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Background and aim. Dental erosion (DE) represents a frequent condition in adults and the elderly. The gastroesophageal reflux disease (GERD) is considered an important endogenous factor causing dental erosions. The objective of this study was to assess the prevalence of DE in GERD patients and to establish the correlation between pathogenic intrinsic and extrinsic factors of DE and their relation to GERD. Methods. A cross-sectional study was conducted on 263 patients (median age 43). Patients with heartburn were recruited in two countries with different prevalence of GERD. Patients were recruited from France (n=158, 60%) and Romania (n=105, 40%) including 163 females and 100 males. The Basic Erosive Wear Examination (BEWE) index for diagnosis and evaluation of dental erosion was used. Based on the value of BEWE score, each patient was included in a risk group for DE development (low risk: BEWE=3-8, medium risk: BEWE=9-13, high risk: BEWE ≥14). Patients filled a questionnaire regarding GERD symptoms, medications, life style. Salivary parameters (pH and buffering capacity) were also assessed and analyzed. Results. DE was significantly more frequent and more severe in GERD subjects than in the non-GERD controls. Low salivary pH but not salivary buffering capacity was associated with BEWE scores. Buffering capacity however was significantly more altered in patients with BEWE score over 9 (medium DE) than in patients with mild DE (BEWE <9). Although extrinsic factors (consumption of citrus fruits, soda drinks) were associated with DE in GERD, there was no statistical correlation with the BEWE score. From the total of 263 patients, 229 (87.1%) presented BEWE score <9, and 34 (12.9%) presented BEWE ≥9. The DE was significantly associated with the presence of GERD (p<0.001). BEWE score >9 was more frequently present in GERD patients (30 patients: 21.3%) than in non GERD patients (4 patients: 3.3%). DE were more frequent in French subjects compared to Romanian subjects. Romanians had lower BEWE scores than the French. Conclusions. DE is more frequent and more severe with GERD vs. non-GERD. DE in GERD is associated with extrinsic dietary factors like citrus fruits and soda drinks.

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Le taux de succès des implants dentaires est, entre autres, déterminé par la bonne évaluation préalable du volume et de la qualité de l'os environnant. Si le volume osseux se définit aisément par la quantité d'os (hauteur et largeur de la crête osseuse) disponible au niveau du site implantaire, la définition de la qualité de l'os est plus vague car elle comporte plusieurs aspects de la physiologie osseuse comme le degré de minéralisation ou l'architecture osseuse. De la classification subjective de Lekholm et Zarb à celles plus récentes utilisant l'échelle Hounsfield, l'évaluation de la qualité de l'os n'a cessé de faire l'objet de controverses notamment de par le manque d'importance accordée à la qualité du réseau trabéculaire de l'os spongieux. T.B.S. (Trabecular Bone Score) est une nouvelle mesure de microarchitecture osseuse obtenue par réanalyse des niveaux de gris des images d'ostéodensitométrie. Ce procédé, actuellement utilisé en rhumatologie pour le diagnostic de l'ostéoporose, est couplé à la mesure de la densité minérale osseuse (D.M.O.) afin de caractériser la microarchitecture osseuse. Le procédé T.B.S. ® appliqué à la radiographie panoramique trouverait de multiples indications en chirurgie orale et notamment en implantologie en complément des examens radiologiques actuellement utilisés. > G T.B.S. G qualité de l'os spongieux G architecture osseuse G implant dentaire Mots clés

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