In vitro and in situ analysis of dental erosion and prevention in pacients with gastroesophageal reflux disease

Author(s)

Juliana dos Reis Derceli

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Ribeirão Preto (PCARP/BC)
• Defense date: 2014-05-27

Examining board members

Regina Guenka Palma Dibb; Marilia Afonso Rabelo Buzalaf; Silvio Issáo Myaki; Ricardo Brandt de Oliveira; Paulo Vinicius Soares

• Advisor: Regina Guenka Palma Dibb

Abstract

The aim of this in vitro study was to evaluated hydrochloric acid liquid and gaseous effect on enamel surface and preventive treatments, to evaluated in situ gatroesophageos reflux disease (GERD) effect on dental enamel and prevenvtive treatments. The in situ study was totally dependent on the in vitro results, ie the superficial treatments performed in situ were selected according to the in vitro results. To in vitro study 234 enamel samples (4x4 mm) were obtained from bovine incisors and isolated with the compound resin except half of the enamel surface which was exposed to preventative treatments and erosive challenges. This study was 3 X 3 factorial, study factor: Superficial treatment in 3 levels: no treatment (C), CO2 laser (CO) and Nd:YAG laser (Nd); and fluoride assiciation in 3 levels: swithout (WA), fluoride gel association (FA) and fluoride narnish association (FVA). Erosive challenges were performed using HCl liquid and gaseous. 180 treated specimens were selected (n=10) and randomized. Erosive challenge using HCl liquid - pH=2, 37 °C, 6 times/day, during 20s, for 5 days; erosive challenge using HCl gaseous - pH=2, 37 °C, 8 times/day, during 3 min, for 12 days. It was evaluated wear depth (perfilometer), degree, volume loss and roughness. Chemical and morphological surface analysis was performed, thus 54 specimens were selected randomly divided according preventive treatments (n=3): XRD and SEM-EDS. Data were analyzed by two-way ANOVA, XRD and EDS was performed descriptive data analysis, SEM was analyzed qualitatively. HCl liquid results - FV association presented higher wear depth (menos and standard deviation: 0.82±0.17) compared to C (0.66±0.14), in the interaction between factors C/FVA and Nd/FVA increased wear depth (0.84±0.21; 0.86±0.12), C (0.70±0.10); the association FV increased roughness (0.26±0.06), C (0.22±0.07), the interaction between factors CO and C/FA were better (0.19±0.07; 0.18±0,03), C (0.21±0.07); For degree and volume loss are not significantly different. HCl gaseous results - Nd presented less wear depth (1.3±0.08) and Nd/FA higher wear depth (1.8±0.51), C (1.4±0.16); F and VF association presented less degree (6.6±4.9; 8.9±3.8), roughness (0.35±0.07; 0.37±0.05) and volume loss (6.0±3.3; 8.3±3.6), C (11.86±4.3; 0.41±0.04; 11.05±4.7; respectively). For EDS analysis there was decrease fluoride content after the treatmentos C, C/FA, C/FVA, CO/FVA, Nd/FA e Nd/FVA, ratio Ca/P was not altered; For XRD was not observed fluoride content changes. Was not observed morphological change by SEM. It can be concluded that hydrochloric acid liquid and gaseous promoted dental erosion, for HCl liquid CO/FA promoted less wear depth, for HCl gaseous F and VF association decreased wear depth, the treatments do not alter fluoride contente on enamel surface. For in situ study, 44 volunteers were selectioned and divided into groups: Control- healthy; Suspect- dental erosion and GERD symptoms; GERD- with disease diagnosis. Were obtained 264 specimens from bovine incisors (2x2x2 mm), which were isolated with the compound resin except half of the enamel surface which was exposed to preventative treatments and oral cavity exposed. The study was factorial 3X2: Superficial treatments in 3 levels: no treatment (C), CO2 laser (CO) and Nd:YAG laser (Nd); and fluoride association in 2 evels: without association (WA) and fluoride gel association (FA),in 2 phases of 30 days and 7-day interval between each phase. Data were analyzed by two-way ANOVA. The results were null (0) foro wear depth, degree, volume loss and roughness, the CO group exposed to oral cavity promoted superficial cracks. It can be concluded that 30-day period in the oral environment are insufficient to cause enamel erosion in GERD patients, in vitro studies and in situ show divergent results among themselves, more studies are needed. (AU)

• FAPESP's process: 10/19531-8 - In vitro and in situ analysis of the dental erosion and prevention methods in patients with gastroesophageal reflux disease
• Grantee: Juliana dos Reis Derceli
• Support Opportunities: Scholarships in Brazil - Doctorate