Reflux disease as an etiological factor of dental erosion

Abstract

Introduction Gastroesophageal reflux is a frequent disease which has a significant influence on the development of dental erosions. Objective The aim of this research was to determine the frequency of dental erosions among the patients with gastroesophageal reflux, as well as to verify the most common symptoms of gastroesophageal disease. Methods The research comprised of two groups, each consisting of 30 patients aged 18-80 years. The experimental group comprised of patients diagnosed with gastroesophageal reflux disease (GERD), while the control group was composed of patients who were not diagnosed with GERD. Based on the illness history data, all patients of the experimental group were registered to have gastroesophageal and extraesophageal symptoms. Dental erosions were diagnosed during a stomatological inspection by using index system according to Eccles and Jenkins. Data processing was accomplished by the Statgraphics Centurion software package. Results Dental erosions were found in 76.7% of experimental group patients, and in 53.3% of control group patients. Fortynine percent of teeth of the experimental group patients and 31.1% of the control group patients showed erosive changes. On average, the number of teeth with erosions in the experimental group was 15.7 per person and in the control group 10 per person. The teeth of the front region of the upper jaw, as well as the lower first molars had the highest average value of dental erosion index. In the experimental group 12.8% of teeth and 24% of teeth in the control group were diagnosed to have dental erosion index value 1. Furthermore, 23.4% of teeth in the experimental group and 7.1% of teeth in the control group were registered to have dental erosion index value 2. Finally, the dental erosion index value 3 was found in 13.0% of teeth in the experimental group only. The highest average value of regional erosion index in the experimental group was found in the region 13-23 equalling 1.0. The same value in the control group equalled 0.6. In the experimental group the average value of dental erosion index for the upper jaw was 0.9, while this value for the lower jaw equalled 0.8. The analysis of the illness history data obtained showed that there was a statistically significant difference between the two observed groups in terms of burning pain (noncardiac in origin) around the heart area, bad breath and dentine hypersensitivity as the dominant symptom of dental erosion (p lt 0.05). Conclusion Dental erosions could be considered to be the extraesophageal manifestation of gastroesophageal reflux. .

Uvod. Gastroezofagealni refluks (GR) je često oboljenje koje značajno utiče na razvoj erozija zuba. Cilj rada. Cilj rada je bio da se utvrdi učestalost erozija zuba kod osoba sa GR i ustanove najčešći simptomi ove bolesti. Metode rada Istraživanjem su obuhvaćene dve grupe od po 30 ispitanika starosti od 18 do 80 godina. Eksperimentalnu grupu su činili ispitanici kod kojih je dijagnostikovana gastroezofagealna refluksna bolest, a kontrolnu grupu zdravi ispitanici. Na osnovu podataka iz anamneze, kod ispitanika su ustanovljeni gastroezofagealni i ekstraezofagealni simptomi. Erozije zuba su utvrđene stomatološkim pregledom korišćenjem indeksnog sistema po Iklesu (Eccles) i Xenkinsu (Jenkins). Podaci su obrađeni u programu Statgraphics Centurion. Rezultati Erozije zuba su zabeležene kod 76,7% ispitanika eksperimentalne i 53,3% ispitanika kontrolne grupe. Utvrđeno je da 49,2% zuba ispitanika eksperimentalne i 31,1% zuba ispitanika kontrolne grupe ima erozivne promene. Broj zuba s erozijama po ispitaniku eksperimentalne grupe je 15,7, a kontrolne 10. Najveću srednju vrednost indeksa erozije imali su zubi gornjeg fronta i prvi donji stalni molari. Indeks 1 utvrđen je u 12,8% zuba ispitanika eksperimentalne grupe i 24% kontrolne, indeks 2 u 23,4% zuba eksperimentalne i 7,1% zuba ispitanika kontrolne grupe, dok je indeks 3 imalo samo 13,0% zuba ispitanika eksperimentalne grupe. Najveća srednja vrednost indeksa erozije zuba ispitanika eksperimentalne grupe bila je 1,0 (u regiji 13-23), a kontrolne grupe 0,6. Srednja vrednost indeksa erozije zuba gornje vilice u eksperimentalnoj grupi bila je 0,9, a zuba donje vilice 0,8. Analiza podataka iz anamneze pokazala je da postoji statistički značajna razlika između dve posmatrane grupe ispitanika u pojavi bola i pečenja u predelu srca (nekardijalnog porekla), zadaha iz usta i preosetljivosti zuba kao dominantnog simptoma erozije zuba (p lt 0,05). Zaključak. Erozije zuba se mogu smatrati ekstraezofagealnom manifestacijom GR. .