Enamel Erosion Research Articles

Tooth-Whitening with a Novel Phthalimido Peroxy Caproic Acid: Short Communication.

Professional tooth whitening in the dental office is a popular cosmetic procedure and is performed under carefully monitored conditions. This allows the controlled application of a relatively high concentration of bleaching ingredients based on hydrogen peroxide or peroxide derivatives which produce reactive oxygen species, and consequently induce enamel erosion, alteration of the microhardness of the teeth, irritation of the gums, pain or post bleach sensitivity. This short communication describes the successful and reliable application of a new professional tooth whitening technique using a novel phthalimido peroxycaproic acid complex while avoiding reactive oxygen species.

Erosion protective properties of the enamel pellicle in-situ

Objectives: Previous studies on short- and long-term pellicles showed that the enamel pellicle provides partial protection against erosion. The aim of the present study was to investigate the protective properties of clinically relevant pellicles formed within 2 to 24 h. The hypothesis was that factors such as pellicle formation time, intraoral location, and acidic challenge severity would not influence the erosion-protective properties of the pellicle.Methods: Six subjects participated in the study. Bovine enamel specimens were prepared and intraorally exposed at buccal or palatal sites for 2, 6, 12, and 24 h to allow pellicle formation, followed by erosion using 0.1 % or 1 % citric acid. Calcium release and surface microhardness were measured, and specimens were analysed using scanning and transmission electron microscopy. Quantitative data were statistically analysed with three-way ANOVA and Tuckey's multiple comparison test (p = 0.05).Results: Pellicle formation time and intraoral location did not significantly influence the erosion-protective properties of the pellicle, while citric acid concentration significantly affected enamel erosion. The pellicle thickness increased with longer formation times and on buccal sites, but decreased or was entirely removed following treatment with 0.1 % or 1 % citric acid, respectively. The enamel surface exhibited a characteristic erosion pattern.Conclusions: This study underscores the importance of investigating pellicle properties within the critical 2- to 24-h timeframe and highlights the significance of pellicle thickness in acid resistance.Clinical significance: These findings provide valuable insights into the factors influencing the protective properties of enamel pellicles and could guide preventive measures in dental practice.

Preventive dental erosion with silver diamine fluoride: An in vitro study

ObjectivesTo evaluate the erosion preventive effect of 38 % silver diamine fluoride (SDF) solution in enamel and dentin of human permanent teeth. MethodsNinety enamel and ninety dentin blocks were prepared from permanent molars and allocated into three groups. Gp-SDF received a one-off application of 38 % SDF solution. Gp-SNF received a one-off application of a solution containing 800 ppm stannous chloride and 500 ppm fluoride. Gp-DW received a one-off application of deionized water. The blocks were submitted to acid challenge at pH 3.2, 2 min, 5 times/day for 7 days. All blocks were immersed in human saliva between cycles for one hour. The crystal characteristics, percentage of surface microhardness loss (%SMHL), surface loss, and elemental analysis and surface morphology were examined by X-ray diffraction (XRD), microhardness test, non-contact profilometry, and energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM), respectively. Data of%SMHL and surface loss were analyzed by one-way ANOVA. ResultsXRD spectra revealed that fluorapatite and silver compounds formed in Gp-SDF, while fluorapatite and stannous compounds formed in Gp-SNF. Gp-DW presented only hydroxyapatite. The median (interquartile range) of%SMHL in Gp-SDF, Gp-SNF and Gp-DW were 27.86(3.66), 43.41(2.45), and 46.40(3.54) in enamel (p< 0.001), and 14.21(1.57), 27.99(1.95), and 33.18(1.73) in dentin, respectively (p < 0.001). The mean (standard deviation, μm) of surface loss of Gp-SDF, Gp-SNF, and Gp-DW were 2.81(0.59), 4.28(0.67), and 4.63(0.64) in enamel (p < 0.001) and 4.13(0.69), 6.04(0.61), and 7.72(0.66) in dentin, respectively (p < 0.001). SEM images exhibited less enamel corruption and more dentinal tubular occlusion in Gp-SDF compared to Gp-SNF and Gp-DW. EDS analysis showed silver was detected in Gp-SDF while stannous was detected in the dentin block of Gp-SNF. Conclusion38 % SDF yielded superior results in protecting enamel and dentin blocks from dental erosion compared to SNF and DW. Clinical significanceTopical application of 38 % SDF is effective in preventing dental erosion in human enamel and dentin.

In vitro effect of fluoride gels supplemented with nano-sized sodium trimetaphosphate on enamel erosive wear

ObjectiveTo assess the protective effect of fluoride (F) gels supplemented with micrometric or nano-sized sodium trimetaphosphate (TMPmicro and TMPnano, respectively) against enamel erosion in vitro. MethodsBovine enamel blocks (n = 140) were selected according to their surface hardness, and randomly divided into seven groups (n = 20/group), according to the gels tested: Placebo (without F/TMP), 4,500 μg F/g (4500F), 9,000 μg F/g (9000F), 4500F plus 2.5 % TMPnano (2.5 % Nano), 4500F plus 5 % TMPnano (5 % Nano), 4500F plus 5 % TMPnano (Micro 5 %) and 12,300 μg F/g (Acid gel). Blocks were treated once during one minute with the gels, and submitted to erosive (ERO, n = 10/group) or erosive plus abrasive (ERO+ABR, n = 10/group) challenges 4 times/day, for 90 s for each challenge (under reciprocating agitation), during consecutive 5 days. Blocks were analyzed by profilometry, and by surface (SH) and cross-sectional hardness (∆KHN). Data were submitted to two-way ANOVA, and Fisher's LSD test (p < 0.05). ResultsFor ERO, both TMPnano-containing gels promoted enamel wear significantly lower than Placebo and 4500F, reaching levels similar to both positive controls (9000F and acid gel); significantly lower softening was observed for enamel treated with 4500F+5 % Micro and 4500F+2.5 % Nano. Also, the lowest ∆KHN values were observed for 4500F+2.5 % TMPnano among the TMP-containing gels. For ERO+ABR, the lowest enamel wear was achieved by the use of 4500F+5 % Nano among all gels, including both positive controls; lower softening was observed for Placebo and 9000F groups. ConclusionThe addition of 5 % nano-sized TMP to a low-fluoride gel produced superior protective effects for enamel under both challenges conditions, when compared with micrometric TMP, reaching values similar to or superior than both positive controls, respectively for ERO and ERO+ABR. Clinical significanceThe supplementation of low-F gels with TMP was shown to significantly improve their effects on enamel erosive wear, and the use of nano-sized TMP further enhances this protective action.

An In Vitro Study on the Effects of Hydrogen Peroxide-Based Bleaching Agents on Enamel: Field Emission Scanning Electron Microscopy (FESEM) With Energy Dispersive Spectroscopy (EDS) Evaluation.

Aim and objective The aim of the present in vitro study is to evaluate the morphological and elemental alterations in enamel following bleaching with hydrogen peroxide-based bleaching agents of different concentrations and pH values when exposed to different treatment times. Materials and method Twenty extracted maxillary central incisors were selected for the study. Tooth samples were prepared by sectioning the tooth cervico-incisally into two halves. The teeth were divided into different groups based on the bleaching protocol and bleaching agent applied: Group IA, Group IB, Group IIA, and Group IIB. Group IA received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 10 minutes with light application. Group IB received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 30 minutes with light activation. Group IIA received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 10 minutes with chemical activation. Group IIB received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 30 minutes with chemical activation. The morphology of the enamel before and after the application of the bleaching agent was evaluated using field emission scanning electron microscopy. The elemental analysis of enamel between the control and test samples was done with the help of energy dispersive spectroscopy. Results Paired t-test was used to analyze the data obtained from the study. The test samples showed erosive alterations in enamel surface morphology and also a decrease in the concentration of minerals when compared to the corresponding control groups. Conclusions The present study evidences the erosive potential of hydrogen peroxide-based bleaching agents.It can be concluded that bleaching agents containing high concentrations of hydrogen peroxide with acidic pH can cause mineral loss and surface erosion of enamel which is extremely detrimental to the tooth integrity.

Determination of consistency in pH of some commercial herbal formulations in Ghana

IntroductionThere are no strict pH standards for herbal formulations; however, pH can affect the characteristics of drugs and herbal formulations. In this study, the pHs of different herbal formulations produced in the past two batch years at the Centre for Plant Medicine Research (Mampong-Akuapem, Ghana) were analysed. We aimed to evaluate pH consistency among the formulations and suggest suitable pH ranges for the different product classes. MethodsThe formulations analysed were 17 decoctions, three ointments, and nine powders. Suitable ointment and powder samples were prepared before pH was measured, whereas decoctions were analysed directly. ResultsWe found that 93.1% of the preparations had average pH < 7 over the two years. The pH values for the decoctions, ointments, and powders were 3.507−6.755, 5.153−5.700, and 5.413−10.719, respectively. Differences in pH over the two production years were not statistically significant for all the powder and ointment formulations as well as for majority of the decoctions (82.4%). This indicates pH consistency for approximately 90% of the products, possibly pointing to consistencies in plant material compositions, formulation conditions, and process parameters. ConclusionsFrom our data and reported literature, we recommend that the labels of oral herbal preparations with pH < 5.5 should include an instruction to dilute the product before intake, or to drink water or rinse the mouth after intake to prevent enamel erosion. Decoctions may also be taken after food. Additionally, pH ranges of 4.6−7.0 and 4.0−6.0 may be suitable for rectal and topical herbal formulations, respectively.

The Effect of Food Polymers (Pectin, Alginate, and Gum Arabic) on Carbonated Drink-Induced Enamel Demineralization: An In Vitro Study.

The increased use of soft drinks leads to a high prevalence of dental erosion (DE), and the use of polymers can decrease tooth demineralization by a carbonated drink. Assessment of the effect of food-approved polymers such as highly esterified pectin (HP), propylene glycol alginate (PGA), and gum arabic (GA) on their efficiency to reduce enamel demineralization on addition with a commercially available carbonated drink was the main objective of this study. For this study, 300 premolar teeth were studied for enamel erosion and were divided into five groups consisting of 60 samples in each group. The teeth treated with distilled water had negative control, a commercially available carbonated drink with pH 2.7 had positive control, and food polymers were added individually to the carbonated drink in a specified quantity with minimal pH change and were taken as groups A, B, and C, respectively. The enamel erosion that occurred in study groups was measured using a laser fluorescence spectroscopic system with laser excitation at 404 nm at different treatment times (30, 60, and 120 seconds). Results: Demineralization was less in samples treated with polymer added to carbonated drink solutions compared to samples exposed to plain carbonated drink. As the time of exposure increased up to 120 seconds, a significant decrease in demineralization occurred in polymer-treated groups of samples as against plain carbonated drink with HP showing more decreased demineralization with extended exposure periods compared to other polymers. The surface morphology of tooth samples exhibited the anti-erosive effect of polymers, and the scanning electron microscopic pictures revealed a smoother surface for the polymer-added group. This study shows the efficacy of HP, PGA, and GA on reducing the effect of carbonated drink-induced enamel demineralization, and these polymers' addition to drinks can be an innovative way to reduce the demineralization potential of carbonated acidic drinks.

Hemoglobin Protects Enamel against Intrinsic Enamel Erosive Demineralization

Introduction: This study investigated the changes in the acquired enamel pellicle (AEP) proteome when this integument is formed in vivo after treatment with sugarcane-derived cystatin (CaneCPI-5), hemoglobin (HB), and a statherin-derived peptide (StN15), or their combination and then exposed to an intrinsic acid challenge. The effectiveness of these treatments in preventing intrinsic erosion was also evaluated. Methods: Ten volunteers, after prophylaxis, in 5 crossover phases, rinsed with the following solutions (10 mL, 1 min): control (deionized water-H₂O) – group 1, 0.1 mg/mL CaneCPI-5 – group 2, 1.0 mg/mL HB – group 3, 1.88 × 10⁻⁵<sc>M</sc> StN15 – group 4, or a blend of these – group 5. Following this, AEP formation occurred (2 h) and an enamel biopsy (10 µL, 0.01 <sc>m</sc> HCl, pH 2.0, 10 s) was conducted on one incisor. The biopsy acid was then analyzed for calcium (Arsenazo method). The vestibular surfaces of the other teeth were treated with the same acid. Acid-resistant proteins in the residual AEP were then collected and analyzed quantitatively via proteomics. Results: Compared to control, treatment with the proteins/peptide, mixed or isolated, markedly enhanced acid-resistant proteins in the AEP. Notable increases occurred in pyruvate kinase PKM (11-fold, CaneCPI-5), immunoglobulins and submaxillary gland androgen-regulated protein 3B (4-fold, StN15), Hb, and lysozyme C (2-fold, StN15). Additionally, a range of proteins not commonly identified in the AEP but known to bind calcium or other proteins were identified in groups treated with the tested proteins/peptide either in isolation or as a mixture. The mean (SD, m<sc>M</sc>) calcium concentrations released from enamel were 3.67 ± 1.48a, 3.11 ± 0.72a, 1.94 ± 0.57b, 2.37 ± 0.90a, and 2.38 ± 0.45a for groups 1–5, respectively (RM-ANOVA/Tukey, p < 0.05). Conclusions: Our findings demonstrate that all treatments, whether using a combination of proteins/peptides or in isolation, enhanced acid-resistant proteins in the AEP. However, only HB showed effectiveness in protecting against intrinsic erosive demineralization. These results pave the way for innovative preventive methods against intrinsic erosion, using “acquired pellicle engineering” techniques.

Effect of peanut stilbenoids, arachidin-1 and arachidin-3, on Streptococcus mutans growth and acid production

In this study we evaluated the effect of prenylated peanut stilbenoids on the growth, biofilm accumulation and acid production of the dental caries pathogen Streptococcus mutans. Prior research with the non-prenylated stilbenes, resveratrol and piceatannol, has shown that these molecules are active against S. mutans. Here we sought to determine if the addition of a prenyl group to the stilbene backbone increased anti-S. mutans activities. Two prenylated stilbenes, arachidin-1 and arachidin-3, were produced using a peanut hairy root production system. Compared to resveratrol and piceatannol, both arachidin-1 and arachidin-3 led to greater inhibition of S. mutans planktonic growth. This effect also led to reduced biofilm formation, by inhibiting growth, instead of a specific action against biofilm cells. Lastly, sub-MIC concentrations of arachidin-3 reduced the acid production of S. mutans above the ‘critical pH’ that leads to tooth enamel erosion. In summary, stilbenoids have anti-S. mutans activity, and prenylation enhances this activity.

Nanoscale Study on Noninvasive Prevention of Dental Erosion of Enamel by Silver Diamine Fluoride

Here, we aimed to demonstrate the efficacy of silver diamine fluoride (SDF) in halting dental erosion caused by dietary selection and offer a potential explanation for the underlying mechanism. We investigated the surface chemical and mechanical characteristics of human tooth enamel when exposed to Coca-Cola from 10 s to 1 h, with and without the topical treatment of SDF. We analyzed the mechanical properties by measuring the enamel surface roughness and elastic modulus using atomic force microscopy and the surface chemical composition through x-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy analyses, with scanning electron microscopy as a supplementary characterization method. After 1 h of immersion in Coca-Cola, the roughness changed from 83 to 287 nm for enamel without SDF treatment and 64 to 70 nm for enamel with SDF treatment. Under the same conditions, the elastic modulus changed from 125 GPa to 13 GPa for enamel without SDF treatment and 215 GPa to 205 GPa for enamel with SDF treatment. Topical coating of SDF onto enamel formed a passivation layer composed of fluorapatite and created added fluorine flux in the system, which protected the teeth from demineralization under Coca-Cola etching, as shown by morphology and chemical composition analysis as well as roughness and modulus characterization. Applying SDF to enamel minimizes changes in chemical compositions and surface roughness while improving enamel elastic modulus.

Effect of a Nano-hydroxyapatite Toothpaste on Enamel Erosive Lesions of Third Molars Induced by Exposure to Orange Juice.

This study aimed to assess the effect of a nano-hydroxyapatite (nano-HA) toothpaste on erosive enamel lesions of third molars induced by exposure to orange juice. In this in vitro, experimental study, the microhardness of 24 sound-extracted third molars was measured by a Vickers tester. The teeth were then randomly assigned to three groups (n = 8) of nano-HA toothpaste (Pharmed), 1.23% sodium fluoride gel, and artificial saliva. The teeth were exposed to orange juice for 5 min daily for 7 days and were then exposed to nano-HA toothpaste, fluoride gel, or artificial saliva (depending on their group allocation) for 10 min a day. The microhardness of the teeth was measured again after 7 days. Data were analyzed using paired t-test, analysis of variance, and Bonferroni test (alpha = 0.05). Within-group comparisons showed a significant reduction in microhardness of the teeth after the intervention in artificial saliva (P = 0.000), and fluoride gel (P = 0.002) groups. However, no significant reduction occurred in the microhardness of the nano-HA group, compared with the baseline (P = 0.132). Between-group comparisons revealed no significant difference in the microhardness of the three groups at baseline (P > 0.05). However, after the intervention, the microhardness of the nano-HA group was significantly higher than that of other groups (P < 0.05). However, the difference in secondary microhardness between fluoride gel and artificial saliva groups was not significant (P = 1.00). Pharmed toothpaste containing nano-HA has optimal efficacy for remineralization of enamel erosive lesions induced by exposure to orange juice.

Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study.

The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion. A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope. In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20). The present study concluded that the fluoride dentifrices' preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride. Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.

Inhibitory effects of Bacillus velezensis ID-A01 supernatant against Streptococcus mutans

BackgroundDental caries is a chronic oral disease caused by microbial infections, which result in erosion of the dental enamel and cause irreversible damage. Therefore, proper disease management techniques and the creation of an environment that prevents intraoral growth and biofilm formation of Streptococcus mutans in the early stages, are crucial to prevent the potential progression of dental plaque to disease. Here, we aimed to investigate antimicrobial and antibiofilm effects of the Bacillus velezensis ID-A01 supernatant (ID23029) against S. mutans, and its inhibitory effects on acidogenesis.ResultsA killing kinetics assay showed a peak lethality percentage of 94.5% after 6 h of exposure to ID23029. In sucrose-exposed conditions, ID23029 inhibited lactic acid formation, preventing the pH from falling below the threshold for enamel demineralization, and inhibited up to 96.6% of biofilm formation. This effect was maintained in the presence of lysozyme. Furthermore, ID23029 retained up to 92% lethality, even at an intraoral concentration at which lysozyme is ineffective against S. mutans.ConclusionsThis study demonstrates the potential of the B. velezensis ID-A01 supernatant for the prevention and treatment of dental caries. Its eventual use in dental practice is encouraged, although further studies are required to confirm its beneficial effects.

Effect of arginine-fluoride varnish on preventing enamel erosion by paediatric liquid medicaments

BackgroundThe study objective was to examine the effect of arginine-sodium fluoride (Arg-NaF) varnish on preventing enamel erosion by acidic paediatric liquid medicaments (PLM).MethodsThe treatment groups were: 1) 2% Arg-NaF; 2) 4% Arg-NaF; 3) 8% Arg-NaF; 4) NaF; 5) MI (CPP-ACFP) varnishes; and 6) no varnish. The pH of PLM (paracetamol and chlorpheniramine) was measured at baseline and after immersing the Perspex® blocks coated with varnishes at 0 min, 30 min, 1 h, and 4 h. Seventy-two enamel specimens (n = 72) were randomly divided into 2 groups by PLM and further by treatment groups. Then, the specimens were pre-treated with varnishes and subjected to erosive cycles (5 min, 2×/day for 4 days) by PLM. After each erosive challenge, the specimens were stored in artificial saliva. At baseline and after 4 days, the specimens were assessed for surface roughness (Ra) using 2D-surface profilometric analysis (SPA) and atomic force microscopy (AFM). Additionally, the Ca/P ratio was determined using scanning electron microscopy with energy-dispersive X-ray spectroscopy. Paired samples dependent t-test, 1-way ANOVA and 2-way ANOVA with Bonferroni post-hoc tests were used to analyse data with the level of significance set at p < 0.05.ResultsThe pH of PLM with 8% Arg-NaF was significantly higher than the other groups at 30 min and 4 h (p < 0.05). With paracetamol, no significant difference was observed between the baseline and post-erosive cycle measured enamel Ra (by SPA/AFM) and Ca/P ratio for all treatment groups (p > 0.05). The Ra determined by AFM, at the post-erosive cycle with chlorpheniramine, when treated with 4 and 8% Arg-NaF was significantly lower than the other groups (p < 0.05); except CPP-ACFP (p > 0.05). With the chlorpheniramine post-erosive cycle, the Ca/P ratio for 4, 8% Arg-NaF and CPP-ACFP treated specimens was significantly higher than the baseline Ca/P (p < 0.05).ConclusionThe 4%/8% Arg-NaF and MI varnish® application exhibit an enhanced preventive effect against low pH (pH < 3.0) PLM-mediated enamel erosive challenges compared to 5% NaF varnish.

Examining The Relationship Between Children's Dietary Patterns and The Development of Dental Problems

Background: This cross-sectional study explores the relationship between children's dietary patterns and the development of dental problems in a sample of 200 participants aged 6 to 12 years. Recognizing the critical role of nutrition in pediatric oral health, the study aims to identify associations between dietary habits, nutrient intake, and prevalent dental issues. Methods: Dietary patterns were assessed using a Food Frequency Questionnaire (FFQ), and nutrient intake was analyzed. Clinical examinations by trained dental professionals evaluated dental problems, including caries, enamel erosion, and malocclusions. Statistical analyses, including logistic regression, were employed to examine associations between dietary patterns and dental outcomes. Results: Demographic characteristics indicated a balanced sample with equal gender distribution and representation across age groups. Analysis of dietary patterns revealed mean values within recommended ranges for caloric intake, protein, carbohydrates, fat, and calcium. Significant associations were found between high sugar consumption and dental caries, low calcium intake and enamel erosion, and irregular snacking habits and malocclusions Conclusion: This study underscores the importance of understanding the intricate relationship between children's dietary patterns and dental health. The identified associations provide insights for targeted interventions aimed at reducing sugar consumption, promoting adequate calcium intake, and addressing irregular snacking habits to enhance pediatric oral health.

Erosive potential of vitamin waters, herbal drinks, carbonated soft drinks, and fruit juices on human teeth: An in vitro investigation.

Dental erosion is the loss of dental hard tissues through the acid dissolution of tooth minerals. One of the major factors that cause erosion is the consumption of acidic food and drinks. This study investigated and compared the effect of vitamin waters, herbal beverages, carbonated soft drinks, and fruit juices on the loss of human dental hard tissue. Human tooth samples were immersed in various drinks: vitamin waters, herbal beverages, carbonated soft drinks, and fruit juices. The pH value of each drink was measured using a pH meter. The weight of each sample was determined before and after six days of immersion in the tested drink, and the weight loss percentage was calculated. The exposed tooth surfaces were also examined under a scanning electron microscope. Most of the tested drinks were acidic and displayed pH values lower than the critical pH for enamel erosion. Significant weight loss of the tooth samples was found in all tested drink groups. Additionally, the samples immersed in fruit juices and herbal beverages exhibited significantly greater weight loss than those immersed in carbonated soft drinks. Scanning electron micrographs showed samples immersed in the tested drinks to demonstrate structural disintegration with occasional void spaces, except for samples immersed in Doi Kham® Lemongrass drink. Most of the tested drinks have the potential to cause dissolution and destruction of dental hard tissues. Consumers should be aware that prolonged exposure to these drinks could lead to permanent loss of tooth mineral and dental erosion.

Erosion behaviour of human, bovine and equine dental hard tissues

Dental hard tissues from different species are used in dental research, but little is known about their comparability. The aim of this study was to compare the erosive behaviour of dental hard tissues (enamel, dentin) obtained from human, bovine and equine teeth. In addition, the protective effect of the pellicle on each hard tissue under erosive conditions was determined. In situ pellicle formation was performed for 30 min on enamel and dentin samples from all species in four subjects. Calcium and phosphate release was assessed during 120 s of HCl incubation on both native and pellicle-covered enamel and dentin samples. SEM and TEM were used to examine surface changes in native enamel and dentin samples after acid incubation and the ultrastructure of the pellicle before and after erosive exposure. In general, bovine enamel and dentin showed the highest degree of erosion after acid exposure compared to human and equine samples. Erosion of human primary enamel tended to be higher than that of permanent teeth, whereas dentin showed the opposite behaviour. SEM showed that eroded equine dentin appeared more irregular than human or bovine dentin. TEM studies showed that primary enamel appeared to be most susceptible to erosion.

Detection of Erosive Changes on Smooth Surfaces with and without Orthodontic Brackets Using an Intraoral Scanner-An In Vitro Study.

Consumption of acidic beverages favours development of erosions. Modern diagnostic methods are required to detect erosions at an early stage. This study aimed to evaluate the suitability of an intraoral scanner (IOS) for detection of erosive changes on smooth surfaces adjacent to orthodontic brackets. Orthodontic metal brackets were attached to the buccal surfaces of 58 extracted permanent human teeth. Teeth were randomly divided into groups: A = 6% citric acid, B = Coca-Cola, C = Redbull, D = Powerade, E = Control, no acid exposure. Teeth were exposed to acid in three erosion cycles, followed by rinsing and brushing. Scans of teeth were performed at baseline and after each erosion cycle and enamel loss was measured. Quantitative light-induced fluorescence (QLF) measurements were performed as reference standard. Significant substance loss was measured in all acid groups after the second and third erosion cycle (p < 0.0001). Correlation between scans and QLF were significant (p = 0.001). With IOS, it was possible to detect and quantify enamel erosion at smooth surfaces with and without orthodontic brackets after a short exposure time. Considering the limitations of in vitro results, the use of IOS can be a promising digital tool to detect and monitor erosive enamel changes during fixed orthodontic treatment.

Заболевания верхних дыхательных путей как внепищеводные проявления гастроэзофагеальной рефлюксной болезни: современное состояние проблемы

Bronchial asthma, chronic cough, laryngitis, erosion of tooth enamel are attributed to extra esophageal manifestations of gastroesophageal reflux disease (GERD). This form of GERD is characterized by the difficulty of establishing the diagnosis and high frequency of ineffective therapy. The article describes the main endoscopic signs of damage to the esophagus and larynx, presents normal pH-impedance reflux monitoring and criteria for pathological reflux into the esophagus and the lower third of the pharynx, as well as the possibilities of additional diagnostic methods – esophageal manometry and pepsin test. Treatment of patients with extra esophageal manifestations of GERD is a difficult task; the results of randomized placebo-controlled studies are contradictory. At the same time, empirical therapy is most effective in patients whose extra esophageal symptoms are combined with typical ones

Interaction between Hexametaphosphate, Other Active Ingredients of Toothpastes, and Erosion-Abrasion in Enamel in vitro

Sodium hexametaphosphate (HMP) as toothpaste additive is claimed to reduce erosive tooth wear and to stabilize stannous ions. However, little is known about the impact of concentration and its interactions with fluoride (F) or stannous+fluoride ions (F/Sn) on enamel erosion and erosion-abrasion. In a 10 day cyclic in vitro erosion-abrasion model, 320 flat human enamel specimens were divided into ten groups (n = 32 each) and daily subjected to six erosive challenges (0.5% citric acid, 2 min) and two toothpaste suspension applications (2 min, 1:3 F-free toothpaste:mineral-salt solution, 0.23% sodium gluconate). Half of specimens per group were additionally brushed twice/day (200 g, 15 s) during suspension immersion. Nine suspensions contained HMP (0.25%, 1.75%, 3.25%), either on its own or combined with F (373 ppm F⁻) or F/Sn (800 ppm Sn²⁺, 373 ppm F⁻). One suspension contained sodium gluconate only (NegContr). After 10 days, specimens’ surfaces were analysed with profilometry, energy dispersive X-ray spectroscopy, and scanning electron microscopy. Tissue loss (µm, mean ± standard deviation) in NegContr was 10.9 ± 2.0 (erosion), 22.2 ± 1.6 (erosion-abrasion). Under erosive conditions, only 0.25% HMP in any combination and 1.75% HMP with F/Sn reduced loss significantly (−28% to −54%); 3.25% HMP without F and F/Sn increased loss significantly (+35%). With additional abrasion, no suspension reduced loss significantly compared to NegContr, instead, in groups without F and F/Sn or with 3.25% HMP loss was increased (+15% to +30%). Conclusively, at higher concentrations, HMP increased erosive tooth wear and seemed to reduce anti-erosive effects of fluoride and stannous ions.