Salivary Hemoglobin Protects against Erosive Tooth Wear in Gastric Reflux Patients

2020 ◽  
Vol 54 (5-6) ◽  
pp. 466-474 ◽  
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

<b><i>Objective:</i></b> Saliva is the most important biological factor to protect against erosive tooth wear (ETW). Gastroesophageal reflux disease (GERD) patients have an increased risk of ETW due to the frequent presence of intrinsic acids in the oral cavity. Remarkably, not all GERD patients suffer from ETW, which might be due to differences in the composition of the saliva. <b><i>Methods:</i></b> This study compared the proteomic profile of saliva in patients (1) with GERD and ETW (basic erosive wear examination, BEWE, score ≥9; GE group) and (2) with GERD without ETW (BEWE = 0; GNE group) using shotgun label-free quantitative proteomic analysis nLC-ESI-MS/MS. The ability of hemoglobin (Hb) to protect against initial enamel erosion caused by a daily 10-s immersion of enamel specimens in 0.01 M HCl (pH 2.3) for 3 days was evaluated in vitro for proof of concept. Surface hardness change was used as response variable. <b><i>Results:</i></b> The differential expression of Hb subunits was significantly increased in the GNE group versus the GE group, in particular the Hb α-subunit that showed a &#x3e;22-fold increase. Expressions of serum albumin (4.5-fold) and isoforms of cytoskeletal keratin type II (&#x3e;3-fold) were also increased in the GNE group. Proteinase inhibitors, such as α<sub>1</sub>-antitrypsin and α<sub>2</sub>-macroglobulin, were only identified in the GNE group. In vitro, Hb (1.0 and 4.0 mg/mL) significantly reduced initial enamel erosion compared to a negative control after 3 days. <b><i>Conclusions:</i></b> Our results indicate that many proteins, with special emphasis on Hb, may be involved in the resistance of GERD patients to the occurrence of ETW. These proteins may be candidates for inclusion in dental products to protect against ETW.

scholarly journals Potential of different fluoride gels to prevent erosive tooth wear caused by gastroesophageal reflux

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Philipp Körner ◽  
Luca Georgis ◽  
Daniel B. Wiedemeier ◽  
Thomas Attin ◽  
Florian J. Wegehaupt
Keyword(s):  
Gastroesophageal Reflux ◽  
Artificial Saliva ◽  
In Vitro Study ◽  
Tooth Wear ◽  
Control Group ◽  
Erosive Tooth Wear ◽  
Custom Made ◽  
Post Hoc ◽  
Bovine Enamel

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.

scholarly journals A New Sugarcane Cystatin Strongly Binds to Dental Enamel and Reduces Erosion

2017 ◽  
Vol 96 (9) ◽  
pp. 1051-1057 ◽  
Author(s):  
A.C. Santiago ◽  
Z.N. Khan ◽  
M.C. Miguel ◽  
C.C. Gironda ◽  
A. Soares-Costa ◽  
...  
Keyword(s):  
Potent Inhibitor ◽  
Surface Hardness ◽  
Dental Enamel ◽  
Reversible Inhibitors ◽  
Force Microscopy ◽  
Atomic Force ◽  
Enamel Erosion ◽  
Acquired Enamel Pellicle

Cystatin B was recently identified as an acid-resistant protein in acquired enamel pellicle; it could therefore be included in oral products to protect against caries and erosion. However, human recombinant cystatin is very expensive, and alternatives to its use are necessary. Phytocystatins are reversible inhibitors of cysteine peptidases that are found naturally in plants. In plants, they have several biological and physiological functions, such as the regulation of endogenous processes, defense against pathogens, and response to abiotic stress. Previous studies performed by our research group have reported high inhibitory activity and potential agricultural and medical applications of several sugarcane cystatins, including CaneCPI-1, CaneCPI-2, CaneCPI-3, and CaneCPI-4. In the present study, we report the characterization of a novel sugarcane cystatin, named CaneCPI-5. This cystatin was efficiently expressed in Escherichia coli, and inhibitory assays demonstrated that it was a potent inhibitor of human cathepsins B, K, and L ( Ki = 6.87, 0.49, and 0.34 nM, respectively). The ability of CaneCPI-5 to bind to dental enamel was evaluated using atomic force microscopy. Its capacity to protect against initial enamel erosion was also tested in vitro via changes in surface hardness. CaneCPI-5 showed a very large force of interaction with enamel (e.g., compared with mucin and casein) and significantly reduced initial enamel erosion. These results suggest that the inclusion of CaneCPIs in dental products might confer protection against enamel erosion.

scholarly journals Monitoring of Erosive Tooth Wear with Intraoral Scanners In vitro

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.

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

2016 ◽  
Vol 31 (6) ◽  
pp. 1105-1112 ◽  
Author(s):  
Thiago Saads Carvalho ◽  
Cristiane Meira Assunção ◽  
Fabian Jost ◽  
Walter Bruno Bürgin ◽  
Jonas Almeida Rodrigues ◽  
...  
Keyword(s):  
Tooth Wear ◽  
Erosive Tooth Wear ◽  
Optical Reflectometer

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

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

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

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.

scholarly journals Impact of mucin on the anti-erosive/anti-abrasive efficacy of chitosan and/or F/Sn in enamel in vitro

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Benedikt Luka ◽  
Vivien Arbter ◽  
Kathrin Sander ◽  
Andrea Duerrschnabel ◽  
Nadine Schlueter
Keyword(s):  
In Vitro Study ◽  
Tooth Wear ◽  
Tissue Loss ◽  
Hard Tissue ◽  
Porcine Gastric Mucin ◽  
Human Enamel ◽  
Enamel Erosion ◽  
Saliva Flow ◽  
Positively Charged

AbstractThe application of stannous ions in combination with fluoride (F/Sn) is one of the central strategies in reducing erosive tooth wear. F/Sn efficacy can be enhanced by adding chitosan, a positively charged biopolymer. For patients with low saliva flow, this efficacy, however, is not sufficient, making further improvement desirable. This could be achieved by combining chitosan with other molecules like mucin, which together might form multilayers. This in-vitro study aimed to investigate the effect of chitosan, mucin, F/Sn and combinations thereof on enamel erosion and erosion-abrasion. Human enamel samples (n = 448, 28 groups) were cyclically eroded or eroded-abraded (10 days; 6 × 2 min erosion and 2 × 15 s/200 g abrasion per day). Samples were treated 2 × 2 min/day with solutions containing either, chitosan (50 or 500 mPas), porcine gastric mucin, F/Sn or combinations thereof after abrasive challenge. Tissue loss was measured profilometrically, interaction between hard tissue and active agents was assessed with energy dispersive spectroscopy and scanning electron microscopy. Chitosan and F/Sn showed the expected effect in reducing tissue loss under erosive and under erosive-abrasive conditions. Neither mucin alone nor the combinations with mucin showed any additional beneficial effect.

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