In vitro validation of a hand-held optical reflectometer to measure clinically observed erosive tooth wear

Abstract Background This in-vitro-study aimed to evaluate the potential of different fluoride gels to prevent gastroesophageal reflux induced erosive tooth wear. Methods Surface baseline profiles of a total of 50 bovine enamel specimens [randomly assigned to five groups (G1–5)] were recorded. All specimens were positioned in a custom made artificial oral cavity and perfused with artificial saliva (0.5 ml/min). Reflux was simulated 11 times a day during 12 h by adding HCl (pH 3.0) for 30 s (flow rate 2 ml/min). During the remaining 12 h (overnight), specimens were stored in artificial saliva and brushed twice a day (morning and evening) with a toothbrush and toothpaste slurry (15 brushing strokes). While specimens in the control group (G1) did not receive any further treatment, specimens in G2–5 were coated with different fluoride gels [Elmex Gelée (G2); Paro Amin Fluor Gelée (G3); Paro Fluor Gelée Natriumfluorid (G4); Sensodyne ProSchmelz Fluorid Gelée (G5)] in the evening for 30 s. After 20 days, surface profiles were recorded again and enamel loss was determined by comparing them with the baseline profiles. The results were statistically analysed using one-way analysis of variance (ANOVA) followed by Tukey`s HSD post-hoc test. Results The overall highest mean wear of enamel (9.88 ± 1.73 µm) was observed in the control group (G1), where no fluoride gel was applied. It was significantly higher (p < 0.001) compared to all other groups. G2 (5.03 ± 1.43 µm), G3 (5.47 ± 0.63 µm, p = 0.918) and G4 (5.14 ± 0.82 µm, p > 0.999) showed the overall best protection from hydrochloric acid induced erosion. Enamel wear in G5 (6.64 ± 0.86 µm) was significantly higher compared to G2 (p = 0.028) and G4 (p = 0.047). Conclusions After 20 days of daily application, all investigated fluoride gels are able to significantly reduce gastroesophageal reflux induced loss of enamel.

Download Full-text

Monitoring of Erosive Tooth Wear with Intraoral Scanners In vitro

Caries Research ◽

10.1159/000514666 ◽

2021 ◽

pp. 1-10

Author(s):

Corinna Witecy ◽

Carolina Ganss ◽

Bernd Wöstmann ◽

Moritz B. Schlenz ◽

Maximiliane A. Schlenz

Keyword(s):

In Vitro Study ◽

Tooth Wear ◽

Systematic Difference ◽

Tissue Loss ◽

Load Bearing ◽

Erosive Tooth Wear ◽

Promising Tool ◽

External Software ◽

Optical Profilometer

Intraoral scanners (IOS) have been used to quantify tooth wear, but so far they have not been systematically validated for monitoring of tissue loss. The aim of this in vitro study was to investigate whether progression of tissue loss can be detected with an IOS and whether IOS values agree with those obtained with noncontacting profilometry (PRO) serving as a standard method. Model jaws were mounted in a phantom head positioned in a dental chair. Flattened areas were prepared on the non-load-bearing cusps of the first molars (model teeth; n = 16) in order to fix flat enamel samples with an experimental area and a reference area. After baseline PRO and IOS, the experimental enamel area was stepwise etched with 35% H3PO4 gel (4 × 30 s and 4 × 15 s). After each etching, PRO and IOS was performed and the vertical tissue loss between the reference and experimental areas was measured, each at the same 3 measurement points. Furthermore, cupped cusps were simulated by stepwise preparation of the load-bearing cusps of the model teeth with a spherical diamond bur, and the maximum vertical depth after each preparation step was measured only by IOS. Trios3 (3Shape, Denmark), Carestream CS3600 (Carestream, USA) and an optical profilometer (MicroProf, Fries, Germany) were used to measure the flat areas of the enamel samples, whereas only IOS were used to measure curved surfaces on the load-bearing cupped cusps of the model teeth. The IOS data were analyzed with an external software (GOM Inspect, Germany) and with the respective internal IOS software. PRO revealed a mean (±SD) tissue loss of 17.1 ± 4.7 µm after 30-s etching steps and 10.1 ± 5.1 µm after the 15-s etching steps. IOS and software types were able to detect the progression of tissue loss after each etching step (p ≤ 0.001 each); Bland-Altmann plots revealed good agreement with PRO regardless of the order of tissue loss, and no systematic difference was found. Increasing cupped lesion depths were detected by all IOS, with no significant differences between IOS and analysis methods. IOS were able to detect small amounts of tissue loss under simulated clinical conditions and seem to be a promising tool for monitoring even initial erosive tooth wear.

Download Full-text

Effect of silver diamine fluoride on the prevention of erosive tooth wear in vitro

Journal of Dentistry: X ◽

10.1016/j.jjodo.2020.100015 ◽

2020 ◽

Vol 3 ◽

pp. 100015

Author(s):

Sultan E. Ainoosah ◽

John Levon ◽

George J. Eckert ◽

Anderson T. Hara ◽

Frank Lippert

Keyword(s):

Tooth Wear ◽

Silver Diamine Fluoride ◽

Erosive Tooth Wear

Download Full-text

Potential of Different Fluoride Gels to Prevent Erosive Tooth wear caused by Gastroesophageal Reflux

10.21203/rs.3.rs-129814/v1 ◽

2020 ◽

Author(s):

Philipp Körner ◽

Luca Georgis ◽

Daniel Wiedemeier ◽

Thomas Attin ◽

Florian Wegehaupt

Keyword(s):

Gastroesophageal Reflux ◽

Artificial Saliva ◽

Tooth Wear ◽

Control Group ◽

Erosive Tooth Wear ◽

Custom Made ◽

Post Hoc ◽

Bovine Enamel ◽

Enamel Wear

Abstract Background: This in-vitro-study aimed to evaluate the potential of different fluoride gels to prevent gastroesophageal reflux induced erosive tooth wear.Methods: Surface baseline profiles of a total of 50 bovine enamel specimens (randomly assigned to five groups (G1–5)) were recorded. All specimens were positioned in a custom made artificial oral cavity and perfused with artificial saliva (0.5 ml/min). Reflux was simulated 11 times a day during 12 hours by adding HCl (pH 3.0) for 30 s (flow rate 2 ml/min). During the remaining 12 hours (overnight), specimens were stored in artificial saliva and brushed twice a day (morning and evening) with a toothbrush and toothpaste slurry (15 brushing strokes). While specimens in the control group (G1) did not receive any further treatment, specimens in G2–5 were coated with different fluoride gels (Elmex Gelée (G2); Paro Amin Fluor Gelée (G3); Paro Fluor Gelée Natriumfluorid (G4); Sensodyne ProSchmelz Fluorid Gelée (G5)) in the evening for 30 s. After 20 days, surface profiles were recorded again and enamel loss was determined by comparing them with the baseline profiles. The results were statistically analysed using one-way analysis of variance (ANOVA) followed by Tukey`s HSD post-hoc test. Results: The overall highest mean wear of enamel (9.88 ± 1.73 µm) was observed in the control group (G1), where no fluoride gel was applied. It was significantly higher (p < 0.001) compared to all other groups. G2 (5.03 ± 1.43 µm) showed the best protection from hydrochloric acid induced erosion, though G3 (5.47 ± 0.63 µm, p = 0.918) and G4 (5.14 ± 0.82 µm, p > 0.999) revealed almost equal and statistically not different results. Enamel wear in G5 (6.64 ± 0.86 µm) was significantly higher compared to G2 (p = 0.028) and G4 (p = 0.047).Conclusions: After 20 days of daily application, all investigated fluoride gels are able to significantly reduce gastroesophageal reflux induced loss of enamel.

Download Full-text

Salivary Hemoglobin Protects against Erosive Tooth Wear in Gastric Reflux Patients

Caries Research ◽

10.1159/000507110 ◽

2020 ◽

Vol 54 (5-6) ◽

pp. 466-474 ◽

Cited By ~ 1

Author(s):

Tatiana Martini ◽

Daniela Rios ◽

Aline Dionizio ◽

Luiza de Paula Silva Cassiano ◽

Vinicius Taioqui Pelá ◽

...

Keyword(s):

Proteinase Inhibitors ◽

Surface Hardness ◽

Group Versus ◽

Tooth Wear ◽

Biological Factor ◽

Α Subunit ◽

Erosive Tooth Wear ◽

Increased Risk ◽

Enamel Erosion

Objective: Saliva is the most important biological factor to protect against erosive tooth wear (ETW). Gastroesophageal reflux disease (GERD) patients have an increased risk of ETW due to the frequent presence of intrinsic acids in the oral cavity. Remarkably, not all GERD patients suffer from ETW, which might be due to differences in the composition of the saliva. Methods: This study compared the proteomic profile of saliva in patients (1) with GERD and ETW (basic erosive wear examination, BEWE, score ≥9; GE group) and (2) with GERD without ETW (BEWE = 0; GNE group) using shotgun label-free quantitative proteomic analysis nLC-ESI-MS/MS. The ability of hemoglobin (Hb) to protect against initial enamel erosion caused by a daily 10-s immersion of enamel specimens in 0.01 M HCl (pH 2.3) for 3 days was evaluated in vitro for proof of concept. Surface hardness change was used as response variable. Results: The differential expression of Hb subunits was significantly increased in the GNE group versus the GE group, in particular the Hb α-subunit that showed a >22-fold increase. Expressions of serum albumin (4.5-fold) and isoforms of cytoskeletal keratin type II (>3-fold) were also increased in the GNE group. Proteinase inhibitors, such as α1-antitrypsin and α2-macroglobulin, were only identified in the GNE group. In vitro, Hb (1.0 and 4.0 mg/mL) significantly reduced initial enamel erosion compared to a negative control after 3 days. Conclusions: Our results indicate that many proteins, with special emphasis on Hb, may be involved in the resistance of GERD patients to the occurrence of ETW. These proteins may be candidates for inclusion in dental products to protect against ETW.

Download Full-text