Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 7-8, Pages: 413-418
https://doi.org/10.2298/SARH1408413S
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The effect of gastric juice on the development of erosive changes in hard dental tissue
Stojšin Ivana (Faculty of Medicine, Dental Clinic of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad)
Brkanić Tatjana (Faculty of Medicine, Dental Clinic of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad)
Živković Slavoljub (School of Dental Medicine, Department of Restorative Dentistry and Endodontics, Belgrade)
Introduction. Gastroesophageal reflux disease (GERD) is an esophageal
disorder where the refluxed gastric contents enters first into the esophagus
followed by the pharynx, oral cavity, larynx, airway and middle ear, causing
a range of disorders and symptoms. Hydrochloric acid from the gastric
contents is responsible for the demineralization of dental hard tissues and
release of matrix metalloproteinase from the dentin. Objective. The aim of
this study was to verify the SEM (scanning electron microscopy) analysis of
the surface enamel, the enamel-dentin border and dentine after the exposure
of intact teeth to filtrate of gastric contents obtained during routine
endoscopy. Methods. Material used in the research was 10 extracted human
impacted third molars. The coronal part of the tooth was divided into two
parts, and then the two halves of teeth were exposed to the filtrate of
gastric juice obtained during routine gastroscopy, which had been frozen
until the moment of the experiment initiation. All samples of teeth were
immersed in the filtrate of the content at a temperature of 20°C for 60
minutes. The prepared samples were observed by the SEM in the area of the
enamel, the enamel-dentin border and in the area of dentin at different
magnification. Results. The SEM analysis showed that both enamel and dentin
had a significant demineralization of these tissues. Enamel surface resembled
a demineralization similar to that of acid conditioning before the
application of composite restorations. The degree of mineralization was more
intense towards the enamel - dentin border, and at this area the enamel
prisms were not fully recognizable. The dentin had a complete loss of
peritubular dentin, the entry points of the dentin tubules were expanded and
intertubular dentin demineralization was also registered. Conclusion. SEM
analysis showed a significant degree of destruction of enamel and dentin.
Significant changes in the surface structure of enamel and dentin were also
registered. The filtrate of the gastric juice degrades enamel pellicle and
the dentin organic component.
Keywords: dental erosion, gastroesophageal reflux disease(GERD), pathophysiology, pathohistopathology