.103284. SOURCE OF FUNDING None. The authors declared no conflict of interest. TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Li P, Oh C, Kim H, Chen-Glasser M, Park G, Jetybayeva A, Yeom J, Kim H, Ryu J, Hong S. Nanoscale effects of beverages on enamel surface of human teeth: An atomic force microscopy study. J Mech Behav Biomed Mater 2020; 110:103930. [PMID: 32957225 DOI: 10.1016/j.jmbbm.2020.103930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 05/17/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022]
Abstract
Dental erosion has become a prevalence disease and attracted increasing attention worldwide. In this research, we quantitatively evaluate the mechanical and morphological changes in the very early stages of softening and weakening of human enamel surfaces induced by soft drinks using atomic force microscopy (AFM). With an increase of the immersion time in soft drinks, we found a significant increase of surface roughness (Rq) of the enamel surface. The prismatic structure of enamel was clearly observed after a 1-h immersion in Coca-Cola®, which shows its strong erosion effect. According to the elastic modulus mapping images obtained by AFM, a considerable decrease of elastic modulus (E) of enamel surface has been found as the enamel surface structures are etched away by soft drinks. A high surface roughness of enamel will result in a high chance of cavities due to easier bacterial adhesion on rougher surface, while a drastic deterioration of the mechanical properties of the enamel will weaken its protection property. Our findings show the serious influence of acidic drinks on enamel surface at the very beginning stage of etching process, which is quite meaningful for people to prevent dental erosion and keep dental health.
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Affiliation(s)
- Panpan Li
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Chungik Oh
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Hongjun Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Melodie Chen-Glasser
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Gun Park
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Albina Jetybayeva
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Jiwon Yeom
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Hoon Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Jeongjae Ryu
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Seungbum Hong
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea; KAIST Institute for NanoCentury (KINC), Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea.
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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: 19] [Impact Index Per Article: 4.8] [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.
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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
| | - 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
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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.
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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.
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Ghisa M, Della Coletta M, Barbuscio I, Marabotto E, Barberio B, Frazzoni M, De Bortoli N, Zentilin P, Tolone S, Ottonello A, Lorenzon G, Savarino V, Savarino E. Updates in the field of non-esophageal gastroesophageal reflux disorder. Expert Rev Gastroenterol Hepatol 2019; 13:827-838. [PMID: 31322443 DOI: 10.1080/17474124.2019.1645593] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Gastroesophageal reflux disease (GERD) is one of the most prevalent conditions in Western Countries, normally presenting with heartburn and regurgitation. Extra-esophageal (EE) GERD manifestations, such as asthma, laryngitis, chronic cough and dental erosion, represent the most challenging aspects from diagnostic and therapeutic points of view because of their multifactorial pathogenesis and low response to proton pump inhibitors (PPIs). In fact, in the case of EE, other causes must by preventively excluded, but instrumental methods, such as upper gastrointestinal endoscopy and laryngoscopy, have low specificity and sensitivity as diagnostic tools. In the absence of alarm signs and symptoms, empirical therapy with a double-dose of PPIs is recommended as a first diagnostic approach. Subsequently, impedance-pH monitoring could help to define whether the symptoms are GERD-related. Areas covered: This article reviews the current literature regarding established and proposed EE-GERD, reporting on all available options for its correct diagnosis and therapeutic management. Expert opinion: MII-pH could help to identify a hidden GERD that causes EE. Unfortunately, standard MII-pH analysis results are often unable to define this association. New parameters such as the mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index may have an improved diagnostic yield, but prospective studies using impedance-pH are needed.
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Affiliation(s)
- Matteo Ghisa
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
| | - Marco Della Coletta
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
| | - Ilenia Barbuscio
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
| | - Elisa Marabotto
- Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties, University of Genoa , Genoa , Italy
| | - Brigida Barberio
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
| | | | - Nicola De Bortoli
- Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa , Italy
| | - Patrizia Zentilin
- Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties, University of Genoa , Genoa , Italy
| | - Salvatore Tolone
- Surgery Unit, Department of Surgery, University of Campania Luigi Vanvitelli , Caserta , Italy
| | - Andrea Ottonello
- Department of Surgical Science and Integrated Diagnostics, University of Genoa , Genoa , Italy
| | - Greta Lorenzon
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
| | - Vincenzo Savarino
- Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties, University of Genoa , Genoa , Italy
| | - Edoardo Savarino
- Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua , Italy
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Zuza A, Racic M, Ivkovic N, Krunic J, Stojanovic N, Bozovic D, Bankovic-Lazarevic D, Vujaskovic M. Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina. Int Dent J 2019; 69:281-288. [PMID: 30730056 DOI: 10.1111/idj.12462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments. AIMS The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors. METHODS A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs. RESULTS Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%). CONCLUSION The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.
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Affiliation(s)
- Aleksandra Zuza
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Maja Racic
- Department of Primary Health Care and Public Health, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Nedeljka Ivkovic
- Department of Oral Rehabilitation, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Jelena Krunic
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Nikola Stojanovic
- Department of Dental Pathology, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Djordje Bozovic
- Department of Oral Rehabilitation, Faculty of Medicine in Foca, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
| | - Dusica Bankovic-Lazarevic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia.,Faculty of Dentistry Pančevo, Pančevo, Serbia
| | - Mirjana Vujaskovic
- Department of Restaurative Dentistry and Endodontics, Faculty of Dentistry Belgrade, University of Belgrade, Belgrade, Serbia
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Buzalaf MAR, Magalhães AC, Rios D. Prevention of erosive tooth wear: targeting nutritional and patient-related risks factors. Br Dent J 2018; 224:371-378. [PMID: 29495031 DOI: 10.1038/sj.bdj.2018.173] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 02/07/2023]
Abstract
This article provides an overview of the nutritional and patient-related risk factors involved in the aetiology of erosive tooth wear (ETW) and the preventive strategies to counteract them. The first step is to diagnose clinical signs of ETW and to recognise causal factors. Low pH and high buffer capacity of foods/drinks are the major risk factors, while the calcium concentration is the main protective factor. Reduction of frequency of consumption and contact time of erosive foods/drinks with the teeth, use of straws appropriately positioned and consumption of dairy products are advisable. Oral hygiene has a role in the development of ETW, however, postponing toothbrushing is not clinically advisable. In cases of drug abuse, chronic alcoholism, GERD or bulimia, the patient must be referred to a doctor. Immediately after vomiting, patients might be advised to rinse the mouth. Saliva has an important protective role and patients with reduced salivary flow can benefit from the use of chewing gum. Recent studies have focused on improving the protective capacity of the acquired pellicle as well as on the role of protease inhibitors on dentine erosion. However, the degree of evidence for these preventive measures is low. Clinical trials are necessary before these measures can be recommended.
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Affiliation(s)
- M A R Buzalaf
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
| | - A C Magalhães
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
| | - D Rios
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
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10
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Skalsky Jarkander M, Grindefjord M, Carlstedt K. Dental erosion, prevalence and risk factors among a group of adolescents in Stockholm County. Eur Arch Paediatr Dent 2018; 19:23-31. [PMID: 29327216 PMCID: PMC5807473 DOI: 10.1007/s40368-017-0317-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/30/2017] [Indexed: 12/30/2022]
Abstract
Aims To investigate the prevalence and risk factors of dental erosion (DE) among a group of adolescents in Stockholm County. Materials and methods This cross sectional cohort study was conducted at three clinics of the Public Dental Service in Stockholm County. Fifteen and 17 year old adolescents (1335) who scheduled their regular dental health examination were asked to participate. After drop-outs a sample of 1071 individuals, 547 males and 524 females were enrolled in the study. Presence of erosive wear was diagnosed (yes/no) on marker teeth by trained dentists/dental hygienists and photographs were taken. The adolescents answered a questionnaire regarding oral symptoms, dietary and behavioural factors. Two calibrated specialist dentists performed evaluation of the photographs for severity of DE using a modified version of the Simplified Erosion Partial Recording System (SEPRS). Results DE was clinically diagnosed in 28.3% of 15 years old and 34.3% of 17 years old. Severe erosive wear (grade 3 and 4 according to SEPRS) was found in 18.3% of the adolescents based upon the intra-oral photographs. DE was more prevalent and severe among males than females. Clinically diagnosed erosive lesions correlated significantly with soft drink consumption (p < 0.001), the use of juice or sport drinks as a thirst quencher after exercise (p = 0.006) and tooth hypersensitivity when eating and drinking (p = 0.012). Furthermore, self-assessed gastric reflux was a factor strongly associated with DE (p < 0.001). Conclusion The study indicated that DE was common among adolescents in Stockholm County and associated with both internal and external risk factors.
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Affiliation(s)
- M Skalsky Jarkander
- Department of Pediatric Dentistry, Public Dental Service, Stockholm, Sweden.
| | - M Grindefjord
- Department of Pediatric Dentistry, Public Dental Service, Stockholm, Sweden
- Divisions of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
- Centre for Pediatric Oral Health Research, Stockholm, Sweden
| | - K Carlstedt
- Faculty of Health Sciences, Institute of Clinical Odontology, University of Tromsö, Tromsö, Norway
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Wilder-Smith CH, Materna A, Martig L, Lussi A. Longitudinal study of gastroesophageal reflux and erosive tooth wear. BMC Gastroenterol 2017; 17:113. [PMID: 29070010 PMCID: PMC5657057 DOI: 10.1186/s12876-017-0670-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/16/2017] [Indexed: 12/15/2022] Open
Abstract
Background Approximately 60% of patients presenting to dentists with erosive tooth wear have significant gastroesophageal reflux (GERD), despite minor reflux symptoms. No longitudinal studies of reflux-associated erosive tooth wear and of reflux characteristics have been reported to date. The aim of this study was to characterize the longitudinal course of GERD and of associated erosive tooth wear, as well as factors predictive of its progression, in a large group of patients. Methods Seventy-two patients presenting to dentists with clinically significant erosive tooth wear and increased esophageal acid exposure by 24-h multichannel intraluminal pH-impedance measurement (MII-pH) were re-assessed clinically and by MII-pH after 1 year treatment with esomeprazole 20 mg twice-daily. Predictive factors for erosive tooth wear were assessed by logistic regression. Results At follow-up, no further progression in erosive tooth wear was observed in 53 (74%) of patients. The percentage of time with a pH < 4, the number of acid reflux episodes and the percentage of proximal esophageal reflux off-PPI did not change significantly after one year, but the number of weakly acidic reflux episodes decreased significantly in the large subgroup without progression. None of the baseline demographic, clinical, endoscopic or esophageal acid exposure characteristics were significantly associated with progression of erosive tooth wear at follow-up. Conclusions In this longitudinal study in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year, erosive tooth wear did not progress further in the majority of patients. Background acidic esophageal reflux exposure appeared stable over time, whereas weakly acidic exposure decreased significantly in patients without erosion progression. MII-pH measurements on-PPI and with healthy controls will be useful in the further elucidation of the causal role of reflux in erosive tooth wear. Trial registration ClinicalTrials.gov, retrospectively registered: NCT02087345.
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Affiliation(s)
- Clive H Wilder-Smith
- Brain-Gut Research Group and Gastroenterology Group Practice, Bubenbergplatz 11, -3011, Bern, CH, Switzerland. .,Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
| | - Andrea Materna
- Brain-Gut Research Group and Gastroenterology Group Practice, Bubenbergplatz 11, -3011, Bern, CH, 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
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Lee RJ, Aminian A, Brunton P. Dental complications of gastro-oesophageal reflux disease: guidance for physicians. Intern Med J 2017; 47:619-623. [DOI: 10.1111/imj.13249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Robert J. Lee
- Faculty of Dentistry, Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | | | - Paul Brunton
- Faculty of Dentistry, Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
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13
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Abstract
Comprehensive guidelines for the diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) were developed by the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition. GERD is reflux associated with troublesome symptoms or complications. The recognition of GER and GERD is relevant to implement best management practices. A conservative management is indicated in infants with uncomplicated physiologic reflux. Children with GERD may benefit from further evaluation and treatment. Since the publications of the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition guidelines in 2009, no important novelties in drug treatment have been reported. Innovations are mainly restricted to the management of regurgitation in infants. During the last 5 years, pros and cons of multichannel intraluminal impedance have been highlighted. However, overall 'not much has changed' in the diagnosis and management of GER and GERD in infants and children.
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Affiliation(s)
| | - Bruno Hauser
- a Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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Rocha CT, Turssi CP, Rodrigues-Júnior AL, Corona SAM. Impact of CO2 laser and stannous fluoride on primary tooth erosion. Lasers Med Sci 2016; 31:567-71. [PMID: 26886587 DOI: 10.1007/s10103-016-1903-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 02/02/2016] [Indexed: 12/31/2022]
Abstract
This study evaluated in vitro the effect of input power of CO2 laser, either associated or not to stannous fluoride (SnF2) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (3 × 3 × 2 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 3 × 1 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups (n = 13) according to fluoride application [absent (control) or 0.4% stannous fluoride gel (SnF2)] and input power of CO2 laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO2 laser irradiation was performed in an ultra-pulse mode (100 μs of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control (p = 0.185). However, a significant effect was detected for input power of CO2 laser (p = 0.037). Tukey's test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W (p = 0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO2 laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.
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Affiliation(s)
- Cristiane Tomaz Rocha
- Faculty of Dentistry, Sobral Campus, Federal University of Ceará, Rua Stanislau Frota, s/n, Centro, Sobral, CE, Brazil, 62.010-560.
| | - Cecilia Pedroso Turssi
- Department of Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Rua Doutor José Rocha Junqueira, 13, Ponte Preta, Campinas, SP, CEP 13045-755, Brazil
| | - Antonio Luiz Rodrigues-Júnior
- Department of Social Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Av. do Café, s/n, Monte Alegre, Ribeirão Preto, SP, CEP:14.040-904, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Café, s/n, Monte Alegre, Ribeirão Preto, SP, CEP:14.040-904, Brazil
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15
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Cheaib Z, Rakmathulina E, Lussi A, Eick S. Impact of Acquired Pellicle Modification on Adhesion of Early Colonizers. Caries Res 2015; 49:626-32. [DOI: 10.1159/000442169] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/30/2015] [Indexed: 11/19/2022] Open
Abstract
New preventive approaches against dental erosion caused by acidic drinks and beverages include fortification of beverages with natural polymers. We have shown that the mixture of casein and mucin significantly improved the erosion-inhibiting properties of the human pellicle layer. This study aimed to investigate the effect of pellicle modification by casein, mucin and a casein-mucin mixture on the adhesion of early bacterial colonizers. Test specimens of human tooth enamel were prepared, covered with saliva and coated with 0.5% aqueous (aq.) casein, 0.27% aq. mucin or with 0.5% aq. casein-0.27% aq. mucin, after which the adhesion of Streptococcus gordonii, Streptococcus oralis, and Actinomyces odontolyticus was measured after incubation for 30 min and 2 h. log10 colony-forming units were compared by nonparametric tests. All three bacterial strains adhered in higher number to pellicle-coated enamel than to native enamel. The protein modifications of pellicle all decreased the counts of adhering bacteria up to 0.34 log10/mm2, the most efficient being the casein-mucin mixture. In addition to the recently shown erosion-reducing effect by casein-mucin, modification of the pellicle may inhibit bacterial adherence compared to untreated human pellicle.
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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.
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