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

Mullan, Francesca; Austin, Rupert; Parkinson, Charles; Bartlett, David

doi:10.1016/j.jdent.2018.01.005

Cited by 17 publications

(18 citation statements)

References 30 publications

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“…Although most published in situ studies have been performed using ex vivo erosion, the ex vivo erosive challenge is not fully comparable to an in vivo challenge because interactions between the acid and oral environment (e.g., temperature, saliva buffering) are absent. However, in the literature, only few in situ studies adopted in vivo erosion models using either palatal [28] or lower appliances [26]. The current in situ design not only exposed the samples to in vivo erosion but also protected the participants' natural teeth (as confirmed by the scanning electron microscope images of the replicas).…”

Section: Discussionmentioning

confidence: 99%

“…The Tooth mousse was applied according to the manufacturer's recommendation. The 5-min erosive challenge was chosen in accordance with previous in situ studies [26,32,33]. Additionally, the participants were requested to rinse and expectorate the acidic drinks because swallowing the acidic drinks may lead to adverse events [25].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in vitro and in situ studies with standardized conditions have been advocated for testing the effectiveness of preventive strategies against dental erosion [25]. Although most of the published studies were conducted in vitro, in vitro models cannot replicate the oral environment and can overestimate erosive changes by approximately 10-fold [26,27]. In situ models allow erosion changes to be measured over time in a natural environment of saliva and pellicle.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, the best available method to simulate the clinical environment is an in situ study with in vivo erosion since the natural oral environment offers extra resistance to erosion compared to only the presence of the applied pellicle. A recently published study reported that surface roughness and SMH of specimens eroded in vivo were significantly different from those eroded ex vivo for 45 min [26]. However, the effects of CPP-ACP on dental erosion have not yet been investigated using in situ / in vivo models.…”

Section: Introductionmentioning

confidence: 99%

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In situ effect of Tooth Mousse containing CPP-ACP on human enamel subjected to in vivo acid attacks

Jiang

et al. 2018

Journal of Dentistry

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OBJECTIVE This in situ study aimed to evaluate the protective effect of Tooth Mousse (GC) containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on human enamel erosion and to compare the difference in erosion between the anteriorly and posteriorly positioned human enamel. METHODS This study used a 2-treatment (7 days each) crossover design with 12 healthy volunteers wearing intraoral appliances. Each appliance contained 4 human enamel specimens positioned on the buccal surfaces of the volunteers' maxillary central incisors and first molars. The specimens were intraorally treated withTooth Mousse (CPP-ACP group) or deionized water (control group) for 3 min and then exposed to in vivo acid attacks by rinsing with 150 ml of a cola drink (4 × 5 min/day). The surface microhardness (SMH) of the specimens was measured and used to calculate the percentage of SMH loss (%SMH). Erosion effect on enamel was also investigated by scanning electron microscopy (n = 4) at the end of study. The data were statistically analysed using two-way analysis of variance (ANOVA) and Tukey's test at a level of P < 0.05. RESULTS A significant decrease in %SMH was observed for the specimens of CPP-ACP group compared to that for the controls (P = 0.007). The specimens positioned posteriorly exhibited a significantly lower %SMH than those positioned anteriorly (P = 0.033). Samples of CPP-ACP group showed fewer etching patterns than those of the control group. CONCLUSIONS In this in situ model, application of Tooth Mousse containing CPP-ACP before erosion reduced the %SMH of human enamel. Enamel located in different positions showed different patterns of erosion. CLINICAL SIGNIFICANCE Application of Tooth Mousse containing CPP-ACP could be considered as a suitable preventive strategy against enamel erosion. ClinicalTrials.gov Identifier: NCT03426150.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In situ effect of Tooth Mousse containing CPP-ACP on human enamel subjected to in vivo acid attacks

Jiang

et al. 2018

Journal of Dentistry

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“…Previous studies have taken impressions at separate epochs, poured the impressions in dental stone and scanned the stone casts with profilometry [13][14][15][16][17][18][19][20][21][22] to create a data set which can be analysed for changes over the intervening time period. However, the associated specialised equipment cost, and scanning time of each cast limits this method to a university setting.…”

Section: Introductionmentioning

confidence: 99%

The sensitivity of digital intraoral scanners at measuring early erosive wear

Kumar

Keeling

Osnes

et al. 2019

Journal of Dentistry

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Objectives: To investigate the sensitivity of intraoral scanners to quantitatively detect early erosive tooth wear. Methods: Natural buccal enamel samples were mounted in acrylic and scanned at baseline with an intraoral scanner (3M True Definition Scanner, 3M, USA). Samples were then exposed to 0.3% citric acid pH 3.2 at intervals of 10 minutes up to a total of 120 minutes and scanned after each exposure resulting in analysis of 13 datapoints per sample. Each scan was aligned with the baseline and data points superimposed using an iterative closest point (ICP) algorithm on the acrylic surfaces (Geomagic Control Software, 3Dsystems, Darmstadt, Germany). Wear was measured using maximum profile loss, average profile loss and volume change. Data were normally distributed and Pearson correlations between erosion time and wear measurements assessed. Results: After each 10-minute exposure until 120 minutes, maximum profile loss (m) increased from 33.4 to 72.8 m, average profile loss from 9.1 to 18.6 m. Wear correlated with increasing acid exposure for both maximum profile loss wear (r=0.877 p<0.001) and average profile loss (r=0.663 p=0.019) respectively. Volume measurements were inconsistent at this level of wear. Conclusions: Using scan data obtained from the intra oral scanners (IOS), increasing step height changes were observed with increasing exposures to acid. This study indicates there is potential of scans taken with an IOS to be used to detect early erosive tooth wear. However, precision was low suggesting limitations for minimal changes. Clinical Significance: Although sub-visual wear was detected by intra-oral scanners on natural enamel surfaces, the accuracy was not sufficient to reliably diagnose that wear had occurred and interpretation of measurements should be done with caution. However, these results may be promising for detecting wear at more advanced stages.

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Erosive loss of tooth substance is dependent on enamel surface structure and presence of pellicle – An in vitro study

Steiger-Ronay

Kuster

Wiedemeier

et al. 2020

Archives of Oral Biology

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OBJECTIVE Aim of this in vitro study was to investigate erosive tooth loss in dependence of the enamel surface structure and presence of an acquired pellicle. METHODS Enamel specimens from 19 bovine incisors (4 specimens/incisor) were allocated to four experimental groups (n = 19). The surfaces of half of the specimens were polished (two groups), while the other half was left native (two groups). Specimens of one polished and one native group were placed in pooled human saliva (30 min) for the formation of an acquired pellicle. Thereafter, all specimens were demineralized by superfusion with hydrochloric acid (17 min, pH 2.3) with collection of the superfluent. Erosive substance loss was determined by measuring the dissolved calcium content using a colorimetric assay with Arsenazo III reagent. Differences in erosive substance loss were statistically analyzed with respect to enamel surface and pellicle. A linear mixed effects model was fitted to the data and pairwise differences between groups were evaluated (significance level = 0.05). RESULTS Enamel surface structure (p < 0.001) and presence of pellicle (p = 0.01) had a significant effect on erosive substance loss. Polished surfaces with pellicle showed the lowest cumulative calcium release [nmol Ca/mm 2 ] (means ± standard deviation: 48+/-5), followed by polished specimens without (51+/-9) and native specimens with pellicle (54+/-10). No significant differences were found between these groups. Highest cumulative calcium release was found for native specimens without pellicle (61+/-9; p < 0.05). CONCLUSIONS Both enamel surface structure and the acquired pellicle are important determinants of the susceptibility to erosive tooth loss.

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

Abstract: This 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.

Cited by 17 publications

References 30 publications

In situ effect of Tooth Mousse containing CPP-ACP on human enamel subjected to in vivo acid attacks

In situ effect of Tooth Mousse containing CPP-ACP on human enamel subjected to in vivo acid attacks

The sensitivity of digital intraoral scanners at measuring early erosive wear

Erosive loss of tooth substance is dependent on enamel surface structure and presence of pellicle – An in vitro study

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