Abstract
BackgroundErosive tooth wear (ETW) is clinically characterized by a loss of tooth surface, and different enamel depths may have different susceptibility to demineralization. Therefore, the aim of this in vitro pilot study was to assess if the progression of erosive demineralization is faster on teeth already presenting signs of ETW when compared to originally sound teeth.MethodsWe selected 23 central incisors: 14 were clinically sound (Sound) and 9 presented clinical signs of early erosive tooth wear (ETW-teeth). The teeth were embedded in resin, leaving an uncovered window of native enamel (6.69 ± 2.30 mm2) on the incisal half of the labial surface. We measured enamel surface reflection intensity (SRI) initially and after each consecutive erosive challenge (1 % citric acid, total of 4, 8, 12, 16, 20 and 24 min). Calcium released to the citric acid was measured with an atomic absorption spectrometer.ResultsWe observed higher initial SRI values in ETW-teeth than in Sound teeth (p = 0.007). During in vitro erosive demineralization, we observed that erosion on originally Sound teeth progressed significantly slower (p = 0.033) than on ETW-teeth: SRI decreased by 75 % (from 100 to 25 %) on Sound teeth, and by 89 % (from 100 to 11 %) on ETW-teeth. Calcium release increased during erosion, but presented no significant differences (p = 0.643) between originally Sound (0.031 μmol/mm2) and ETW-teeth (0.032 μmol/mm2). There was satisfactory correlation between calcium release and rSRI values (rs = −0.66).ConclusionThe optical reflectometer distinguished originally sound teeth from those with signs of ETW, and the results suggest that acid demineralization progresses differently on teeth already presenting clinical signs of ETW than on sound teeth.
Highlights
Erosive tooth wear (ETW) is clinically characterized by a loss of tooth surface, and different enamel depths may have different susceptibility to demineralization
Since enamel specimens from teeth with typical signs of erosive wear presented significantly higher initial surface reflection intensity (SRI0) values than originally sound teeth, null hypothesis 1 was rejected
After 24 min in vitro erosion, teeth with ETW presented significantly greater relative surface reflection intensity (SRI) (rSRI) decrease than originally sound teeth (p = 0.033)
Summary
Erosive tooth wear (ETW) is clinically characterized by a loss of tooth surface, and different enamel depths may have different susceptibility to demineralization. Native enamel surfaces are usually less liable to acid dissolution than ground enamel surfaces [5, 6], and solubility has been shown to increase according to enamel depth [7]. In this case, the loss of the top layer of enamel (loss of perikymata) in teeth with initial signs of ETW may render them more liable to further erosive demineralization, but this still remains to be tested.
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