牙齿酸蚀症

牙齿酸蚀症与频繁消费酸性饮料及食物、患某些疾病使胃酸频繁进入口腔内接触牙齿等有一定的关系。牙齿酸蚀症影响着人们的牙齿健康。本文就牙齿酸蚀症的流行状况、病因、临床表现及诊断和治疗的研究进展作一综述     

牙酸蚀症指数的研究现状

［摘要］ 近年来,随着国内外牙酸蚀症患病率的增长,此疾病受到研究者的关注,同时,不少针对酸蚀症的评估指数也被提出并应用到临床检查、流行病学调查和实验室研究中。本文就几种当前主要应用于流行病学调查和临床检查的酸蚀症指数作一综述。     

牙齿酸蚀症

牙齿酸蚀症与频繁消费酸性饮料及食物、患某些疾病使胃酸频繁进入口腔内接触牙齿等有一定的关系。牙齿酸蚀症影响着牙齿健康但人们对其认识不多。本文对牙齿酸蚀症的流行状况、病因、临床表现及诊断和治疗的研究进展作一综述。     

牙齿酸蚀症

牙齿酸蚀症与频繁消费酸性饮料及食物、患某些疾病使胃酸频繁进入口腔内接触牙齿等有一定的关系。牙齿酸蚀症影响着牙齿健康但人们对其认识不多。本文对牙齿酸蚀症的流行状况、病因、临床表现及诊断和治疗的研究进展作一综述。     

影响牙齿酸蚀症风险性的唾液因素研究进展

唾液是牙齿的外环境。唾液的无机成分、有机成分、缓冲能力及流速流量对酸蚀症风险性都有着重要的影响。了解影响酸蚀症风险性的唾液因素,可对唾液针对性地检测,能够及早发现酸蚀症易感人群, 有助于酸蚀症的早期诊断、早期预防。该文就影响酸蚀症风险性的唾液因素研究进展作一综述。     

牙齿酸蚀症实验室评估技术的研究进展

牙齿酸蚀症是指在无细菌参与的情况下,仅由化学作用而导致的牙齿硬组织不可逆性丧失。近年来,由于饮食结构的改变和各种饮料的流行,牙齿酸蚀症的发病率明显提高,因此,牙齿酸蚀症也越来越受到关注,而且有多种研究技术被用于牙齿酸蚀症的评估。本文就牙齿酸蚀症实验室评估技术的研究进展作一综述。     

视神经炎患者激素治疗引起牙酸蚀症1例

牙酸蚀症是指牙齿受到不涉及细菌的化学物质侵蚀使得牙齿硬组织发生进行性破坏的一种疾病。病因包括内在因素和外在因素，内在因素如暴食、厌食、胃肠道疾病、药物等导致的胃食管反流而引起的牙齿酸蚀，外在因素则主要包括饮食、药物、职业因素等。本文介绍了1位患者，因诊断为视神经炎而接受糖皮质激素治疗，从而引起胃食管反流症状，出现全口牙齿尤其是上颌牙列的重度酸蚀破坏。本文主要就视神经炎激素治疗与牙酸蚀症发生的机制进行了探讨。     

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近十余年来,牙酸蚀症患病率不断上升,已成为一个新的口腔健康问题。各国学者进行了大量的调查和研究,认为牙酸蚀症是一种多因素的疾病,是化学、生物、行为等多种因素相互影响、相互作用的结果。对于牙酸蚀症的易感人群,应对其饮食习惯、口腔卫生习惯、牙齿结构、唾液及获得性膜等方面进行风险评估,并综合分析各项评估结果,以利于诊断和为不同风险级别的易感者制定全面的预防策略。     

激光对牙酸蚀症预防作用的研究进展

酸蚀症是在化学作用下,酸侵蚀导致的牙体硬组织丧失,其过程与细菌作用无关。激光治疗可以抑制牙体硬组织的脱矿作用,进而预防酸蚀症的发生。本文就激光对酸蚀症的预防机理及预防效果作综述。     

唾液对牙釉质酸蚀保护作用的体外实验研究

目的 研究酸蚀症儿童唾液和无酸蚀症儿童唾液对牙釉质酸蚀的保护作用及程度.方法 收集5名患酸蚀症男童和5名无酸蚀症男童非刺激性唾液各10 ml.收集因正畸需要而新鲜拔除的健康青少年前磨牙15个,制备牙釉质块30个,随机分成酸蚀症唾液组、无酸蚀症唾液组和去离子水组3组.釉质样本分别浸泡在唾液和去离子水内,每天2次用0.3%的枸橼酸溶液酸蚀5 min,10 d循环结束后,用原子力显微镜观察釉质表面粗糙度以及显微硬度计进行釉质硬度测量.结果 去离子水组的釉质样本表面粗糙度大于两个唾液组釉质样本,显微硬度值小于两个唾液组的釉质样本(P<0.00 1).酸蚀症唾液组和无酸蚀症唾液组釉质样本的表面粗糙度值和显微硬度值间差异均无统计学意义(P=0.695,P=0.432).结论 唾液对牙釉质酸蚀起到保护作用,有无患酸蚀症的儿童唾液对牙釉质的保护作用无差异.     

牙侵蚀与胃食管反流病间的关系

牙侵蚀是指牙体硬组织在无细菌参与的化学作用下的不可逆性丧失,胃食管反流病是常见的胃肠道紊乱性疾病,是牙侵蚀主要的病因之一。本文主要就牙侵蚀的病因、胃食管反流病导致的牙侵蚀机制,牙侵蚀的临床表现,牙侵蚀的预防和治疗等研究进展作一综述。阐明了牙侵蚀是胃食管反流病食管外最重要的表现之一,其诊治需要多科的共同协作,早期诊断胃食管反流病并通过改变生活方式和药物来抑制酸反流,对预防牙侵蚀的发生和干预牙矿质的进一步丢失和损伤极为重要。     

北京某大学学生志愿者牙侵蚀症患病情况及相关因素调查

目的 对北京某大学学生牙侵蚀症（又称牙酸蚀症）患病情况进行初步调研，分析其相关因素。方法对179名北京某大学在校学生志愿者，采用问卷方式调查牙侵蚀症相关因素，并用van Rijkom改良标准进行临床评估。结果该组人群牙侵蚀症患病率为45．8％，均为牙釉质病损。好发牙面为前牙唇面。牙侵蚀症的发生与碳酸饮料、果汁、冲饮饮料和香蕉等酸性饮食因素相关。结论应对我国青年人群牙侵蚀患病情况加以重视，加强口腔卫生教育和饮食指导。     

北京市12岁人群牙侵蚀症患病情况及酸性饮料危险性分析

目的 调查北京市12岁人群牙侵蚀症(又称牙酸蚀症)的患病情况,并进行酸性饮料危险性分析.方法 采取多阶段分层等容量(多级、分层、等额)随机抽样方法抽取北京市12岁人群共844人进行酸性饮料摄人情况问卷调查,并应用适合我国青少年牙侵蚀症流行病学调查分级标准进行评估.结果 共获得有效问卷844份,其中有522人患牙侵蚀症.本组人群牙侵蚀症患病率为61.8%(522/844),其中1级(轻度牙釉质病损)占74.1%(387/522),2级(重度牙釉质病损)占24.9%(130/522),3级(轻度牙本质病损)为1.0%(5/522).结论 大量饮用碳酸饮料和果汁是牙侵蚀症的危险因素,应重视青少年人群牙侵蚀症患病情况并加强饮食指导.     

Prevalence of dental erosion and related factors in the deciduous dentition of Japanese children

ObjectivesThe objectives of this study were to clarify the prevalence of dental erosion in the deciduous dentition of child patients, and to identify dietary habits and other factors related to dental erosion.MethodsA total of 116 weaned child patients (67 boys, 49 girls) aged 2–6 years who attended the outpatient pediatric dental clinic of a university hospital for treatment or a periodic checkup were included in the study. A questionnaire survey of the patients' dietary habits and a clinical examination were performed. Dentition was divided into four areas, and responses to erosion-related questions were evaluated for each area using multiple logistic regression analysis.ResultsThe prevalence of subjects with erosion, including pre-erosion lesions without tooth surface defects, was 86%; the prevalence of advanced erosion accompanied by tooth surface defects was 34%. Some food- and drink-related items were found to be significantly associated with erosion of the maxillary anterior teeth but not the mandibular teeth. Medication, use of fluoride, and past dental or medical history did not have any significant effect on erosion in any of the four areas.ConclusionsThe occurrence of dental erosion in deciduous dentition and factors related to its appearance were clarified for each area. An epidemiological survey is required to further reveal the state of deciduous dental erosion in Japanese children and to investigate the necessity of, and, if necessary, establish relevant guidelines for the prevention of dental erosion.     

Dental erosion, summary

Although reports on dental erosion have always appeared in the dental literature, there is currently a growing interest among researchers and clinicians. Potential risk factors for dental erosion are changed lifestyle and eating patterns, with increased consumption of acidic foods and beverages. Various gastrointestinal and eating disorders expose the dentition to frequent contacts with very acidic gastric content, which may lead to erosion. Whether these factors indeed lead, on a population scale, to a higher prevalence and incidence of erosion is yet to be established. This article summarizes the different aspects of the prevalence, pathology, etiology, assessment, prevention and treatment of dental erosion, and concludes with recommendations for future research.     

Erosion Caused By Gastroesophageal Reflux: Diagnostic Considerations

Dental erosion occurs with a high prevalence in the general population, but its impact on prosthodontic care is often unrecognized. The etiology of dental erosion is difficult to establish because it may result from a variety of causes and may have different presentations. Our purpose was to review the literature relevant to dental erosion and to report a patient presentation in which an unusual pattern of severe erosion was the dental manifestation of asymptomatic gastroesophageal reflux disease.     

Etiology of dental erosion – intrinsic factors

Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must be taken into account as possible intrinsic etiological factors of dental erosion are thoroughly discussed with respect to the clinical picture, prevalence and risk of erosion.     

Erosion — chemical and biological factors of importance to the dental practitioner

The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.     

Restorative Management of Intrinsic and Extrinsic Dental Erosion

The restorative management of tooth surface loss is highlighted through the presentation of two advanced cases of dental erosion. On presentation, the causes of the dental erosion in both patients had been previously diagnosed and stopped. The first patient was a 67 year old with intrinsic erosion and an element of attrition where a multidisciplinary approach was used. The other, a 17 year old patient with extrinsic erosion managed via adhesive restorations. Adhesive techniques are a relatively simple, effective and conservative method for the treatment of dental erosion. The two treatment modalities (conventional versus contemporary) are compared and discussed.