Las erosiones serán inevitablemente nuestra principal preocupación en términos de salud bucal en el presente siglo.
La batalla contra la caries está siendo ganada en los países desarrollados, los que han vuelto ahora sus ojos hacia el daño que produce el ácido por cualquiera de las vías en que llega a la boca, endógena o exógena.
Esta recopilación sobre este tema es nueva y recién comienzo a hacerla en 2010. A pesar de todos los resguardos y contra todo pronóstico, he perdido la original que tenía más de 8 años. Trataré de recuperarla de a poco.
Nutr Res. 2009 Aug;29(8):558-67.
Prolonged in vitro exposure to white wines enhances the erosive damage on human permanent teeth compared with red wines.
Willershausen B, Callaway A, Azrak B, Kloss C, Schulz-Dobrick B.
Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Augustusplatz 2, D-55131 Mainz, Germany. willersh@uni-mainz.de
The aim of this in vitro study was to determine and compare the erosive potentials of red and white wines, exerted on enamel surfaces prepared from extracted human permanent teeth. European wines (50 red, 50 white wines) from different regions were purchased, and the pH values were measured. Eight wines with different pH values were selected. Enamel samples with an average surface area of 25 mm(2) were prepared from 25 extracted permanent teeth from male and female patients aged 40 to 65 years and incubated with wines for up to 24 hours; the amounts of released calcium were determined colorimetrically, and mean surface roughness was measured with a profilometer. A quantitative elemental analysis for Ca was carried out in various depths (5-50 microm), using an electron probe microanalyzer. Incubation of the enamel surfaces with different wines caused a time-dependent release of calcium. After 24 hours, white wines caused a significantly higher (P = .003) Ca release (range: 8.74-28.56 mg dL(-1) 25 mm(-2)) than red wines (range: 4.85-19.43 mg dL(-1) 25 mm(-2)), whereas the values for surface roughness were similar (white wines: 2.67 +/- 0.92 microm; red wines: 2.64 +/- 0.66 mum). Incubation with white wines resulted in a higher loss of Ca down to a depth of 60 microm. In this study, it was demonstrated that white wines have higher erosive potentials than red wines. Within the limits of this in vitro study, it can be predicted that a frequent consumption of white wines might lead to severe dental erosion.
J Am Dent Assoc. 2009 Sep;140(9):1137-43.
The effect of salivary factors on dental erosion in various age groups and tooth surfaces.
Piangprach T, Hengtrakool C, Kukiattrakoon B, Kedjarune-Leggat U.
Section of Dental Public Health, Nonthai Hospital, Nakorn Ratchasima, Thailand.
BACKGROUND: Saliva, tooth experiences and tooth position may be associated with dental erosion. To identify factors that may provide a potential protective effect against erosion, the authors compared salivary factors and behavioral aspects in participants in three age groups. Materials and METHODS: The authors evaluated 79 volunteer participants in three age groups: 16 through 20 years, 26 through 30 years and 46 through 50 years. They classified all teeth as having no erosion, having erosion involving only enamel or having erosion involving dentin on at least one surface. They collected saliva from each participant and determined pH, flow rate, buffering capacity, urea, total protein and volume required to neutralize orange juice. RESULTS: Unstimulated salivary buffering capacity and urea concentration in salivary samples of participants aged 16 through 20 years with no erosion (facial/buccal surface) were significantly greater than those in the group with enamel erosion (P < .05). In participants aged 26 through 30 years (occlusal surface), the stimulated salivary flow rate was higher in the group with enamel erosion than in the group with dentin erosion (P < .05). In the group aged 46 through 50 years (lingual and palatal surfaces), only stimulated salivary total protein was significantly higher in the group with enamel erosion (P < .05). In groups aged 16 through 20 years and 46 through 50 years, erosion appeared to be related to a preference for sour (acidic) tastes (P < .05). CONCLUSIONS: Saliva protects enamel and dentin from erosion. Its effectiveness in this role depends partly on salivary factors and may differ according to a person’s age and to the severity and site of erosion. CLINICAL IMPLICATIONS: Salivary factors including flow rate, urea, buffering capacity and neutralization capability help prevent dental erosion. The protective level of saliva varies by age and tooth experiences.
Aust Dent J. 2009 Sep;54(3):238-44; quiz 277.
Erosive potential of beverages sold in Australian schools.
Cochrane NJ, Cai F, Yuan Y, Reynolds EC.
Centre for Oral Health Science, Melbourne Dental School, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Victoria.
BACKGROUND: Dental erosion is an increasingly prevalent problem in Australia. The aim of this study was to analyse the composition and erosive potential of beverages sold for consumption in Victorian schools. METHODS: Fifteen drinks were selected and analysed to determine their pH, titratable acidity and ionic composition (calcium, fluoride and inorganic phosphate). The erosive potential of the beverages was measured by analysing weight loss, surface loss and the release of calcium ions from human enamel following a 30-minute or 24-hour exposure. The association of the chemical parameters with the measures of erosion was determined using Spearman’s rank correlation. RESULTS: All beverages tested except the milks and the bottled water produced significant dental erosion in vitro. The only chemical parameter that correlated significantly with all measures of erosion was the initial pH of the beverage (p < 0.01). Levels of fluoride similar to those of Australian reticulated water were found in the carbonated beverages. CONCLUSIONS: The majority of the tested beverages sold from school canteens exhibited erosive potential.
ust Dent J. 2009 Sep;54(3):228-32.
The effects of saliva on the erosive potential of three different wines.
Brand HS, Tjoe Fat GM, Veerman EC.
Department of Basic Dental Sciences, Section of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. hs.brand@vumc.nl
BACKGROUND: The erosive potential of wine on teeth may be modified by the buffering capacity of saliva. This potential effect was studied for three different wines in vitro and in vivo. METHODS: The buffering capacity was studied in vitro by stepwise addition of small volumes of a dry white wine, a medium sweet white wine and a red wine to collected stimulated saliva. In vivo, this was studied by six volunteers vigorously rinsing 5 mL of each wine in their mouth for 15 to 45 seconds. Changes in salivary flow rate and pH were measured during a period of 10 minutes after rinsing with 5 mL wine. RESULTS: pH values < 5.5 were observed in vitro after addition of 0.2 mL dry white wine and medium sweet wine and after 0.3 mL red wine to 1 mL saliva. During rinsing with all wines, the intra-oral pH decreased to below 4 within 15 seconds and remained below this value for at least 45 seconds. After expectoration, the salivary pH remained significantly low for two to six minutes, despite a doubling of the flow rate observed during the first two minutes. CONCLUSIONS: Vigorously rinsing wine induced a decrease in intra-oral pH of significant degree and duration, which increases the risk of developing dental erosion.
Aust Dent J. 2009 Sep;54(3):212-9.
The cervical wedge-shaped lesion in teeth: a light and electron microscopic study.
Daley TJ, Harbrow DJ, Kahler B, Young WG.
School of Dentistry, The University of Queensland, Brisbane, Australia.
BACKGROUND: The cervical non-carious wedged-shaped lesion is controversial in that its aetiology may involve attrition, erosion, abrasion and stress-corrosion (abfraction). This study examined the histopathology of anterior teeth with cervical wedge-shaped lesions by light and electron microscopy to elucidate their pathogenesis. METHODS: Ten undecalcified human teeth with cervical lesions were available for investigation. Patency of the dentine tubules was tested using red dye penetration from the pulp chamber. The morphology of normal and sclerotic dentine adjacent to the cervical wedge-shaped lesions was investigated by scanning electron microscopy. The numbers and diameters of dentinal tubules were measured at different levels beneath the surfaces of the lesions. RESULTS: The gross and microscopic features of the worn teeth were described. Red dye penetration tests showed white tracts of sclerotic tubules contrasted with red tracts of patent tubules. Numbers of tubules per square area and diameters of patent and sclerotic tubules varied at different levels within the dentine due to deposits of intratubular dentine. CONCLUSIONS: The cervical wedge is shaped by interactions between acid wear, abrasion and dentinal sclerosis. No histopathological evidence of abfraction was found. Clinical diagnosis, conservation and restoration of non-carious cervical lesions need to take into account the extent of sclerotic dentine beneath wedge-shaped lesions.
Am J Gastroenterol. 2009 Nov;104(11):2788-95. Epub 2009 Aug 4.
Quantification of dental erosions in patients with GERD using optical coherence tomography before and after double-blind, randomized treatment with esomeprazole or placebo.
Wilder-Smith CH, Wilder-Smith P, Kawakami-Wong H, Voronets J, Osann K, Lussi A.
Brain-Gut Research Group and Gastroenterology Group Practice, Bern, Switzerland. cws@braingut.com
OBJECTIVES: Dental erosion, the chemical dissolution of enamel without bacterial involvement, is a rarely reported manifestation of gastroesophageal reflux disease (GERD), as well as of recurrent vomiting and dietary habits. It leads to loss of tooth substance, hypersensitivity, functional impairment, and even tooth fracture. To date, dental erosions have been assessed using only very basic visual methods, and no evidence-based guidelines or studies exist regarding the prevention or treatment of GERD-related dental erosions. METHODS: In this randomized, double-blind study, we used optical coherence tomography (OCT) to quantify dental tissue demineralization and enamel loss before and after 3 weeks of acid-suppressive treatment with esomeprazole 20 mg b.i.d. or placebo in 30 patients presenting to the Berne University Dental Clinic with advanced dental erosions and abnormal acid exposure by 24-h esophageal pH manometry (defined as >4% of the 24-h period with pH<4). Enamel thickness, reflectivity, and absorbance as measures of demineralization were quantified by OCT before and after therapy at identical localizations on teeth with most severe visible erosions as well as several other predefined changes in teeth. RESULTS: The mean+/-s.e.m. decrease of enamel thickness of all teeth before and after treatment at the site of maximum exposure was 7.2+/-0.16 black trianglem with esomeprazole and 15.25+/-0.17black trianglem with placebo (P=0.013), representing a loss of 0.3% and 0.8% of the total enamel thickness, respectively. The change in optical reflectivity to a depth of 25 black trianglem after treatment was-1.122 +/-0.769 dB with esomeprazole and +2.059+/-0.534 dB with placebo (P 0.012), with increased reflectivity signifying demineralization. CONCLUSIONS: OCT non-invasively detected and quantified significantly diminished progression of dental tissue demineralization and enamel loss after only 3 weeks of treatment with esomeprazole 20 mg b.i.d. vs. placebo. This suggests that esomeprazole may be useful in counteracting progression of GERD-related dental erosions. Further validation of preventative treatment regimens using this sensitive detection method is required, including longer follow-up and correlation with quantitative reflux measures.
J Dent. 2009 Oct;37(10):781-5. Epub 2009 Jun 18.
Interplay between fluoride and abrasivity of dentifrices on dental erosion-abrasion.
Hara AT, González-Cabezas C, Creeth J, Parmar M, Eckert GJ, Zero DT.
Oral Health Research Institute, Department of Preventive and Community Dentistry, Indiana University School of Dentistry, 415 N. Lansing Street, Indianapolis, 46202-2876 IN, USA. ahara@iupui.edu
OBJECTIVES: Eroded teeth are more susceptible to toothbrushing wear than sound teeth. We tested the hypothesis that fluoride and abrasivity of dentifrices can interact, modulating the development of erosive-abrasive lesions. METHODS: Human enamel and root dentin specimens were submitted to cycles of demineralization, remineralization and toothbrushing using six dentifrices formulated with three different abrasivity levels: low (L), medium (M) and high (H); with (+F) and without (-F) fluoride. Surface loss was quantified by optical profilometry and compared among groups (alpha=0.05). RESULTS: In dentin, it was ranked: L<M<H, for both +F and -F dentifrices. In enamel, +F dentifrices had similar results; however for -F formulations, M and H did not differ. Fluoride reduced surface loss in enamel, at all abrasive levels. In dentin, the same fluoride effect was observed but only for the low abrasive formulation. CONCLUSIONS: Both fluoride and abrasivity were important modulators of enamel surface loss, while abrasivity had a higher impact than fluoride on dentin.
Med Oral Patol Oral Cir Bucal. 2009 Aug 1;14(8):e376-83.
Dental erosion in alcoholic patients under addiction rehabilitation therapy.
Manarte P, Manso MC, Souza D, Frias-Bulhosa J, Gago S.
Department of Medical Sciences, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal. patmon@ufp.edu.pt
OBJECTIVE: To determine the occurrence and severity of dental erosion in alcoholic patients undergoing detoxification at the North Alcoholic Regional Centre (CRAN), Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental erosion occurrence. DESIGN: A cross-sectional descriptive study was carried out in one centre (CRAN) for addiction rehabilitation therapy in the north of Portugal. A sample of 1064 teeth was examined. The condition of the dental erosion was classified by means of severity and anatomic location, according to the Eccles and Jenkins dental erosion index, and a dichotomous outcome assessing the occurrence of dental erosion (severity dental erosion levels > 0 ). Dental erosion results were linked to data supplied by a questionnaire assessing socio-demographic characteristics, behaviour related to alcohol and drug use, including a history of drug and alcohol abuse, and oral health promotion using logistic multivariate regression analysis. RESULTS: Enamel and/or dentine erosion lesions were present on 49.4% of the teeth. Among these, 36.9% of occlusal surfaces presented dental erosion with a severity level of 1, 11.4% with a severity level 2 and 1.1% with a severity level 3. The highest occurrence of severity level 3 was found to exist in palatal dental surfaces (1.9%). Dental erosion on teeth surfaces was found to be independently associated with intra oral location (by arch, tooth type), patients’ socio-demographic characteristics, behaviour associated with a history of alcohol and drug abuse, and oral health promotion. Maxillary teeth, more so than mandibular teeth, presented moderate to higher severity erosion injuries (Wilcoxon test; p< 0.001); and significant differences in the severity of dental erosion were found between anterior and posterior teeth, in both the maxillary and the mandibular arches (Friedman test, p< 0.001). CONCLUSIONS: Alcohol-dependent patients undergoing a detoxification programme presented a high occurrence and a low severity of dental erosion lesions.The palatal surfaces of the anterior teeth, followed by incisive/occlusal surfaces in both anterior and posterior teeth, respectively, were most affected by erosion injuries.
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