An in-situ pilot study to investigate the native clinical resistance of enamel to erosion

Abstract

ObjectivesTo investigate the differences in susceptibility of the surface of native and polished enamel to dietary erosion using an in-situ model. MethodsThirty healthy volunteers (n = 10 per group) wore mandibular appliances containing 2 native and 2 polished enamel samples for 30 min after which, the samples were exposed to either an ex-vivo or in-vivo immersion in orange juice for 5, 10 or 15 min and the cycle repeated twice with an hour’s interval between them. Samples were scanned with a non-contacting laser profilometer and surface roughness was extracted from the data, together with step height and microhardness change on the polished enamel samples. ResultsAll volunteers completed the study. For native enamel there were no statistical difference between baseline roughness values versus post erosion. Polished enamel significantly increased mean (SD) Sa roughness from baseline for each group resulting in roughness change of 0.04 (0.03), 0.06 (0.04), 0.04 (0.03), 0.06 (0.03), 0.08 (0.05) and 0.09 (0.05) μm respectively. With statistical differences between roughness change 45 min in-vivo versus 45 min ex-vivo (p < 0.05). Microhardness significantly decreased for each polished group, with statistical differences in hardness change between 30 min in-vivo versus 30 min ex-vivo (p < 0.05), 45 min in-vivo versus 30 min ex-vivo (p < 0.01), 45 min in-vivo versus 45 min ex-vivo (p < 0.01). ConclusionsThe native resistance to erosion provided clinically is a combination of the ultrastructure of outer enamel, protection from the salivary pellicle and the overall effects of the oral environment. ClinicalTrials.gov identifierNCT03178968. Clinical significanceThis study demonstrates that outer enamel is innately more resistant to erosion which is clinically relevant as once there has been structural breakdown at this level the effects of erosive wear will be accelerated.